Lesbian, Gay, Bisexual, and Transgender Health Disparities: Executive Summary of a Policy Position Paper From the American College of Physicians

Daniel, Hilary; Butkus, Renee

doi:10.7326/m14-2482

Cited by 216 publications

(171 citation statements)

References 20 publications

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“…3 The American College of Physicians' position on the health care of transgender persons is that all services should be covered as they would for other beneficiaries, and that coverage should not discriminate on the basis of gender identity. 6 However, health insurance policies frequently prohibit coverage for transgender people under a clause expressly prohibiting coverage for transitional care, or based on carriers' contract interpretation. 7 Transgender exclusions result in denial of coverage when subscriber gender marker and physiology are incongruent.…”

Section: Introductionmentioning

confidence: 99%

Societal Implications of Health Insurance Coverage for Medically Necessary Services in the U.S. Transgender Population: A Cost-Effectiveness Analysis

Padula

Heru²,

Campbell³

2015

J GEN INTERN MED

107

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Section: Introductionmentioning

confidence: 99%

Societal Implications of Health Insurance Coverage for Medically Necessary Services in the U.S. Transgender Population: A Cost-Effectiveness Analysis

Padula

Heru²,

Campbell³

2015

J GEN INTERN MED

107

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“…10,11 Recently, the Centers for Medicare & Medicaid Services released Meaningful Use Stage 3 guidelines that require all certified EHR systems to have the capacity to record sexual orientation data, 12 but very few health systems or hospitals report routinely collecting such data. 11 Emergency departments (EDs) are the source of nearly half of inpatient admissions in the United States and the primary point of entry for uninsured and underinsured patients.…”

mentioning

confidence: 99%

Emergency Department Query for Patient-Centered Approaches to Sexual Orientation and Gender Identity

et al. 2017

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and The Joint Commission recommend routine documentation of patients' sexual orientation in health care settings. Currently, very few health care systems collect these data since patient preferences and health care professionals' support regarding collection of data about patient sexual orientation are unknown.OBJECTIVE To identify the optimal patient-centered approach to collect sexual orientation data in the emergency department (ED) in the Emergency Department Query for Patient-Centered Approaches to Sexual Orientation and Gender Identity study. DESIGN, SETTING, AND PARTICIPANTS An exploratory, sequential, mixed-methods design was used first to evaluate qualitative interviews conducted in the Baltimore, Maryland, and Washington, DC, areas. Fifty-three patients and 26 health care professionals participated in the qualitative interviews. Interviews were followed by a national online survey, in which 1516 (potential) patients (244 lesbian, 289 gay, 179 bisexual, and 804 straight) and 429 ED health care professionals (209 physicians and 220 nurses) participated. Survey participants were recruited using random digit dialing and address-based sampling techniques. MAIN OUTCOMES AND MEASURESQualitative interviews were used to obtain the perspectives of patients and health care professionals on sexual orientation data collection, and a quantitative survey was used to gauge patients' and health care professionals' willingness to provide or obtain sexual orientation information.RESULTS Mean (SD) age of patient and clinician participants was 49 (16.4) and 51 (9.4) years, respectively. Qualitative interviews suggested that patients were less likely to refuse to provide sexual orientation than providers expected. Nationally, 154 patients (10.3%) reported that they would refuse to provide sexual orientation; however, 333 (77.8%) of all clinicians thought patients would refuse to provide sexual orientation. After adjustment for demographic characteristics, only bisexual patients had increased odds of refusing to provide sexual orientation compared with heterosexual patients (odds ratio, 2.40; 95% CI, 1.26-4.56). CONCLUSIONS AND RELEVANCEPatients and health care professionals have discordant views on routine collection of data on sexual orientation. A minority of patients would refuse to provide sexual orientation. Implementation of a standardized, patient-centered approach for routine collection of sexual orientation data is required on a national scale to help to identify and address health disparities among lesbian, gay, and bisexual populations.

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“…8 It is not surprising that despite demonstration of health disparities experienced by LGBT people across the life cycle, many LGBT people find it difficult to access quality care. 6,9 In addition, studies have shown that many LGBT students question being open about their sexual orientation or gender identity when studying to be health professionals due to concerns of bias affecting their professional futures. 10 These findings point to a need in the area of LGBT health care training for development of core competencies that students can use regardless of their eventual speciality or practice setting, 11 in addition to creating health care environments that are welcoming and affirming for LGBT patients, students and staff.…”

mentioning

confidence: 99%

Advancing health equity for lesbian, gay, bisexual and transgender (LGBT) people through sexual health education and LGBT-affirming health care environments

2017

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Abstract. Lesbian, gay, bisexual and transgender (LGBT) people face pervasive health disparities and barriers to highquality care. Adequate LGBT sexual health education for emerging health professionals is currently lacking. Clinical training programs and healthcare organisations are well poised to start addressing these disparities and affirming LGBT patients through curricula designed to cultivate core competencies in LBGT health as well as health care environments that welcome, include and protect LGBT patients, students and staff. Health education programs can emphasise mastery of basic LGBT concepts and terminology, as well as openness towards and acceptance of LGBT people. Core concepts, language and positive attitudes can be instilled alongside clinical skill in delivering inclusive sexual health care, through novel educational strategies and paradigms for clinical implementation. Caring for the health needs of LGBT patients also involves the creation of health care settings that affirm LGBT communities in a manner that is responsive to culturally specific needs, sensitivities and challenges that vary across the globe.Received 18 July 2016, accepted 9 January 2017, published online 6 February 2017Despite recent advances in the recognition of lesbian, gay, bisexual and transgender (LGBT) people, with data demonstrating a rapid increase in the acceptance of LGBT people 1,2 and attainment of equality in many sectors, 3 education on LGBT health needs for health professionals still lags greatly. 4,5 As recently as a decade ago there were no standard texts that included information about care for LGBT people, and numerous studies and reviews of health issues have documented a continued gap in health care education. [4][5][6][7] A study of LGBT topics in medical education published in 2011 showed a median of 5 h of education in both the US and Canada. 8 It is not surprising that despite demonstration of health disparities experienced by LGBT people across the life cycle, many LGBT people find it difficult to access quality care. 6,9 In addition, studies have shown that many LGBT students question being open about their sexual orientation or gender identity when studying to be health professionals due to concerns of bias affecting their professional futures. 10 These findings point to a need in the area of LGBT health care training for development of core competencies that students can use regardless of their eventual speciality or practice setting, 11 in addition to creating health care environments that are welcoming and affirming for LGBT patients, students and staff. 12,13 Participants in health care settings will only engage effectively and thrive if they can comfortably and openly express their true selves. 10,14,15 With regard to education, especially in the context of principles of adult learning, existing studies call for developing competencies that encompass critical knowledge, skills and attitudes needed to provide affirmative care to LGBT people. [4][5][6][7][8]11 These cannot be measured in hours, b...

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Lesbian, Gay, Bisexual, and Transgender Health Disparities: Executive Summary of a Policy Position Paper From the American College of Physicians

Cited by 216 publications

References 20 publications

Societal Implications of Health Insurance Coverage for Medically Necessary Services in the U.S. Transgender Population: A Cost-Effectiveness Analysis

Societal Implications of Health Insurance Coverage for Medically Necessary Services in the U.S. Transgender Population: A Cost-Effectiveness Analysis

Emergency Department Query for Patient-Centered Approaches to Sexual Orientation and Gender Identity

Advancing health equity for lesbian, gay, bisexual and transgender (LGBT) people through sexual health education and LGBT-affirming health care environments

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