The Challenge of Invisibility in Health Care for LGBT People

Despite advances in protections for lesbian, gay, bisexual, and transgender (LGBT) people—or, as some refer to this population, sexual and gender minorities—that have occurred over the last several decades, many barriers to good health and high-quality health care remain. According to authorities such as the Institute of Medicine and The Joint Commission, collecting sexual orientation and gender identity (SO/GI) data in health care settings is essential to providing high-quality, patient-centered care to LGBT individuals, as well as an important part of efforts to better understand and address LGBT population health disparities.

Because most clinical records systems do not support the collection of structured SO/GI data, however, LGBT people are often invisible in care settings. This invisibility masks disparities and impedes the provision of important health care services for LGBT individuals, such as appropriate preventive screenings; assessments of risk for HIV and other sexually transmitted infections; and effective interventions for mental and behavioral health concerns, particularly those that may be related to experiences of anti-LGBT stigma and discrimination. Moreover, like all patients, LGBT people have many concerns related to aspects of everyday life such as relationships, family planning, and issues of aging that occur in different stages of the life cycle. Providing patients with opportunities to share information about their sexual orientation and gender identity in a welcoming environment facilitates important conversations with clinicians who are in a position to significantly promote these patients’ optimal health and wellbeing.

It is important that clinical staff be trained in how to provide culturally competent and affirming care to LGBT patients, and how to ask about sexual orientation and gender identity in an efficient, effective, and respectful manner as part of that process. The National LGBT Health Education Center offers online trainings and technical assistance to help health centers and hospitals provide culturally competent, affirming, and nondiscriminatory care.

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