Creating an inclusive culture at your pediatric practice does more than support a diverse group of physicians, staff, and families. LGBTQ+ youths are more likely to be homeless, more at risk for bullying, relationship violence, and mental health problems, issues that can lead to lifelong health outcomes. Patients who feel safe at their pediatrician’s office can be open about their choices and health, allowing physicians to create the solid relationships that great healthcare is based on.
In this post, we’ll cover the needs of kids and teens of minority sexual orientations and gender identities and ways your practice can support their wellbeing and create a safe, inclusive environment, both for them and for all patients under your care. This post will not cover the definitions of common language associated with LGBTQ culture, such as the process of coming out or what it means to be “ace”.
If you, a parent, or a patient has questions about the definitions of LGBTQ identity or wants to know how teens can explore their identities further, there are many great resources to explore, such as Planned Parenthood, The Trevor Project, and the Centers for Disease Control.
Why is it important for pediatricians to consciously promote inclusion, provide resources for LGBTQ support, and practice gender-affirmative care? First and foremost, it is because inclusion can help promote honesty and transparency in LGBTQ youth in regards to their choices and lifestyles, which leads to better healthcare.
Secondly, pediatricians can help protect and support patients in these gender and sexual orientation minorities, who are more at risk of more social inequities and discrimination than their heterosexual peers. These inequalities can lead to a myriad of risks such as poorer mental health outcomes, substance abuse, intimate partner or domestic violence, or unsafe sexual health practices. When these issues affect young patients, the associated risks can quickly begin to jeopardize their overall health, as well as negatively affect school performance.
While some LGBTQ youth talk about their gender or sexual orientation openly and evolve their views as they grow older, the nature of “coming out” for some patients can be more sudden. Whether they have a supportive network or not, this shift in perspective can leave families struggling to cope mentally and emotionally, making conversations with a trusted pediatrician important to ensure the safety and wellbeing of patients, as well as helping families learn how to support their child’s identity at home and in school.
While creating a safe space is relatively simple, the comfort and security it offers your patients is priceless. It may also give patients the reassurance they need to be open about their health needs and lifestyles, giving pediatricians the opportunity to provide the best possible care.
You can begin by listing your practice in the GLMA Provider Directory to help families and patients find your practice. According to the American Medical Association, “The Gay and Lesbian Medical Association (GLMA) is the national leader in LGBTQ health issues, and their GLMA Provider Directory is a free-to-the-public listing of LGBTQ-friendly practices in the United States.” You can also sign up to be listed in the The Healthcare Equality Index, which measures equity and inclusion in healthcare settings.
In-take forms, questionnaires, forms, and even your EHR can be customized to record sexual orientation, relationship status, and gender identities. It helps patients and families feel accepted to find that not only that questions are asked respectfully and without judgement, but that their LGBTQ identity is validated by inclusion.
By simply stating that your practice values all patients regardless of sex, gender identity, or orientation, you’re off to a great start in creating an inclusive practice culture. What’s important to remember is that this value should extend to every part of your culture, from hiring new employees to how you word your emails.
There are many ways to be inclusive, from small gestures to larger ones. You could go as far as decorating your office for Pride Month and cultivating conversations about LGBTQ healthcare on your practice’s social media or website. You could also start as simply as hanging a sign that welcomes all patients. When hiring or promoting employees, you can frame questions such as, “How comfortable are you providing care to a patient that self-identifies as LGBTQ?” to measure how your employees’ values pair with your office culture. Even gestures such as rainbow lanyards, pins, or stickers can help signal to patients that their identity will be treated with compassion and respect.
You may also wish to guide staff through sensitivity training and study appropriate language to use. The Gay and Lesbian Medical Association has created a useful guide for physicians for these topics and many more.
In many cases, LGBTQ patients have similar healthcare needs as their classmates and peers. There are however some important points to consider to ensure patients are healthy and safe:
While each conversation, exam, and interaction with LGBTQ patients and their families will be a little different, entering into each with empathy, compassion, and an open mind is the foundation for a trusting relationship and a positive healthcare experience for every child. For more information about treating LGBTQ patients, be sure to visit the AAP’s resource page and healthychildren.org for insights on how you might approach conversations with patients and parents.
Supporting LGBT youth is just one value of many for a modern pediatric practice, and for many trans patients, it can be hard to find specific resources. Find trans-specific resources for families and your practice below to learn more -- many of these resources will also be useful to LGBTQ+ families.