{"id":19111,"date":"2021-06-14T11:10:24","date_gmt":"2021-06-14T16:10:24","guid":{"rendered":"https:\/\/thepapergown.zocdoc.com\/?p=19111"},"modified":"2023-03-19T11:49:18","modified_gmt":"2023-03-19T16:49:18","slug":"1-question-5-answers-how-are-providers-improving-care-for-lgbtq-patients","status":"publish","type":"post","link":"https:\/\/www.zocdoc.com\/blog\/advice\/1-question-5-answers-how-are-providers-improving-care-for-lgbtq-patients\/","title":{"rendered":"1 Question, 5 Answers: How Are Providers Improving Care for LGBTQ+ Patients?"},"content":{"rendered":"<h5 style=\"padding-left: 40px;\"><span style=\"color: #99ccff;\"><em><a style=\"color: #99ccff;\" href=\"https:\/\/www.zocdoc.com\/blog\/tag\/1q5as\/\"><span style=\"color: #9dafc4;\">1 Question, 5 Answers<\/span><\/a><span style=\"color: #9dafc4;\">\u00a0is a column where we ask different types of healthcare pros to weigh in on the same issue.<\/span><\/em><\/span><\/h5>\n<hr \/>\n<p><span style=\"font-weight: 400;\">In 1973, the American Psychiatric Association <\/span><a href=\"https:\/\/www.nytimes.com\/1973\/12\/16\/archives\/psychiatrists-in-a-shift-declare-homosexuality-no-mental-illness.html\"><span style=\"font-weight: 400;\">issued a historic statement<\/span><\/a><span style=\"font-weight: 400;\">: It would be removing homosexuality from the Diagnostic and Statistical Manual of Mental Health (better known as the DSM). \u201cWe will no longer insist on a label of sickness for individuals who insist they are well,\u201d the APA\u2019s trustees announced.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">While the LGBTQ+ community \u2014 an ever-expanding group that includes people of wide-ranging sexual orientations and gender identities \u2014 has made profound and lasting inroads in every sector of American in the years since, <\/span><span style=\"font-weight: 400;\">LGBTQ+ individuals face a wide array of health disparities, and many <\/span><span style=\"font-weight: 400;\"><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5444328\/\">lack access to culturally competent preventive care<\/a>.<\/span><\/p>\n<p>But as Jessica Halem, an LGBTQ+ advocate and consultant put it, \u201cHelp is on the way.\u201d Graduating classes of medical professionals include more queer and trans-identifying providers than ever, and LGBTQ+ practitioners working in the field today are revolutionizing what it means to provide inclusive, affirming healthcare for queer and trans patients. We asked five LGBTQ+ providers what their practices are doing to improve health outcomes for their queer, trans and gender-expansive patients.<\/p>\n<hr \/>\n<h3><a href=\"https:\/\/www.centraloutreach.com\/\">Dr. Tamar Carmel<\/a> (He\/Him), MD<\/h3>\n<p><em>Psychiatrist and medical director of mental health services at the Central Outreach Wellness Center<br \/>\nPittsburgh, Pennsylvania\u00a0<\/em><\/p>\n<p><span style=\"font-weight: 400;\">Central Outreach Wellness Center has a unique setup in so many ways. It started as a small LGBTQ+ primary care and HIV clinic and has expanded over time. The clinic is primarily geared towards LGBTQ+ and HIV-positive populations, and a lot of our staff members are LGBTQ+-identifying individuals and HIV-positive individuals who are out about their status. We have a very nontraditional lens for what it means to provide healthcare. There\u2019s a lot of social media outreach, texting and emailing to engage people in care. We started a PrEP-to-me program, doing virtual visits and sending patients PrEP and STI test kits in the mail. The clinic\u2019s founder, Dr. Stacy Lane, is a wonderfully fierce woman. She really thinks outside of the box, considering how to meet unmet needs in healthcare.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As an out queer and trans person in medicine, I\u2019ve experienced a lot of toxicity in the medical world. I understand how the queer community experiences trauma in medical settings. I have vowed personally to right those wrongs on a small scale, by being trauma-informed and meeting people where they\u2019re at. Part of that is being open as a queer and trans physician; self-disclosure really goes a long way in building the therapeutic relationship and putting patients at ease. My ultimate goal is to help people live fruitful and fulfilling lives by providing high quality, culturally competent and affirming care.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">One of the many cool things about our clinic is that our dress code is just black pants and a company t-shirt; they\u2019re quirky t-shirts with positive affirmations and sex-positive statements \u2014 things like, \u201cUndetectable = Untransmissible,\u201d \u201cYou Are Strong\u201d and \u201cAll Black Lives Matter.