LGBT individuals often suffer discrimination in receiving health care and as a result have a lack of trust in the medical system. Health care providers are vital in the effort to reduce health care disparities in the LGBT community.

It is crucial for patients to feel accepted and trusting of their health care provider as to prevent miscommunication and provide accurate patient histories. One report has shown that LGBT patients often search for subtle signals in the health care environment to determine acceptance[1]. Making small changes both the language used in forms and office practices, for example non-gender specific intake forms and offering unisex bathrooms, can go far in making LGBT patients feel more accepted in the health care environment. Additionally providers can participate in LGBT organizations’ provider referral programs to ease LGBT patients’ distrust before they enter the office.

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Physicians must take steps to ensure LGBT patients’ trust as well as cater to LGBT specific issues as they arise. Openness is important and it should be made clear that doctor-patient conversation is confidential. The LGBT community suffers from heightened risk factors for infection and disease as result of lifestyle, under-education, and societal marginalization. It is important that physician address these issues with sensitivity and proper training. Physicians should respect their patients’ self-identities and use patients’ preferred terminology. Providers should not make unfounded assumptions and restrict questions to those relevant to the current situation.

There is an explicit need for more comprehensive education regarding LGBT issues for healthcare providers. The process starts with medical school curricula, where LGBT training is scarce, with a median of only 5 hours of LGBT specific training across years of training[2]. There is a need and want by medical students to have a more comprehensive LGBT related education. One survey of medical students showed “a current lack of exposure to LGBT content, agreement that LGBT material is applicable to students’ work as future physicians and the relevance of including such information in the medical school curriculum”[3]. One proposal for integrating LGBT issues into medical training included integrating four additional sessions of LGBT education: an introduction to Transgender health, taking LGBT inclusive patient history, hormone therapy for Transgender patients and a LGBT-focused standardized patient encounter[4].  While this training would help provide a foundation for LGBT focused education, additional training is necessary during residency and for professionals already in the field.

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[1] Eliason MJ, Schope R. Does “Don’t ask don’t tell” apply to health care? Lesbian, gay, and bisexual people’s disclosure to health care providers. Journal of the Gay and Lesbian Medical Association. 2001;5(4):125-34.

[2] Obedin-Maliver J, et al. Lesbian, gay, bisexual, and transgender-related content in undergraduate medical education. JAMA. 2011;306(9):971-977.

[3] Gina M. Sequeira, Chayan Chakraborti, Brandy A. Panunti, (2012) Integrating Lesbian, Gay, Bisexual, and Transgender (LGBT) Content Into Undergraduate Medical School Curricula: A Qualitative Study. The Ochsner Journal: Winter 2012, Vol. 12, No. 4, pp. 379-382.

[4] Ibid Table 1