VIDEO: Prioritize acceptance, acknowledge sexual health when caring for LGBTQ+ patients
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June is Pride Month, and in this installment of our diversity, equity and inclusion video series with ASGE, Matthew B. McNeill, MD, discusses how providers can counter health disparities and help LGBTQ+ patients receive equitable care.
“There is a long history of legal and illegal discrimination against the LGBTQ+ population from families, religious institutions, governments, social programs, school systems ... that have contributed to a particular pattern of health disparities,” McNeill, a gastroenterologist at Summit Health and clinical instructor at NYU Langone Health, said. “Health disparities are preventable differences that affect the burden of disease, the burden of injury, the burden of violence, the burden of opportunities to achieve optimal health in certain populations.”
According to McNeill, some of these disparities include the fact that LGBTQ+ youth are more likely to experience homelessness and unemployment, are “two to three times more likely” to commit suicide and have higher rates of substance abuse.
McNeill also noted that lesbian women are less likely to obtain preventive care, including colonoscopies, and are more likely to be overweight or obese, which may lead to metabolic syndrome or fatty liver disease. Gay men are more likely to have higher rates of STDs and HIV, as well as eating disorders and body dysmorphia, he said, and transgender individuals are “often being banned from having access to affirming care in many of our states.”
To help this population, McNeill advised providers to:
- Know the terminology and correctly identify patients to create a welcoming environment.
- Acknowledge the role of sexual health on patients’ physical, mental and emotional well-being and consider how specific conditions, such as irritable bowel syndrome, inflammatory bowel disease, hemorrhoids and fissures, may negatively affect sexual health.
- Speak with patients about their barriers to care and meet them where they are.
- Engage in research on sexual identity, gender identity and sexual practices to become better informed and improve patient recommendations.
- Show an outward sign of acceptance and make your patients feel comfortable.
“At the end of the day, LGBTQ+ patients just want to know that they are going to be cared for in an equal way and not feel stigmatized, not feel discriminated against,” McNeill said. “If you take some of these approaches moving forward, you’re going to really help a population that has historically not felt that they’re getting the help they need and hopefully reduce some of these disparities that we have seen for generations.”
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