Related terms every healthcare provider should know:7


Sexual orientation: An individual’s romantic or sexual attraction as relating to the opposite party’s gender or sex


Heterosexuality: Attraction between people of the opposite sex or gender Homosexuality: Attraction between members of the same sex or gender


Bisexuality and pansexuality: Attraction to more than one gender, or attraction regardless of sex or gender identity Asexuality: The lack of sexual attraction to others


Gender identity: How an individual perceives their own gender


Cisgender: A person whose gender identity corresponds to their assigned sex at birth


Transgender: A person whose gender identity or expression does not correlate with their assigned sex at birth


Genderqueer/nonbinary: When a person identifies outside of the gender binary and does not perceive their innate sense of gender as either male or female


Gender expression: How an individual outwardly expresses their innate sense of gender; this may be reflected in style of dress, speech, hair and comportment or temperament, and it may change from day to day and over time


Queer: Originally used as a derogative slur, it has been reclaimed and to broadly refer to nonheterosexual cisgender people; It’s more embraced by the younger demographics


71% of transgender patients undergoing imaging procedures experienced at least one negative imaging encounter involving physical and/or psychological trauma. As an innovative, cutting- edge specialty, we are well-suited for addressing this issue, starting with our own practices.


Creating an inclusive environment won’t happen organically. It must be crafted with intention based on the needs of each unique community we serve. It calls for a nuanced approach in our role as minimally invasive specialists engaged in direct patient care and as leaders in shaping the policies and practices of our institutions. Although this seems like a daunting topic to address, there are specific steps that physicians can take to create a welcoming practice.


26 IRQ | WINTER 2023


Step 1: Understand disparities As with any group, it’s crucial that providers understand the historic disparities, lived realities and risk factors associated with that patient population. There are multiple structural and historical factors that have impacted the healthcare of the LGBTQ+ community with demonstrable disparities in breast, cervical and colorectal screening rates. This in turn leads to later-stage diagnoses and poorer outcomes.


On average, LGBTQ+ patients come from backgrounds where adverse childhood experiences such as emotional abuse, physical abuse, bullying, homophobia and transphobia occur at much higher levels than their cis-gendered heterosexual counterparts.4


While


these experiences occur in childhood, they often lead to problems in adult life reflected in health, overall wellbeing, educational attainment and economic potential. These problems may be significantly compounded by other social determinants of health such as economics, education, healthcare access, built environment and community. Further, LGBTQ+ individuals are more likely to be underinsured and to not have a primary care provider. Biases—both institutional and interpersonal—may make them more reluctant to seek medical care at all.5


LGBTQ+ individuals and racial minorities have higher incidents of poverty than the overall population, and insecure housing also impacts this at-risk population.5,6


It’s estimated that


LGBTQ+ people constitute 20-40% of the overall homeless population, which is significantly higher than their representation in the overall population.6


Step 2: Adjust patient interactions Practitioners by their very nature want to help patients and don’t want to engage in offensive behaviors. However, ignoring the full humanity of our patients to avoid potentially uncomfortable territory isn’t the best approach. In a 2017 study, providers indicated they believed 80% of their patients would not be open to disclosing their sexual orientation, while 90% of patients in the same pool said that they would. That’s not just a narrow gap in misunderstanding; it’s a broad chasm that demands we reconsider the choices we’ve made engaging with our patients.


Pronouns The pronouns people use for themselves have expanded over the past 15 years. Though this dynamic may be especially fraught for those who are unfamiliar, using the appropriate pronouns conveys respect, while applying the incorrect pronouns can have significant consequences. Professional psychological and psychiatric organizations have demonstrated that not using inclusive language for LGBTQ+ individuals increases anxiety, depression and suicidal ideations for those affected.8


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40