The lesbian, gay, bisexual, and transgender (LGBT) communities now make up nearly 4% of the adult population in the U.S. (Gallup 2015). As healthcare providers, it is our duty to provide culturally competent care to patients with diverse values, beliefs and behaviors, and to tailor delivery to meet patients’ social and cultural needs (National Center for Cultural Competence). Gender identity and sexual orientation – just like race, ethnicity and religion – affect the way our patients perceive their health and utilize healthcare services.
For far too long, the LGBT populations have experienced discrimination and inequalities in health care. The American College of Physicians notes the following disparities affecting the LGBT population: less likely to be insured, higher cancer rates, higher risk of HIV, increased likelihood of having a mental health disorder, and higher rates of tobacco, alcohol and other drug use. These findings are based upon limited data available, as information on gender identity and sexual orientation has traditionally not been captured on government documents (e.g. Census) and medical forms (Institute of Medicine).
Dental students typically receive very little education and training in the specific needs of and how to properly care for LGBT individuals. According to a study by the American Dental Hygienists’ Association, “increasing the knowledge and demystifying sexual minority issues can enhance the confidence and attitudes of healthcare workers when treating LGBT individuals.” The Association of American Medical Colleges now recommends that “medical school curricula ensure that students master the knowledge, skills, and attitudes necessary to provide care for LGBT patients.” The Commission on Dental Accreditation (CODA) certainly values diversity in educational settings and in the patient populations we serve, but does not yet include gender identity and sexual orientation in the facets of diversity and culture to consider.
So, if you’d like to take it upon yourself to become better informed and prepared to provide care to LGBT individuals, here are a few ideas:
- Self assess – Reflect on your own cultural beliefs and personal values. How may they be interfering with your ability to provide the best evidence-based care for your patients?
- Medications – Some of your patients may be using pharmacological agents that are difficult for them to discuss or divulge, such as hormone replacement therapy. Do your best to create an open and welcoming environment so your patients feel comfortable sharing this important information that could impact their bone health and dental needs.
- Sensitive and inclusive language – Be sure to use sensitive and inclusive language when speaking with patients. For instance, don’t assume your patient’s significant other is of the opposite gender. If you don’t feel comfortable asking your patient for this clarification, use neutral terms such as “partner.” If you want to go above and beyond, talk to clinical affairs and administration about the wording on intake forms. Are there any options for patients to select for gender other than male and female?
- Learn from the community around you – Does your school have an LGBT organization? (See below for a partial list.) If so, attend a meeting! Become more aware of the specific concerns of colleagues and patients in your area.
- Declare yourself an Ally! – Allies are those who “strive to make the culture of a campus or workplace more aware and accepting of gay, lesbian, bisexual and transgender individuals” (Human Rights Campaign). Challenge yourself to help improve the environment and the care for LGBT individuals.
Still want to learn and do more? Here are a few resources for students and health professionals:
- Consider joining the ADEA Gay-Straight Alliance Section
- Attend the LGBT Health Workforce Conference or a regional meeting
- Check out the Gay & Lesbian Medical Association (GLMA), Health Professionals Advancing LGBT Equality
- Access healthcare ally materials from Straight for Equality
- Campus Pride and LGBTQ On Campus for Students – online resources to help create a safe and supportive campus
- Expand your knowledge to other aspects of diversity at the National Center for Cultural Competence
Dental School LGBTA (Lesbian, Gay, Bisexual, Transgender, Ally) Organizations:
- LGBTQ & Allies at Harvard Medical School and Harvard School of Dental Medicine
- Michigan School of Dentistry Alliance for Inclusion
- Penn School of Dental Medicine (SDM) LGBTQ Alliance
- Rutgers Dental Association for Equality
- Tufts School of Dental Medicine LGBTA
- Gay/Straight Dental Alliance at UCSF School of Dentistry
If your school has an LGBT organization that is not listed here, please comment below!
~Chelsea F. Rajagopalan, Rutgers ’17, associate, Council on Professional Issues