Can these factors lead to missing a potential diagnosis or unintentionally cause someone to refrain from sharing important information? Will this unease or discomfort prompt a patient to never return for care?
Evidence-based practice! A 2017 national survey showed that LGBTQ patients experienced discrimination in healthcare settings because of their sexual orientation, and this discrimination keeps them from seeking care or may lead to trouble finding care if turned away (Mirza & Rooney, 2018). This recent study demonstrates the discrimination that still exists against the LGBTQ population and the need to educate healthcare providers to mitigate such disparity. conditions. Asking the patient about their definition of behavior, sexual activities, language, or terminology helps prevent misperceptions that endanger health. An example may be a person who do not consider themselves in terms of sexual orientation and has sex with both genders; or someone who may identify as heterosexual yet have sex with people of both genders. Or, assuming that a lesbian, or her female partner, has never had intercourse with a male or has never been pregnant is another example of this way of thinking. To obtain pertinent health-related information, it is important to ensure confidentiality and gather a complete sexual history during a nonjudgmental discussion. This sexual history form should be used with all patients in the healthcare practice. If staff members are obtaining this information, practitioners should display a privacy statement in the office and/or provide such a policy to patients. Ensuring privacy is important and should be guaranteed for everyone. It is important to understand that some patients may have different sexual practices on business trips or vacations, or that their sexual practices in general may have recently changed. Many forms used today assume heterosexual and monogamous behavior. Changing the form to include gender rather than sex, and providing the options “male,” “female,” “transgender,” or “both” to questions about recent sexual partners, recognizes that alternative relational patterns exist. This provides patients with the opportunity to provide accurate information. identity may or may not conform to birth sex. At birth Sam was identified as female according to anatomy and now identifies as male and is referring to himself as “he.” Gender transition occurs when a person begins to live their gender identity. This is different for each individual and may include changing clothing, appearance, name, pronoun, identification, and for some, may include hormone therapy and/or surgery. 2. There are multiple barriers that can affect a person’s access to healthcare. Relational or interpersonal interactions and system or institutional functions can present barriers impeding or serving as a discouragement for individuals needing or desiring healthcare. Sam purposefully left a previous healthcare provider because of insensitivity and bias from an employee who commented on his male identification. This is an example of a personal or relational barrier that created a stressful situation for Sam and resulted from the bias of another person. The experience of stigma is common among LGBTQQ people and is a cause for stress and avoidance of healthcare. Insensitivity and/or discomfort of providers and office staff and occasionally refusal of care are also in this personal/relational category. System or institutional barriers are issues like transportation, distance, access to appropriate care, insurance restrictions, and assumed heteronormativity.
No judgment The National LGBTQQIA+ Health Education Center has published suggestions for improving healthcare environments for LGBTQ patients (National LGBTQQIA+ Health Education Center, 2016). One suggestion includes posting a nondiscrimination policy, signed by the staff, in plain view of patients. A nondiscrimination policy helps ensure commitment to an environment in which all people are valued and respected and provides an opportunity for staff members to examine their own beliefs and assumptions about race, age, sex, gender, and marital relationships. Another suggestion is to provide an area to display local LGBTQ resource information. This area can include information on local counseling options, food pantries, support groups, as well as general information on a specific practice location. Using an intake form that allows a patient to provide personal information in a nonjudgmental manner will set the tone for quality patient-provider interactions. The inclusion of domestic partnership under the “relationship status” of a history form as well as options for transgender individuals, such as male-female or female-male, may help patients feel more comfortable sharing this information. Additional suggestions include providing more inclusive options for screening questions, using open-ended questions, and using the term “partner” rather than “spouse.” It is dangerous to assume how others may behave. When a provider believes a particular person, group, or community has a characteristic or action, they risk overlooking potential Case study – Part 1 Sam had been searching for a primary care provider for months. He wanted to find someone who would treat him like a person, not a freak. In the previous primary care clinic where he received care, he overheard a front desk person commenting it was a shame that such a pretty girl was going to be a male. Fortunately, that was a different place and he was now away at graduate school in a liberal arts college with a Campus Pride Index of 4.5. Someone in the resource center recommended this office and he had a few things he hoped to find once he arrived. Sam called to inquire and received a package of information electronically that already gave him some comfort. Instead of the questions Sam had normally seen, these forms had options for gender that included transgender and relationship questions that did not assume married or single but allowed for partnered. Questions 1. From the information in the case study, how does Sam identify? 2. What type of barrier to care did Sam experience in his previous primary care practice? Discussion 1. Gender identity is a personal feeling or idea that one has of themselves. One may choose to express their gender identity through the way they dress, behave, and mannerisms they use. They may also select pronouns they feel express who they are. The most identified genders are male, female, intersex, non-binary, trans, and non- conforming. Gender Case study – Part 2 Sam entered the office and scanned the waiting room/reception area. There were several areas for literature around the room with one section dedicated to sexual minorities. The receptionist greeted Sam and he handed her his previously filled out forms.
The receptionist asked for a preferred first name and pronoun. Sam felt relieved that he could tell the office his preferred pronouns were he/him/his because the legal-name-change paperwork was not finalized.
Page 113
Book Code: SWTX1524
EliteLearning.com/Social-Work
Powered by FlippingBook