How To Be a More PRIDEful Provider

Coming out was truly the most intimidating experience of my life. Fortunately, my friends and family accepted it with grace and unconditional love and support. Unfortunately, not everyone’s support systems are as compassionate as mine.

As a future medical provider, I ask myself, how can I make sure I support my patients who are part of the Lesbian-Gay-Bisexual-Transgender-Queer/Questioning (LGBTQ) community? How can I make sure they know I offer a safe space? How can we, as a medical community and medical education institution, create a more open and welcoming environment for the LGBTQ community? Unintentionally, the answers to some of these questions were answered during my first year of clinical rotations.

While my friends and family have been overwhelmingly supportive, I have not encountered open arms to homosexuality in every circumstance. I was repulsed by the ignorance and downright homophobia portrayed by one of my preceptors during my general surgery rotation. I will never forget feeling like my blood was boiling while being subjected to his cruel, homophobic jokes during a laparoscopic cholecystectomy. I deeply desired to storm out of the operating room, but my position as first assist did not allow me to abandon him.

I have always worried about my patients viewing me differently because of my sexuality, but I had not yet considered experiencing homophobia in the workplace. This preceptor is a highly respected surgeon with more than 20 years of experience. However, his superior surgical ability and wealth of medical knowledge were discredited, in an instant, by what appeared to be open homophobia.

How many of his peers/medical students/patients had he made feel disrespected, shamed, and angered in the way I had? Some of my experiences with him made me want to scream, throw a fit, and expose his prejudice to hospital administration. However, a part of me feared his retaliation to my final evaluation and him not accepting future students. So, I took the opportunity to learn from his ignorance and never give him the satisfaction of laughing at his jokes. While he was my preceptor, I came to the realization of how I could help prevent homophobia within the workplace.

I recognize, as a future medical provider, the opportunity I have to impact the profession and my patients. Awareness of this issue will allow me to be a better advocate and to make sure that I create a safe place where my patients feel comfortable to be open. According to the LGBT Foundation, research has demonstrated that many in the LGBTQ community avoid accessing public health services for fear of homophobia. A large portion of lesbian and bisexual women report inappropriate comments and other negative experiences in health care settings, and people are often reluctant to disclose their sexual orientation to mainstream mental health care providers.

I admit that I am one of those patients. I have never informed my health care providers that I am homosexual for fear that I will be treated differently. I have never been asked what my sexual preference is; rather it is assumed that I am heterosexual. I cannot emphasize enough how painful and isolating assumptions can be for someone. If a patient is in a clinic, the vulnerable position is already present. Adding the pressure or fear of being treated differently only adds to the stress, possibly worsening the condition for which they are being seen.

According to Pediatric News, 8% of lesbian, gay, and bisexual people report that a health care provider refused to see them because of their sexual orientation and 29% of transgender people report that their health care providers refused to see them because of their gender identity or expression. It is not any wonder that LGBTQ people are more likely than heterosexuals to experience mental health problems, abuse drugs, and intentionally self-harm. It is our duty to help LGBTQ people just as we help heterosexuals. It is our oath as healthcare providers to DO NO HARM.

It is obvious that we need to be better as providers and educators. By sharing this story, I hope to help open the eyes of both current and future providers/medical educators. We have a unique and very powerful influence. We must choose wisely how we influence as that has the potential to be therapeutic or detrimental.

I recognize that not everyone has exposure to this topic and that medical education provides very little on this matter in the curriculum. Until formal training exists, I challenge you to educate yourself in order to become comfortable with the conversation. Take a moment during your studying to include education on the matter by completing the Pride in Practice Training Academy provided by the LGBT Foundation.

Taking small measures can make an enormous impact. According to the Canadian Medical Association Journal, something as small as having a poster supporting LGBTQ health services can send a message to LGBTQ patients that they are in a safe environment. It will take collaborative efforts to make medicine a safer place for all. After all, it is not just our patients; it is our colleagues, our friends, our family, and our future children. Let us stand together! I am proud to be an ally and I hope you will be too.

Here are a few of the many ways you can make an impact:

• Urge medical institutions to require more education on LGBTQ in the curriculum
• Complete the Pride in Practice Training Academy provided by the LGBTQ Foundation. It’s an easy way for anyone to increase his or her knowledge and confidence of LGBTQ including.
• Support initiatives that benefit the LGBTQ community
• Participate in the Human Rights Campaign’s Healthcare Equality Index
• Take part in local Pride events to increase visibility in the community
• Register your clinic with the Gay and Lesbian Medical Association so that you are listed in a database as an LGBTQ-friendly provider
• Implement Sexual Orientation Monitoring
• Donate to the LGBT Foundation here
• VOTE in favor of LGBTQ rights

Resources

Collier, R. Promoting Pride in Practice. CMAJ. 2012 Oct 16; 184(15): E789–E790.

Dysart-Gale, D. Social Justice and Social Determinants of Health: Lesbian, Gay, Bisexual, Transgendered, Intersexed, and Queer Youth in Canada. Journal of Child and Adolescent Psychiatric Nursing. 2010; 23:23–8

Montano, G. How medical providers can observe LGBT Pride Month. Pediatric News. 2019.

The Human Rights Campaign Healthcare Equality Index