\u201d That keeps the space positive and the air light. I don\u2019t wear a doctor\u2019s coat! I have always scorned the doctor\u2019s coat. I hate the power differential it creates. I try to break that down as much as possible.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Being the sort of super-progressive, radical, breaking-down-boxes-in-healthcare clinic that we are, HIV is not stigmatized at all. A lot people on our staff are open about their HIV status and help our patients process when they learn they are positive. I think that brings a humanizing perspective, to connect with someone else, and recognize that it\u2019s not something to be ashamed of. It really is helpful to talk to another individual who is living their truth and happens to be HIV-positive. It helps us reframe it as a chronic medical condition like anything else, and helps patients understand that even with HIV, you can still have the life that you want for yourself.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The thing that gives me hope is how much I see other physicians reaching out to us to figure out how to be queer and trans-affirming. Every profession has people who don\u2019t want to keep up with the times \u2013 but I would say the vast majority are capable of change.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">I hope there will be more and more out queer and trans physicians, and that we can continue to change what it looks like to be a physician in America.<\/span><\/p>\n<hr class=\"squiggle\" \/>\n<h3>Dr. Barbara E. Warren (She\/Her), PsyD, CPXP<\/h3>\n<p><em><a href=\"https:\/\/www.mountsinai.org\/about\/lgbt-health\/staff#:~:text=Warren%2C%20PsyD%2C%20LMHC-,Barbara%20E.,care%20across%20the%20Health%20System.\">Senior director<\/a> for LGBT programs and policies in the Mount Sinai Health System Office for Diversity and Inclusion, and assistant professor at the Icahn School of Medicine at Mount Sinai<br \/>\nNew York City<\/em><\/p>\n<p><span style=\"font-weight: 400;\">We have a fairly large DEI (diversity, equity &amp; inclusion) program at Mount Sinai &#8230;\u00a0<\/span><span style=\"font-weight: 400;\">our commitment is both patient and employee-facing. We have more and more employees, providers, students and post-grad trainees coming into the system who identify as LGBTQ+. We are dedicated cultivating a safe, inclusive and supportive environment. We\u2019re not just emphasizing providing resources to clinicians \u2014 which is still so important \u2014 but all the employees who make our hospitals run, everyone from security guards to radiology techs. Often, there\u2019s not as much attention paid to the tools and resources they need to create an environment where patients of all backgrounds can receive the best care and be treated with dignity and respect.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">I also recently became a <a href=\"https:\/\/pxinstitute.org\/?\">certified patient experience professional<\/a> (CPXP) which complements my role in LGBTQ+ diversity, equity and inclusion. CPXP is an emerging field of practice that focuses on improving all aspects of the patient experience in healthcare. Mount Sinai has a significant commitment to addressing structural and environmental barriers within our system, with an emphasis on anti-racism, and I serve as part of a systemwide team to offer training and support to mitigate unconscious bias at the intersections of the diverse identities and lived experiences of our patients and staff.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Central to our approach is ensuring that every Mount Sinai door that an LGBTQ+ patient walks through is welcoming and clinically and culturally competent. Everybody working in our system needs the tools and resources to treat all our patients with respect for their intersecting identities and lived experiences. That\u2019s a tall order, and it is a work in progress. But there\u2019s a real and full institutional commitment to LGBTQ+ inclusion in all of our work.<\/span><\/p>\n<hr \/>\n<h3>Dr. Jonathan Mathias Lassiter (He\/Him), PhD<\/h3>\n<p><em>Clinical Psychologist, assistant professor at Rowan University, f<\/em><em>ounder of Lassiter Health Initiatives<\/em><em><br \/>\nGlassboro, New Jersey<br \/>\n<\/em><\/p>\n<p><span style=\"font-weight: 400;\">My specialty is multiculturalism and intersectionality. I&#8217;ve focused on drawing attention to the ways in which people have complex identities and understanding how those complex identities influence their health.