6 ways LGBT patients can get the most out of their health care
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Visiting the doctor can be a high-anxiety experience for any patient, but those who identify asLGBT are especially prone to discomfort.
Standard interactions with medical professionals often revolve around the assumption that a patient is straight, causing distress for members of the LGBT community during even the most routine checkups.
SEE ALSO: 10 meaningful ways you can celebrate LGBT Pride Month
There's also the fear of gender-based discrimination that transgender people face when visiting a health professional. Medical records can "out" trans people when name and pronoun changes aren't accounted for in bookkeeping. But even willingly coming out to a doctor exposes trans patients to the possibility of being both medically misunderstood and a victim of violence.
The anticipation of encountering an intolerant doctor is enough to make LGBT patients want to cancel all of their checkups. And a lot of them do.
While 17% of straight individuals report delays in seeking medical care, 29% of LGBT individualssay they put off their doctor visits. Yet LGBT people are more likely to need care addressing emotional health, suicide ideation, substance abuse, HIV/AIDS care and cancer treatments.
While the Affordable Care Act provided some protections for LGBT individuals seeking medical care, there are still no national laws banning discrimination on the basis of gender identity and sexual orientation. A number of states have instituted non-discrimination laws on their own, which mostly protect patients on the basis of sexual orientation, and some clinics have anti-discrimination clauses in their practice policies. But the lack of nationwide protection is still a very real issue LGBT people face.
Navigating a health care system that is not designed with your needs in mind is daunting, and educating your doctor on your identity can be frustrating. But Barbara Warren, Psy.D., the director of LGBT Programs and Policies for the Mount Sinai Health System in New York, says confronting uninformed medical professionals is necessary in our current health care climate.
“My belief is that the onus should be on the health system and not on the patient," Warren tellsMashable. "But the reality right now is that we are not quite there yet in terms of LGBT issues. Hopefully we can empower patients to say who they are and ask for what they need.”
To get the most out of your health care, and to receive the most complete care possible, read this guide to being a more empowered LGBT patient.
1. Do your research.
Don't feel compelled to go to the same health care provider your family has gone to for generations if it isn't the safest space for you. Researching your options — even if they seem insignificant — will help you pick the best provider for your needs.
“I always tell people, 'Be a shopper,'” Warren says. “Before you go there, check it out.”
Shop around for a clinic that’s sensitive and inclusive, and promotes it. If the clinic’s LGBT patient values aren’t apparent on its website, dig deeper with a preliminary phone call. A clinic you want in charge of your health will answer any and all questions you have about its policies and practice.
The best place for you may be a clinic that’s farther away than the office down the street, but it's worth the travel for competent care.
2. Know what issues may arise, and think about the best ways to address them.
If you are a member of the LGBT community, you probably have a mental list of uncomfortable moments that always arise at the doctor's office. Maybe that includes questions about sex that assume you're with someone of the opposite sex, or assumptions about your gender identity that aren't quite on-point with how you identify.
Whatever the case, instead of just brushing these moments off as inevitably uncomfortable, think of how you would address them before stepping into the doctor's office. For example, your doctor is always going to ask some form of, “Are you sexually active?” It’s standard on intake forms and some need-to-know medical information. But, if your medical provider assumes you're straight, he may not consider what your answer implies about your sexual health and potential health risks.
In that situation, it’s best to clarify what he is trying to ask. Does he want to know if you have had sex within the past six months with a person with a penis? Is he wondering if you could be pregnant? Or maybe you’ll want to just offer straightforward information about your identity by saying, “I currently have one sexual partner and she’s a woman.”
Make a list of questions you may encounter, and have a plan for addressing them.
3. No matter how you do it, bring up your identity.
While coming out is always a personal decision, it's important to weigh that personal choice with the necessity of health care tailored to your complete self. Warren believes it’s essential to be open with your identity to receive the most relevant, competent care.
“That is my personal opinion. That is my strategic opinion. That is also my social justice opinion,” Warren says.
In some cases, it might be helpful to request a preliminary chat with your doctor to address your identity. However you bring up your sexuality or gender, do so honestly and openly. If you need some support, bring someone with you who can serve as an advocate in possibly tough moments.
Coming out is the only way to receive care tailored to your specific needs as someone of a marginalized gender or sexuality — and it's also the only way to know if your health care provider will be an unwavering supporter of you as a patient.
4. Call out problematic moments.
If you are in the middle of an appointment and even the smallest microaggression occurs, call it out — if you're comfortable to do so. Feel empowered to challenge your provider's missteps. Ultimately, challenging their assumptions, language and biases will help them provide you and others with more inclusive care.
Warren says this is more than warranted, and sometimes absolutely necessary for people of marginalized genders and sexualities.
“It’s absolutely OK for you to say, ‘My preferred name is Jane, it’s also my legal name. My gender pronoun is 'she' and that’s what you need to be calling me,’” Warren says.
If your provider isn’t complying with your requests or has a harsh reaction, consider filing a formal complaint against the practitioner and the clinic. Warren recommends knowing the proper channels to file a complaint before you even step into a doctor's office.
5. Take control of your own health care.
Taking ownership of your health is the best thing you can do for your well-being. Warren recommends having a relationship with your doctor in which you are open to share your needs and questions without judgment.
“[It’s] OK to go to your provider and ask questions and make certain demands,” she says. “We’ve sort of had this hierarchical system where the doctor's the expert — and they are usually white, male, cisgender and straight — and the patient's an idiot.”
Instead of prescribing to that hierarchy, challenge it. A doctor may be an expert in medicine, but you are the expert on yourself. Use your knowledge of your identity to discern what you need from your health care. Then, advocate for those needs.
6. Practice self care.
Navigating even the most standard doctor visit with a queered sexuality or gender expression can be frustrating, difficult and draining. During the process, it’s important to keep track of your own well-being to ensure you're not only getting the best treatment possible, but also taking care of yourself.
If you're in a situation with your doctor that feels dangerous, uncomfortable or out-of-line, call off the appointment — even if it’s in the middle of a physical while you’re wearing an ill-fitting medical gown.
Always feel empowered to end a consultation if your needs are not being adequately addressed, especially if you are being disrespected. When it comes to your health, your needs should come before everything else.
