New Guidelines for Healthcare Workers and Forum Aim to Improve LGBTQ Care

Confusion and misunder-standing between patient and healthcare provider have long created a barrier for members of the lesbian, gay, bisexual, transgender, and queer community in accessing proper treatment. But the needs of LGBTQ people — especially transgender people — are becoming more mainstream, and their health concerns are being taken more seriously.

In November, the Association of American Medical Colleges released guidelines for training physicians to care for LGBTQ patients. The standards are to be used along with current curricula.

Kristen Eckstrand, an MD/PhD candidate at Vanderbilt University Medical School, edited and helped author the publication in her role as chair of the AAMC Advisory Committee on Sexual Orientation, Gender Identity, and Sex Development.

“Medical education has paralleled the national stage on LGBT issues,” said Eckstrand in a press release from Vanderbilt. “As more states are eliminating discriminatory policies, passing same-sex marriage laws, and moving toward equality for all people, medical education has taken responsibility for its role in educating the next generation of physicians to provide comprehensive care for LGBT patients.”

Among the published goals are educating physicians on LGBTQ health concerns and improving institutional climate for LGBTQ students, staff, faculty, and patients.

The standards may seem relatively simple and self-evident, but too many doctors take steps for granted and could be putting patients at risk if they fail to consider them. For example, transgender men still require cervical cancer screening, and overlooking this could be detrimental to their health.

The American Nurses Association also featured news regarding healthcare for and by the LGBTQ population, by posting numerous connections on their website to the Gay and Lesbian Medical Association’s news and guidelines. GLMA’s mission is to ensure equality in healthcare for lesbian, gay, bisexual, and transgender individuals, as well as LGBTQ healthcare providers.

This past summer, the GLMA debuted a Nursing Section.

“The GLMA Nursing Section provides a strong platform to advocate for changes within the nursing profession that address the issues we face as LGBT nurses, and to secure changes to nursing education that are responsive to LGBT health needs,” said Laura Hein, PhD, RN, a GLMA board member and chair of the board’s External Affairs Committee, in their press release about the news.

Others agree that nursing students need to be more aware of sexual diversity in order to be better caregivers.

Maggie Compernolle (left) and fellow Goldfarb nursing student Adriana Vanbianchi use high-fidelity mannequins to teach proper body mechanics and positioning to members of a caregiver training program.
Maggie Compernolle (left) and fellow Goldfarb nursing student Adriana Vanbianchi use high-fidelity mannequins to teach proper body mechanics and positioning to members of a caregiver training program.

Maggie Compernolle, a recent graduate of the Goldfarb School of Nursing at Barnes-Jewish College in St. Louis, says doctors and nurses are not being intentionally ignorant.

“It’s so important for nurses to be exposed to different ideas and just to know that differences exist,” she says. “If a nurse walks into a room and the person in the hospital bed is holding the hand of someone of the same sex — if [that nurse] hasn’t been exposed to different ideas, they might just say, ‘It’s that person’s cousin, or friend’ and destroy the chance of any rapport.”

Compernolle has always been concerned with LGBTQ health needs, particularly those of transgender people. So she was surprised when she saw that some of her peers were not used to and were confused by transgender patients.

“At my first clinical experience, there was a transgender patient that we cared for. Everything went well with the care, but afterwards, listening to questions and comments from my classmates, I realized they kind of didn’t get it,” she says. “We are so used to the binary of male and female, gay and straight, that some people have a hard time understanding sexual identities.”

After attending a panel put on by the Metro Trans Umbrella Group of St. Louis during Pride Week 2013, Compernolle “started connecting the dots.”

Every transgender person on the panel mentioned the challenges they face in accessing adequate healthcare, so she organized a presentation to help educate fellow nursing students about transgender health concerns. Four transgender people from the MTUG presented their workshop “Trans 101,” and Compernolle says an array of students attended from many health disciplines, such as pharmacy and physical therapy.

“Ages [of the presenters] ranged from 20 to 60, so that the lived experience of being LGBT was shared through the lens of societal change,” says Michael Bleich, president of the Goldfarb School of Nursing. “It was a remarkable presentation, with the first half dedicated to clinical and medical issues, the second to their life stories.”

Since then, transgender health has been the topic at an Open Space presentation, with plans to hold similar presentations twice yearly. The Open Space series takes place every Thursday at Goldfarb, from 10 a.m. to 2 p.m.

Students, faculty, and staff meet “to share in perspectives, experience the arts, and conduct meetings,” says Bleich. Topics range from sex trafficking and housing to veterans’ affairs, and no classes or meetings are scheduled at this time to allow all to attend.

Compernolle stresses how receptive everyone was about the presentation she organized.

“The faculty was so open to talking about transgender issues,” she says. “I didn’t have to convince anyone that this was a good idea.”

Administrators are in favor, too. Compernolle says an elective class on human sexuality was an option at first, but students at Goldfarb could see classes on LGBTQ health as an integral part of the curriculum.

“The Curriculum Committee will be considering soon the idea of threads through the nursing curriculum,” says Jack Pennington, assistant professor at the Goldfarb School of Nursing. “The thread we will begin with is care of the LGBT patient. The thread will appear in different courses with different emphases. For example, pathophysiology might consider the hormonal transformations that occur with transgender patients, while psychiatric nursing would consider the psycho social aspects of the transgender patient.”

Compernolle, who graduated in December, is sad she won’t be around to see these changes implemented at Goldfarb. She says she hopes to work in community healthcare, aiding underserved populations.●

Rebecca Prinster is a staff writer for INSIGHT Into Diversity.