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There is always an LGBTQ+ lens to the work that I do with my patients, not necessarily in the discrete categories we define in \u00adwestern society, but because of my particular position as a Black cisgender, same-gender-loving male, and the ways I\u2019ve had to navigate racism, homophobia and class discrimination. All of that comes with me in my role as a therapist. So when I\u2019m working with LGBTQ+ clients, I\u2019m not interested so much in categories of mental health or mental illness, I am much more interested in how they make meaning of life, how they live their lives in ways that go against those predetermined labels. I\u2019m bringing in queer theory and mixing this with Afrocentric psychology theory, which places an emphasis on liberation.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As a faculty member in the psychology department at Rowan University, all the courses I teach deal with multiculturalism and human diversity, and have a social justice orientation. I am very intentional in making my classes and research lab not just tolerant but welcoming and affirming for LGBTQ+ students. For one, I am myself. I model what it looks like to be a scientist who is part of the LGTBQ+ community openly and proudly. Representation matters. I don\u2019t shy away from that, I integrate it. That means we\u2019re reading LGBTQ+ scholars in my classroom: we\u2019re critiquing their work, we\u2019re using their theories to inform the research we do. We\u2019re reading LGBTQ+ scholars of color, and those who have different mental health and physical health statuses. If you\u2019re working with me, you\u2019re learning queer and Afrocentric theories, you\u2019re learning intersectionality theories.\u00a0\u00a0<\/span><\/p>\n<hr \/>\n<h3>Whitney D. Davidson (She\/Her), FNP<\/h3>\n<p><em>Clinician at <a href=\"https:\/\/folxhealth.com\/\">FOLX Health<\/a>, a digital healthcare services provider for the LGBTQ+ Community<br \/>\n<span style=\"color: #000000;\">New York City<\/span><br \/>\n<\/em><\/p>\n<p><span style=\"font-weight: 400;\">The traditional medical community often takes a very heteronormative, cisgender-centered approach to medicine, and this can prevent patients from receiving appropriate wellness care, comprehensive sexual healthcare and the option of hormone therapy. Queer and trans patients can also face being misgendered or \u201cshamed\u201d for living their lives, and it can result in them disengaging from the medical system (as we sometimes call it, the \u201ccis-tem\u201d), because of those experiences. This can often lead to missed diagnoses and poor health outcomes.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">I think the diversity of the people who work for FOLX Health is a huge factor in ensuring that we are walking the walk and not just talking the talk. My fellow clinicians are a beautifully diverse group of people, in terms of race and identity, that have been working to provide adequate LGBTQ+ healthcare for years. We are committed to ensuring that the gaps in care that have plagued the community are filled and our members can feel like they are able to live the lives they were always meant to live.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">FOLX Health aims to create a space that offers a non-judgmental place for members to receive the care that the traditional medical community has not afforded them. A lot of this is based on the fact that we are members of the community, know what things can be missed and want to ensure it no longer happens. We are a digital healthcare service provider, offering personalized medical plans for LGBTQ+ patients. We provide customized plans for hormone replacement therapy (HRT) including at-home lab work kits, expert one-on-one telehealth visits with trans and queer-centric clinicians and even letters for document name change and surgery. In the future, we\u2019ll be expanding to include STI testing and treatment, PrEP (Pre-exposure prophylaxis, a medication that protects against contracting HIV), and treatment for skin and hair loss issues that can be a side effect of hormone therapy.<\/span><\/p>\n<hr class=\"squiggle\" \/>\n<h3><a href=\"https:\/\/www.dallasducar.com\/\">Dallas Ducar<\/a> (She\/Her), MSN, APRN<\/h3>\n<p><em>CEO of Transhealth Northampton, faculty member at the University of Virginia Schools of Medicine &amp; Nursing, Columbia University, Northeastern University and the MGH Institute for Health Professions<br \/>\nNorthampton, Massachusetts<\/em><\/p>\n<p><span style=\"font-weight: 400;\">What interests me right now is the question of, &#8220;How do we create new healthcare systems that honor identity and the whole person?