The eQuality Toolkit: Practical Skills for LGBTQ and DSD-Affected Patient Care

Abstract

WHAT IS THE PURPOSE OF THE eQUALITY TOOLKIT? is manual will help providers build a foundation of inclusive clinical skills to competently care for lesbian, gay, bisexual, transgender, and queer-identi ed (LGBTQ) patients and individuals born with di erences of sex development (DSD, sometimes called intersex). Although this toolkit was designed for medical students, any healthcare provider who wants to learn inclusive clinical skills can bene t from this manual. Other published resources address LGBTQ/DSD health and clinical skills comprehensively (see Appendix A). e purpose of this manual is to provide a brief primer that is accessible to all medical students with actionable steps to improve clinical care. It was speci cally written for use at the University of Louisville School of Medicine; therefore, some resources or laws may be region/city speci c. However, most of the content is applicable to any provider caring for LGBTQ/DSD patients. WHY IS THIS MANUAL NEEDED? Simply, this manual addresses gaps in healthcare provider training in caring for LGBTQ/DSD communities. ese populations experience repeated instances of stigma and discrimination related to their identities, with consequent health and healthcare disparities that knowledgeable 1 The number of people who identify as LGBTQ is growing, including 7.3% of millennials. 1 DSD is estimated to a ect 1.7% of births. 2,3 These individuals are our patients, and it is our responsibility to learn how to provide quality care for them. eQuality Toolkit how other considerations, such as insurance coverage, may in uence these decisions (see Part IV). Finally, LGBTQ/DSD health is an evolving eld, and the authors will make e orts to periodically update this manual with current information. e information in the following sections represents best practice as of the time of this writing.

Physiatry and the needs of LGBTQIA+ patients

“…The eQuality Toolkit: Practical Skills for LGBTQ and DSD‐Affected People 47 (https://ir.library.louisville.edu/medicine_ume/1/)…”

“…Curriculum about LGBTQIA+ health is increasing in undergraduate and graduate medical education 43,44 ; those already practicing can update their knowledge and skills through continuing education modules 45,46 and clinical skills guides. 47…”

“…Competency goes beyond inclusive communication, as it comprises knowledge and skills related to the health care needs of LGBTQIA+ people. Curriculum about LGBTQIA+ health is increasing in undergraduate and graduate medical education 43,44 ; those already practicing can update their knowledge and skills through continuing education modules 45,46 and clinical skills guides 47 …”

A Review of Patient Experiences and Provider Education to Improve Transgender Health Inequities in the USA

“…One elective was on LGBTQ health broadly and showed promising initial results, including medical students feeling prepared to work with LGBTQ patients and expressing satisfaction with the curriculum [70]. The curriculum used there has also been made into a publicly available toolkit by the University of Louisville School of Medicine, so that it can be used by other educators [86]. This can serve as a good example for other curriculum developers.…”

Restructuring LGBTQ Curriculum in Medical Schools

“…Other attempts of promoting LGBTQ health at the University of Louisville have included hosting a community forum on transgender healthcare and involving students in interprofessional groups to discuss cases related to LGBTQ health [13,14].…”