LGBTQ persons tend not to seek care as often for services, such
as pap smears and mammograms. Their reproductive organs may not serve their
gender identity and therefore are neglected in terms of medical seeking
behaviors. One meta-analysis supported the
fact that “health and utilization of
healthcare services among LGBTQ individuals are adversely affected by
marginalization; and
approximately 30% of LGBTQ adults do not seek healthcare
services or lack a regular healthcare provider compared to 10% of age-matched
heterosexuals.”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4609168/ https://www.kff.org/health-reform/fact-sheet/preventive-services-covered-by-private-health-plans/
My hope for my graduate medical training and
for the students entering medical school is that institutions will embrace
awareness of the need for climate change around LGBT health and implement a curriculum
to suit these needs. We must be the outspoken advocates for protection of
patients’ rights to care.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4609168/ https://www.kff.org/health-reform/fact-sheet/preventive-services-covered-by-private-health-plans/
Paps for Chaps
The current laws that provide pap smears and mammograms for
transgender males are being threatened by publicly announced attitudes held by
the highest seat of federal power this year.
One physician shared the frustration she experienced while
navigating transgender healthcare for her patients on the heels of these public
announcements this summer on the AAFP blog:
This problem could be avoided if legally, and in the
electronic health care records, people can be identified by their biological
reproductive organ status in compliment to their gender status. Some EHRs have
transitioned to this holistic approach but insurance companies and the
government have not yet adopted this strategy to better serve the health of its
constituents.
Medical provider and healthcare societies such as the AAFP,
AMA, APA, ACOG and many more have
supported the equality of rights for transgendered individuals which is a
promising step in the right direction.
Educating the Medical Workforce
Further efforts have been made by the Association of
American Medical Colleges (AAMC) to create a database to educate medical
providers on how to create and maintain trusted physician patient relationships
so as to appreciate the diversity of medical needs and risks within the
interplay of gender identity, biological sex and sexual orientation that
comprise individuals. Particularly
important to medical education is assessing how well providers are motivated to
acquire knowledge and retain the skills to provide competent care for LGBTQ
patients.
One resource for medical education tools in assessing Trainee
Competence in LGBT Patient Care is the
MedEdPortal.org, a peer-reviewed, open-access journal that promotes educational
scholarship and dissemination of teaching and assessment resources in the
health professions.
Learning modules created and sponsored by the Fenway
Institute for the National LBGT Health Education center can be found here for
interested students and providers.
Practice guidelines for endocrine treatment of LGBT
individuals have just been updated this year by the Endocrine Society. This
step is significant in providing structure for interdisciplinary collaboration,
evaluating patient outcomes, and further highlighting the validity and
appropriateness of medical treatments for this patient population.
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