Your Custom Text Here
When health care organizations partner with Violet, clinicians not only access education to upskill and benchmark cultural competence but also access exclusive webinars presented by thought leaders.
History & Inclusive Language for LGBTQIA+ Patients, presented by Jessica Halem, MBA and Violet educator. Enjoy the discussion and Q&A providing in-depth knowledge about inclusive communication strategies.
Want to learn more about Violet? Visit us at https://www.joinviolet.com.
As frontline workers, allied health professionals are key for creating a welcoming environment for LGBTQ+ patients and workers, which may boost health outcomes and provide greater healthcare resources.
Read the blog here: https://americanmedtech.org/Blog/Blog-Post/a-space-for-everyone.
CVS Health and Accenture are proud to present an in-depth conversation on transgender health care, alongside a toolkit (to be found at https://cvs.co/3Bsz4ji) of guidance and resources to improve the transgender patient experience.
Part of our ongoing speaker series focusing on LGBTQ+ Health Equity, the goal of this panel is to provide increased awareness and understanding of the transgender patient journey, to explore ways to improve transgender patient access to health care, and to facilitate positive experiences for transgender patients and health care providers.
This panel, moderated by Jessica Halem, explored the barriers and facilitators encountered by successful LGB-identified academic clinicians and educators. This conversation is meant to be broadly applicable and audience Q&A will follow.
Speakers:
Jessica Halem, MBA, LGBTQ Diversity, Equity, and Inclusion Expert and Consultant
Chase Anderson, MD, Child Psychiatry Fellow, UCSF
Robin Reister, MD, Internal Medicine Primary Care Program Director, Dell Medical School
René Salazar, MD, Assistant Dean for Diversity and Professor of Internal Medicine and Medical Education, Dell Medical School
Exact numbers of LGBTQ medical students and doctors are unknown. In 2018, the AMA added sexual orientation and gender identity as an option for members to include in demographic profiles the group compiles. Of the 15,000 doctors and students who have volunteered that information so far, about 4% identify as LGBTQ. That’s similar to Gallup estimates for the general U.S. population, although LGBTQ advocates believe the numbers are higher and rising as more people are willing to “out” themselves.
This past fall, Harvard’s entering class of medical students was 15% LGBTQ, a milestone that is no accident.
June is LGBTQ Pride Month, a good time to better understand the health and wellness concerns of the lesbian, gay, bisexual, transgender and queer community. A panel of experts from Harvard Medical School will share research and experiences with LGBTQ patients, answer questions about health disparities, and discuss the importance of social supports and how to foster an inclusive environment that is welcoming to all.
I believe that optimism can be taught. Or more specifically, remembered and conjured when needed. Finding ways to deal with these difficult moments requires us to engage our own personal mix of optimism, resilience, and self-efficacy. And the very act of using these personal attributes in small ways everyday can actually build up our reserves and make those necessary muscles stronger. The beauty of resiliency isn’t found in the ability to keep taking the hits, but in the bouncing back part. Every time we bounce back, we get stronger and wiser. The bounce can get faster, and the hits can sink in less deeply.
"Optimism: A Building Block for Organizational Change," Medical Care, December 2018
[Reposted from the blog Paging Dr. Rainbow]
"Hello! I have a question for the experts: Do any medical organizations have established guidelines against the usage of the term "homosexual"? I know GLAAD, The Associated Press, the NYT and many media sources and universities advise against usage of the term, but do we still use it in a medical setting? I had a lecturer today say that MSM, MSW, WSW, WSWM, etc. are incorrect and to use the terms, "heterosexual, homosexual, and bisexual" when giving a case presentation. I challenged the idea and was told they are "medical terms" and we always use the "medical terms." So, help a student out!"
-PA in training seeking better answers
Dear PA in training seeking better answers:
First off, let me say how pleased I am to hear that you have cases with LGBTQ patients in your education. It wasn’t that long ago that cases like this weren’t available, discussed, or appreciated as an important part of patient care. We have come a long way.
Language that describes the LGBTQ community has changed and will continue to change. But language is just a tool to use to describe what we observe, learn, or hear from our patients. So, everyone will have to be a bit flexible as we continue to listen better and illicit more information from patients. In fact, at the turn of the last century in the US, the “medical term” was “invert” which represented the conflation of gender and sexual orientation and then the word “homosexual” became more widely used. Both were terms used more with derision and judgement than care from the medical community. So, there’s that history.
