How Can You Help?

Healthcare Provider Guide

Intro Situation Key Issues How can you help Resources Glossary

“I think health care professionals really need to open themselves up to learning.” – m.bodiment focus group participant

It is vital that health care providers engage in learning and working towards fostering a more inclusive health care system that normalizes and validates the diverse identities and lived experiences of patients.

Here are some of examples of practices that you can do on an individual, clinical, and systems change levels:

Individual Level

Healthcare Provider Accountability

It is crucial that healthcare professionals be honest, humble, transparent, and accountable about instances of mistakes and errors with their patients:

  • While, the College of Physicians and Surgeons does not require all physicians and surgeons to know how to prescribe transition-related medical services, it has a policy about profession obligations and human rights, regarding limiting health services. If physicians are not able to prescribe these medications, either because of clinical competence or religious beliefs, are legally required to facilitate a referral to a doctor who can meet the patient’s needs. 

Increase Your Knowledge

As our health care systems continue to shift towards patient centred care, training and reading up-to-date research on population health including marginalized populations within the communities that you are serving is fundamental to suitable and culturally competent care:

Training

Healthcare professionals often make mistakes and medical errors while serving LGBTQI2S patients due to the lack of knowledge and training.  There are many organizations that specialize in training healthcare professionals as well as corporate workplaces on LGBTQI2S:

 

Books and Articles

Increasingly, there are more resources available to healthcare professionals on treating LGBTQI2S patients as well as anthologies of queer and trans patients experiences of the healthcare system.

Clinical Level

LGBTQI2S Friendly Clinic

Promoting a comfortable and inclusive clinical environment is crucial, as it promotes trust and among patients as well as equity centred health care.

Creating a welcoming and equitable space for patients:

  • Provide access to gender neutral washroom.
  • Poster LGBTQI2S signifiers such as the Pride-flag sticker or pins within the clinic.
  • Make literature and signage relevant to LGBTQI2S patients.
  • Posters and display brochures with content relevant to LGBTQI2S communities such as services, supports, and health promotion.
  • Integrate LGBTQI2S affirming language and literature on your clinic’s website.

Review your clinical practices:

Intake Forms
  • Make space for diverse relationship identities, intersex identities, queer identities, gender identities, and racial identities in a respectful manner. For example, categories to capture gender include: cis-female, cis-male, agender, trans-feminine, trans-masculine as well as a blank space to allow patients to self-identify.
  • Make space for patient preferred name in addition to their legal name as well as pronouns.
Language
  • Ensure staff adopt LGBTQI2S affirming language and provide LGBTQI2S literature.
  • Ask patients how they identify to avoid assumptions around gender identity, pronoun use, and sexual attraction (orientation).
  • Ask open ended questions to allow patients to discuss their health concerns and create space for dialogue and trust building with your patient.

“When you go into these clinics, they call you by your legal name if that is what they see. So even if you’re saying to them, ‘please don’t come out and scream this name,’  and they come out and they say it loud.” – m.bodiment focus group participant

Inclusive Screening
  • Use respectful and non-judgmental language in discussing and screening for mental health disorders, substance use, HPV, and other STIs.
  • Use a “Screen what you have” approaches with the awareness that transgender and non-binary patients may be experiencing significant anxiety and emotional distress around discussing their body parts (McNamara and NG, 2016).
    • For example, when obtaining sexual history or assessing sexually related practices ask: “What parts of your body do you use during sex?” and “What is the gender identity and sexual orientation of your partners?” or “What body parts do your partner(s) use during sex?” (McNamara and NG, 2016, pp 532).
    • In addition, these approaches can include different options in the body position of the patient, how much clothing they are wearing, and allowing them to self-identify how they would like physicians to refer to body parts such as using terms like top and bottom instead to gendered labels. Some approaches to these exams can be found at the Centre of Excellence For Transegender Health
Reproductive Health
  • With the recently passed legislation in Ontario, British Columbia, and Quebec to include LGBTQI2S parental rights and recognition, LGBTQI2S communities increasingly are considering assisted human reproduction as a method of family planning. Health care providers can support LGBTQI2S patients by using inclusive and non-judgmental language around reproduction as well as referring patients services such as in vitro fertilization (IVF), surrogacy, sperm donation, and other methods of assisted human reproduction.
  • Due to the lack of longitudinal studies on transgender patients, the World Professional Association of Transgender Health (WPATH) has advised that fertility preservation be  considered a component of transitioning and discussed with transgender patients.

Systemic Level

 Community Health
  • Learn about and contact local LGBTQI2S organizations in your community in order to increase your knowledge and ability to make suitable referral to your patients.
  • Become familiar with with local resources and services able to LGBTQI2S people and other marginalized communities.
Health Care System
  • Educate yourself on holistic and patient cared approaches to health care and continue to be current on literature about population health as well as existing health disparities within the LGBTQI2S populations.
  • Seek out professional development opportunities such as conferences, workshops, and training regarding LGBTQI2S health care and practices.
  • Become an ambassador and advocate among your peers about promoting more inclusive practices in treating LGBTQI2S patients.

 

Intro Situation Key Issues How can you help Resources Glossary