&#8221; I think the trans and gender-diverse community has a lot to teach America in terms of how to provide care. A lot of the core tenets of gender-affirming care are holistic and individual. Clinicians must follow patients&#8217; leads, instead of assuming what they want. Throughout our history as a community, trans and gender-diverse people have looked to each other for healing and affirmation. I believe that <\/span><a href=\"https:\/\/www.transhealth.org\/\"><span style=\"font-weight: 400;\">Transhealth Northampton<\/span><\/a><span style=\"font-weight: 400;\"> really honors that. We do that through research, expert care and fierce advocacy, to secure a health and affirming future for us all.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">We\u2019re looking at a larger systems approach; we\u2019re really trying to serve the needs of the estimated 20,000 trans and gender-diverse folks in our area. We know people need primary care, psychotherapy, sexual and reproductive care; all of this really falls under the umbrella of gender-affirming healthcare, along with many other things. For me, one of the most empowering things in my own transition was when my grandmother bought me my first dress. That wasn\u2019t a clinical care intervention! But that was a part of this support that we know is so vitally important for trans and gender-diverse folks and their families. So we are actively expanding what care looks like and who decides that. We are envisioning a space where we don&#8217;t just provide clinical care, but makeup tutorials, weight-lifting classes, tax preparation and more. This is really about expanding the scope of care.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Transhealth is independent and comprehensive in our care. One-hundred percent of our budget is dedicated to caring for the trans and gender-diverse community. We strive to build a team that is, in part, made up of trans and gender-diverse folks, because we want to make sure we\u2019re representative of the community we serve.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There are so many myths out there. Many <a href=\"https:\/\/www.businessinsider.com\/arkansas-becomes-first-state-to-ban-healthcare-for-trans-youth-2021-3\">medical bans<\/a> around the country claim that gender-affirming care is experimental, or not evidence-based, or claim that they are protecting youth. These are all false assumptions. This is rigorously studied medical care. There are dramatic positive benefits for youth who have gender-affirming care. We\u2019re trying to improve access, but we\u2019re also working to follow the evidence and be intentional, and to give parents the opportunity to connect with their children. The simple truth is that gender-affirming care affords each human the freedom to be who they are.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Trans people have always been here, and we will continue to be here: this is nothing new. We are trying to make visible what has been invisible in a safe way, and to emphasize that visibility in the care we provide. We are working to create new systems that welcome all voices to the table.\u00a0\u00a0<\/span><\/p>\n<hr \/>\n<p><i><span style=\"font-weight: 400;\">Responses have been condensed and lightly edited.<\/span><\/i><\/p>\n<hr \/>\n<h1 class=\"p1\" style=\"text-align: center;\"><span class=\"s1\">Ready to book a doctor&#8217;s appointment? Visit <a href=\"https:\/\/www.zocdoc.com\/\"><span class=\"s2\">Zocdoc.<\/span><\/a><\/span><\/h1>\n","protected":false},"excerpt":{"rendered":"<p>5 LGBTQ+ healthcare experts sound off.<\/p>\n","protected":false},"author":67,"featured_media":18256,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[228],"tags":[6,207,56],"class_list":["post-19111","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-advice","tag-1q5as","tag-lgbtq","tag-primary-care","reviewer-dr-nassim-assefi","specialist_by_city-dermatologists"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>1 Question, 5 Answers: How Are Providers Improving Care for LGBTQ+ Patients? - Advice<\/title>\n<meta name=\"description\" content=\"5 LGBTQ+ healthcare experts sound off.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.zocdoc.com\/blog\/advice\/1-question-5-answers-how-are-providers-improving-care-for-lgbtq-patients\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"1 Question, 5 Answers: How Are Providers Improving Care for LGBTQ+ Patients? 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