Try to use gender- neutral language when appropriate. Promoting breast or cervical cancer screening sites may be accepted more broadly if branded under Gynecologic or Breast Cancer Treatment Center rather than “Women’s Cancer Center.”


throughout the year or during Pride Month in June.


Finally, try to use gender-neutral language when appropriate. Promoting breast or cervical cancer screening sites may be accepted more broadly if branded under Gynecologic or Breast Cancer Treatment Center rather than “Women’s Cancer Center.”


Step 5: Consider your physical environment Through design, the built physical environment of a healthcare space is another opportunity to ensure patients feel welcomed. For instance, consider displaying the Patients’ Bill of Rights11 and using LGBTQ+ imagery in brochures and institutional art.


When possible, gender-neutral bathrooms can reduce stress for everyone. Best practices for signage offer a variety of ways to demonstrate sensitivity in this universal human matter.


Step 6: Seek outside resources If your organization is starting to reach out to the LGBTQ+ community, don’t go it alone or with a well- intended but inexperienced internal group. Get input from those with deep expertise in this domain. There are several high-quality resources developed by institutions that specialize in LGBTQ+ healthcare, such as The Fenway Institute.12


Founded


in Boston’s Back Bay neighborhood in 1971, The Fenway Institute started as a one-day-a-week drop-in center staffed by medical students and has evolved to become a worldwide leader in evidence-based care for LGBTQ+


28 IRQ | WINTER 2023


patients. In 2009, they opened a 10-story, 100,000-square foot facility— at the time, the largest building ever constructed by an organization with a specific mission to serve the LGBTQ+ community. Their National LGBTQIA+ Health Education Center facilitates education for healthcare organizations and providers to advance health equity, eliminate disparities, optimize access and improve healthcare quality for all sexual and gender minorities.


The National LGBTQ Cancer Network13 is a nonprofit organization that aims to improve the lives of LGBTQ+ patients living with cancer. Their website provides an immense wealth of information including a resource library and provider database, and they offer an online cancer peer support group three times a week. They provide education to the LGBTQ+ community regarding cancer risks as well as the importance of screening and early detection. Further, they provide training to healthcare providers and institutions so they may deliver more culturally competent care in a safe and welcoming environment.


They also offer a powerful, free CME course, “Welcoming Spaces: Treating Your LGBTQ+ Patient,” that offers education regarding LGBTQ+ healthcare disparities and how practitioners and organizations can act to dismantle their effects.


Local LGBTQ+ organizations can also help you customize efforts to meet the specific needs and concerns of the community you serve, as they vary by locality. Also consider forming a community advisory board regarding local LGBTQ+ health needs.


4 components of a welcoming practice


• Respectful patient interactions • Accessible environment


• Policies, processes and systems that consider unique patient needs


• LGBTQ+-friendly public image


Conclusion As IRs, collaboration is our superpower. Be open to proactively reaching out to healthcare practices and community entities who specialize in serving LGBTQ+ populations. Be a player in developing pathways to care for populations who may not easily have access to advanced medical specialties.


References


1. Jones J. LGBT identification in U.S. ticks up to 7.1%. Gallup, Feb. 17, 2022. news.gallup.com/ poll/389792/lgbt-identification-ticks-up.aspx.


2. aamc.org/data-reports/students-residents/ report/graduation-questionnaire-gq.


3. New report reveals rampant discrimination against transgender people by health providers, high HIV rates and widespread lack of access to necessary care. National LGBTQ Alliance. thetaskforce.org/new-report-reveals-rampant- discrimination-against-transgender-people- by-health-providers-high-hiv-rates-and- widespread-lack-of-access-to-necessary-care-2.


4. Hafeez H, Zeshan M, Tahir MA, Jahan N, Naveed S. Healthcare disparities among lesbian, gay, bisexual, and transgender youth: a literature review. Cureus. 2017 Apr 20;9(4):e1184. doi: 10.7759/cureus.1184. PMID: 28638747; PMCID: PMC5478215.


5. Carroll L. LGBT adults less likely to have jobs, health insurance. Reuters Health. July 26, 2018. reuters.com/article/us-health-lgbt-employment- insurance/lgbt-adults-in-u-s-less-likely-to-have- jobs-health-insurance-idUSKBN1KG36V.


6. Morris A. The Forsaken: A Rising Number of Homeless Gay Teens Are Being Cast Out by Religious Families. Rolling Stone. Sept. 3, 2014. rollingstone.com/culture/culture-news/ the-forsaken-a-rising-number-of-homeless- gay-teens-are-being-cast-out-by-religious- families-46746/.


7. Glossary of terms. Human Rights Campaign. hrc. org/resources/glossary-of-terms.


8. Russell ST, Pollitt AM, Li G, Grossman AH. Chosen name use is linked to reduced depressive symptoms, suicidal ideation, and suicidal behavior among transgender youth. J Adolesc Health. 2018 Oct;63(4):503–505. doi: 10.1016/j.jadohealth.2018.02.003. Epub 2018 Mar 30. PMID: 29609917; PMCID: PMC6165713.


9. Cabrera M, Cheevers C. Intake form best practices for LGBTQ patients. One Colorado. one-colorado.org/wp-content/ uploads/2019/06/Intake-Questions-Best- Practices.pdf.


10. Patient forms. Callen-Lorde. callen-lorde.org/ patient-forms.


11. Patient bill of rights. Dept. of Health and Human Services, National Institutes of Health. clinicalcenter.nih.gov/participate/patientinfo/ legal/bill_of_rights.html.


12. The Fenway Institute. fenwayhealth.org/ the-fenway-institute.


13. National LGBT Cancer Network. cancer- network.org.


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