Establishing Effective Health Care Partnerships with Sexual and Gender Minority Patients: Recommendations for Obstetrician Gynecologists

Abstract

The evidence that sexual and gender minority patients experience high rates of inappropriate treatment, disrespect, discrimination, and harassment in health care settings is clear and strong.1-7 Even when sexual and gender minority patients do not experience outright mistreatment or disrespect, they describe interacting with health care teams who are under-educated and unprepared to provide culturally relevant care or address many of the health care issues and challenges they face. 1,2,7-12 And when sexual and gender minority patients anticipate or experience culturally incompetent or disrespectful care, they are less likely to disclose these parts of their identities to health care team members, which can result in inadequate communication, lack of preventive services, inaccurate diagnosis, inappropriate treatment, and poor health outcomes. 11,13Examples of sexual and gender minority patients' negative health care experiences include, but are not limited to, registration systems and forms that do not allow patients to specify same-sex partners, a transgender identity, or a preferred name that is different than the legal name; assumptions that parents of pediatric patients are opposite-sex and hold heterosexual identities; electronic health records that do not prompt providers that transgender patients may require preventive screenings not associated with their gender identity (e.g., male patients may require cervical or breast cancer screening); providers assuming that patients who identify as lesbian do not require screening for sexually transmitted infections or cervical cancer; patient education materials and images in clinics that depict only heterosexual families and gender conforming individuals; restroom designations that require identification with either the male or female binary gender; staff and providers deliberately or Keywords ► sexual orientation ► gender identity ► prejudice ► patient-provider interactions ► culturally competent care AbstractSexual and gender minority patients have historically experienced high rates of inappropriate and low-quality care, disrespect, and discrimination in health care settings, as well as significant health disparities. Obstetricians and gynecologists can take action on multiple fronts if they wish to improve the quality of care for their sexual and gender minority patients. Examples include improving their relationships with sexual and gender minority patients and family members by purposefully reflecting upon individual and team biases, engendering empathy for sexual and gender minority patients, and creating effective working health care partnerships with them. They can also take steps to improve their cultural competency by improving their knowledge base about sexual orientation and gender identity, using welcoming language and creating health care environments that signal to sexual and gender minority patients that they are welcomed and understood. This article documents multiple suggestions and resources that health care teams can use to improve the health ...

Contraceptive Beliefs, Decision Making and Care Experiences Among Transmasculine Young Adults: A Qualitative Analysis

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“…These patient-, provider-and system-level interventions may facilitate the delivery of high-quality, individualized contraceptive care to transmasculine young adults and address the specific and unique contraceptive concerns and needs of this marginalized and underserved population. 9,25,[36][37][38][39]…”

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