How to deliver culturally competent healthcare to LGBTQIA+ patients continues to evolve within the healthcare industry. Disparities that minorities and the LGBTQIA+ community experience in healthcare have a direct correlation to health risks and higher rates of psychiatric disorders, substance abuse, and suicide. It is crucial that nurses treat all patients with dignity and respect.
These are some things nurses can do to increase their sensitivity:
- Expand LGBTQIA+ knowledge
- Understand definitions and terminology
- Never guess gender identity
- Create a welcoming environment
- Show respect
Expand your LGBTQIA+ knowledge
System-wide awareness and inclusive care remain top priorities for healthcare providers. Providing a welcoming environment requires a commitment from every worker in a healthcare setting. Nurses can start by making a personal commitment to improve their awareness of the LGBTQIA+ community and adjust the delivery of care to ensure equitable patient outcomes.
Healthcare professionals should not wait for employers to take the lead with equity in healthcare services. Nurses can seek out information to help them better understand the LGBTQIA+ community. Some continuing education courses focus on subjects like sexual orientation, gender identity, and how to be inclusive within the healthcare setting. Another resource is the National LGBT Center for Health Education. Part of the Fenway Institute, the center provides educational programs, consultations with experts, and other valuable resources.
Understand definitions and terminology
The National LGBT Center for Health Education provides a guide that breaks down definitions and terms used by the LGBTQIA+ community. Some of the terms that nurses can find in the handbook include:
- Gender identity: A person’s internal sense of being a male, female, both, neither, or another gender. Some identify with a gender that is different from the one they were assigned at birth.
- LGBTQIA+: An acronym that stands for Lesbian, Gay, Bisexual, Transgender, Questioning/Queer, Intersex, and Asexual. The plus symbol at the end was added to signify the evolving nature of the acronym to cover any new subsects of the community.
- Lesbian: A sexual orientation that describes women who are emotionally and sexually attracted to other women.
- Gay: A sexual orientation that describes men and women who are emotionally and sexually attracted to the same sex.
- Bisexual: A sexual orientation that describes a person who is emotionally and sexually attracted to people of all genders.
- Transgender: Those whose gender identity and/or gender expression differs from what is typically associated with the sex they were assigned at birth.
Best Life defines ‘QIA+’ as:
- Questioning/Queer: Non-heterosexual people who are still “questioning” their place within the queer community. Questioning and queer do not necessarily mean the same thing.
- Intersex: People who are born with reproductive or sexual anatomy that doesn’t fit the typical definitions of male and female.
- Asexual: People who are defined as those who do not feel a sexual attraction to others. This does not mean that they can’t be romantically attracted to others.
- 2s: This is a new designation that means ‘Two-Spirited’ which is a term used by Indeginous people to describe their sexuality or gender.
Never guess gender identity
It is never a good idea to try to guess someone’s gender identity based on their name or the way they present physically. Avoid using gender-specific pronouns when meeting a patient for the first time. Gender-neutral terms or complete avoidance of gender greetings is recommended. For instance, instead of saying, “Hi sir, I’m here to take your vitals before the doctor comes in,” try saying, “Hello, I’m going to take your vitals before the doctor sees you.” Nurses can politely ask patients for their preferred pronouns, especially if it is a patient who will be in their care for a few days or longer.
Ideally, healthcare communities should use a system that allows patients to provide their preferred names, gender identities, and pronouns. Some already do this, while others have not caught up to current best practices regarding gender identity inclusion.
Create a welcoming environment
Asking open-ended questions is an effective strategy for helping LGBTQIA+ patients feel comfortable enough to share information with their nurses. An example could be, “Is there anything else I can do to help you get the most out of your visit?” For some, that will be enough prompting to help patients be open about their gender identity and preferred pronouns. If patients do share, be sure to thank them for their trust and openness. A great way to do that is by saying something like, “Thank you for sharing that with me. It will help me provide you with better care.”
Never overwhelm patients with questions that have nothing to do with their visit. Even if a patient shares their preferred gender identity and pronouns, that is never an invitation to ask them personal questions about their lifestyle. It is not their job to educate nursing professionals. Asking intrusive questions can make the patient uncomfortable.
LGBTQIA+ patients take risks when they confide in medical professionals. Ensuring they have a positive experience is paramount to providing quality healthcare. Nurses, like all healthcare practitioners, take an oath to maintain and elevate the standards of their profession. Nurses must put aside any personal beliefs or feelings they have and provide the absolute best care to all their patients. Compassion and respect are hallmarks of the nursing profession. The quality of the interaction nurses have with LBGTQIA+ patients can make a difference in both their health and lives.
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