Today, we know “nonbinary” is a widely used word to describe a gender identity or expression that some would have called “androgynous” just a few years ago. And of course, transsexual was a word we used to use as well, but now use the word transgender. I am sure there are cases and textbooks that haven’t been updated accordingly.
So, finding an authority on “medical terms” seems to be the issue with your lecturer. I can say with authority -- we do not use the word “homosexual” to describe patients anymore. It actually isn’t a word that people use to describe themselves or does a good job of describing behavior that needs to be discussed.
What is key here is appreciating two distinct differences in discussing sexual orientation – first, language that describes the SEXUAL BEHAVIOR of our patients and secondly, language that patients use to describe themselves. What we still like about MSM is that it describes sexual behavior and doesn’t assume identity. We know plenty of men have sex with other men and are married to women. We also know plenty of women describe themselves as lesbians but have had or will have sex with men.
In terms of who else is an authority on medical terms for the LGBTQ community – the NIH now uses the phrase “sexual and gender minorities” and the hospitals you will work with have electronic health records that probably already have SOGI (sexual orientation and gender identity) data collection in place and use words like “gay” and “cisgender”.
Medical terms are only authoritative if they are helpful in understanding, valuing, and supporting the patients you are being trained to care for in the future.
If this analysis doesn’t work, attached here are guidelines from Harvard Medical School here.
-Jessica Halem, MBA, LGBT Program Director, Harvard Medical School
Thank you Jessica for your awesome contribution to our blog! What an amazing conversation starter you have been!
A note to the LGBTQ and Allies of Harvard Medical School:
Today is a hard day for our community and families. Yesterday, the New York Times reported that the current federal administration was: “considering narrowly defining gender as a biological, immutable condition determined by genitalia at birth, the most drastic move yet in a governmentwide effort to roll back recognition and protections of transgender people under federal civil rights law.”
We know that the sex we are assigned at birth and our gender identity are not the same. We can’t exam a baby at birth and project the life they will live, who they will love, and how they will come to see themselves.
In every corner of the HMS system, I am inspired by the providers who are taking care of transgender, nonbinary, and gender nonconforming patients with sensitivity and respect. Many of you have announced this care with your websites, rainbow stickers, and the forms in your office. Some of you are doing this quietly with no other support, just approaching each person with openness and care knowing everyone has a rich and meaningful story to tell you.
Historian Joanne Meyerowitz, in her award-winning book: “How Sex Changed”, describes that throughout history, individuals expressed genders that were different from sex. And by the 1950s, even American doctors decided this distinction was medically sound. "They distinguished biological sex from the sense of a sexed self, which they labelled "psychological sex" and later "gender". They began identifying component parts of gender, distinguishing gender role from gender identity, and also separating gender from sexuality."
So, doctors created this distinction as a way to understand people. It wasn’t what they could see in a microscope or brain scan, but what they saw in their patients. Just like you are doing today.
Today, the Class of 2022 of HMS medical students is nearly 20% LGBTQ and many embracing a nonbinary identity. Many more on top of that percentage are here to carve out a career that cares for transgender patients. I am not afraid by the latest from this current administration because I get to support you all in your work. I know today you will approach each patient with a little more care and curiosity. You remain a vital bulwark against the hardships faced by transgender, nonbinary, and gender nonconforming patients. I’m proud to stand with you.
###
The LGBTQ community needs health care providers to open their eyes and commit to our health, well-being, and healing. We need them to be aware of our history and the reasons why so many of us don't trust that doctors and nurses will treat us with respect. We need them to refuse to go along with historic or religiously based attitudes that belie our humanity. We need them to embrace their role as a positive, powerful force in mitigating the discrimination and shame felt by patients. Seeing and healing this foundational pain is the first step to our health and wellness today.
Transgender people encounter many barriers to health care, and recommendations about where their treatment would best be offered can promote or thwart good care. This case examines the care setting from the perspective of a patient whose experiences with specialists have been negative. We argue that an ethos of harm reduction and informed consent, with a strong emphasis on continuity of care within a primary care setting, should guide questions about how to refer transgender patients to caregivers and to good care settings.