Meeting the Patient Care, Education, and Research Missions: Academic Medical Centers Must Comprehensively Address Sexual and Gender Minority Health

Abstract

More than 4.5% of the U.S. population identifies as a sexual and/ or gender minority (SGM) person (see Box 1 for definition). 1,2 These individuals live in every county, face unique health disparities, and have both similar and unique health care needs when compared with heterosexual and cisgender (i.e., those whose gender identity aligns with their sex assigned at birth) people. While sociopolitical advances have improved rights, SGM people continue to face a discriminatory health care system that does not consistently provide competent, comprehensive care. 3 Despite calls for advancing research, 4,5 there remains limited research funding, mentorship, and institutional support addressing SGM health. While some community health centers address the needs of the local SGM populations, academic medical centers, 6 including undergraduate and graduate medical education programs, are uniquely suited to systematically tackle disparities and improve care for SGM people. It is time that academic medical centers fully recognize and act to address the health and well-being of these underserved and often misunderstood populations by:• Ensuring comprehensive and equitable care for SGM populations that addresses their unique health needs and eliminates health and health care disparities;

Intersectionality and cancer survivorship: Sexual orientation and racial/ethnic differences in physical and mental health outcomes among female and male cancer survivors

“…The development of such interventions will require health care professionals, including oncology providers, to be trained to meet the needs of sexual and gender minority patients 28,29 and to acknowledge the past and present racism of the health care system 30,31 . As our study notes, data collection that better reflects multiple intersecting social positions must be prioritized and standardized across various data sources, including the Surveillance, Epidemiology, and End Results program 29,32 . Ultimately, creating a more equitable cancer care continuum that accounts for the unique experiences of multiply marginalized communities requires advances in training, data collection, and political will to prioritize health equity across multiple intersecting axes of social inequality.…”

“…Furthermore, highlighting cancer survivorship disparities allows for the development of interventions that take into account the unique experiences of individuals across multiple intersecting social positions. The development of such interventions will require health care professionals, including oncology providers, to be trained to meet the needs of sexual and gender minority patients 28,29 and to acknowledge the past and present racism of the health care system 30,31 . As our study notes, data collection that better reflects multiple intersecting social positions must be prioritized and standardized across various data sources, including the Surveillance, Epidemiology, and End Results program 29,32 .…”

Transgender men's preferences when choosing obstetricians and gynecologists

“…Transgender issues are either not included or have not been updated in medical studies [ 19 , 40 ]. There is a dearth of education on the issues that concern transgender people’s health, and even more so with regard to issues of gynecology and reproduction [ 41 , 42 ]. Medical providers, such as obstetricians/gynecologists, acquire their knowledge from several limited resources (World Professional Association for Transgender Health-Standards of Care and Diagnostic and Statistical Manual of Mental Disorders), and are usually not aware of the unique physical and mental needs of their transgender patients [ 28 , 40 , 43 , 44 ].…”

Building a Multidisciplinary Academic Surgical Gender-affirmation Program: Lessons Learned

“…Creating clinical databases, collecting prospective data regarding surgical and patient-reported outcomes, and analyzing surgical recovery pathways and surgical innovation are essential. 35 Based on evidence-based medicine and the authors’ experience, this article will focus on the different aspects of how to build a state-of-the-art transgender practice.…”

“…It is important to build and maintain prospective electronic databases; a designated research coordinator and/or personnel with focus and interest in these areas will help develop a database research program. 35 In the last several years, websites and technological platforms with specific interest on patient outcomes and satisfaction have been driving further patient referrals, forum discussions, and group reputation. 28 …”