{"id":4703,"date":"2018-01-12T00:00:00","date_gmt":"2018-01-12T00:00:00","guid":{"rendered":"https:\/\/prd-www.mccdn.io\/vitals\/?p=4703"},"modified":"2025-02-03T18:55:06","modified_gmt":"2025-02-03T18:55:06","slug":"improving-health-care-lgbtq-community","status":"publish","type":"post","link":"https:\/\/updates-www.mccdn.io\/vitals\/improving-health-care-lgbtq-community\/","title":{"rendered":"Q&amp;A: Improving health care for the LGBTQ+ community","gt_translate_keys":[{"key":"rendered","format":"text"}]},"content":{"rendered":"<p>We talked to <a href=\"https:\/\/updates-www.mccdn.io\/doctors\/joseph-angel\/\">Joseph Angel, MD<\/a>, about the challenges faced by the LGBTQ+ community and what health care providers can do to create a more welcoming and accepting environment for this marginalized group. Dr. Angel is a MultiCare family medicine physician who focuses on women\u2019s health and LGBTQ+ health, as well as serving all marginalized communities.<\/p>\n<p><strong>Q: What are the biggest health concerns for the LGBTQ+ community?<\/strong><\/p>\n<p><strong>Dr. Angel:<\/strong> A lot of people clump this group together as if there\u2019s one singular issue faced by everyone in the community, but it\u2019s a huge and varied population. The answer really is that each one of these groups is extremely different and each are affected by different health concerns.<\/p>\n<p>For example, lesbian women in general are less likely to be pregnant or be on birth control, and studies show increased gynecological cancers because of that.<\/p>\n<p>For the transgender and gender queer community, who face a lot more discrimination than others, there are huge health disparities \u2014 but unfortunately there\u2019s not a lot of research. What we do know, from the 2011 National Transgender Discrimination Survey of 6,450 transgender individuals, is that:<\/p>\n<ul>\n<li>55 percent\u00a0of respondents had lost a job due to discrimination<\/li>\n<li>51 percent\u00a0were bullied or harassed in school<\/li>\n<li>61 percent\u00a0were victims of physical assault<\/li>\n<li>64 percent\u00a0were victims of sexual assault<\/li>\n<li>33 percent\u00a0delayed or didn\u2019t access preventive care due to fear of discrimination<\/li>\n<li>41 percent\u00a0had attempted suicide<\/li>\n<li>26 percent\u00a0used drugs or alcohol to cope with discrimination<\/li>\n<li>48 percent\u00a0postponed or avoided medical care when sick or injured due to fear of discrimination<\/li>\n<\/ul>\n<p>Many of these disparities are faced by anyone who is part of a marginalized community, so you do see several of these issues cropping up for lesbian, gay and bisexual individuals, as well as people of color and other groups that face discrimination.<\/p>\n<p>It\u2019s important to make a distinction here. LGBTQ+ people don\u2019t have mental health problems because they\u2019re LGBTQ+. There\u2019s nothing intrinsic about being LGBTQ+ that leads to mental health problems, substance abuse, and so on. Daily stress caused by stigma and discrimination can lead to these negative mental and physical health outcomes. People develop these problems after being subjected to the stress that comes with being part of a marginalized group.<\/p>\n<p><strong>Q: What are the biggest barriers to the LGBTQ+ community receiving and accessing health care?<\/strong><\/p>\n<p><strong>Dr. Angel:<\/strong> Discrimination is a big one, and it exists for everyone in this community. It\u2019s daunting. You walk into a clinic and maybe you don\u2019t look like the sex stated in your medical record. The front desk is confused, asks for your ID or other proof that you are who you say you are. You\u2019re already put off by the whole situation and feel unwelcome. Then you see a provider who doesn\u2019t have any experience treating LGBTQ+ individuals who maybe makes assumptions based on you being part of the LGBTQ+ community \u2014 perhaps jumping to conclusions about sexual promiscuity.<\/p>\n<p>Being asked the wrong questions, or inappropriate questions, is another struggle. Independent of what group you\u2019re a part of, everyone wants to be treated with dignity and respect. No one wants to be asked unnecessary questions that make them feel uncomfortable \u2014 especially when seeing their health care provider. Providers should only ask medically appropriate questions, rather than questions out of curiosity, upholding the same standards with the LGBTQ+ community that they do for all other patients. The burden should be on the provider to use inclusive and neutral language, not on the patient to explain what\u2019s appropriate. For example, asking \u201cWhat personal pronouns do you prefer?\u201d instead of \u201cAre you a girl or a boy?\u201d and \u201cWhat do you call your partner?\u201d instead of \u201cDo you have a wife\/husband or boy\/girlfriend?\u201d<\/p>\n<p><strong>Q: How can health care providers better care for LGBTQ+ patients?<\/strong><\/p>\n<p><strong>Dr. Angel:<\/strong> The goal should be the same as with every other patient: quality and compassionate care. A lot of it is common sense. It\u2019s more welcoming for LGBTQ+ patients if you familiarize yourself with commonly used terms and different identities within the community.<\/p>\n<p>With transgender patients, use preferred name and pronouns. Listen to patients and how they describe their own identities, recognizing the importance of affirming their gender identity, because sometimes that supersedes other health concerns. If someone feels uncomfortable in their own skin, they\u2019re not going to care if their diabetes is uncontrolled. Making them feel comfortable will help make them care about other health issues.<\/p>\n<p>Many people in the LGBTQ+ community have had negative experiences with the health care system, and can be defensive because of those experiences \u2014 until they feel comfortable.<\/p>\n<p><strong>Q: How did you come to specialize in LGBTQ+ care yourself?<\/strong><\/p>\n<p><strong>Dr. Angel:\u00a0<\/strong>I\u2019m a gay Latino from a working class background, so I have firsthand experience of having to navigate a complex and uninviting medical system. I came out 20 years ago as a teenager and things were a little bit different then. The idea that my doctor could be LGBTQ+ was not even fathomed. So when I became a physician, specifically a family medicine provider, I wanted to focus on underserved populations.<\/p>\n<p>My goal and philosophy is that all individuals, independent of their race, socioeconomic status, gender identity, religion, etc. should be able to receive high-quality and compassionate care in a welcoming environment. It\u2019s not a novel idea but unfortunately it\u2019s one that still needs to be emphasized.<\/p>\n<p><strong>Q: What do you hope for the future of LGBTQ+ care?<\/strong><\/p>\n<p><strong>Dr. Angel:\u00a0<\/strong>It\u2019s unfortunate that I have to say I hope the future is that people within the LGBTQ+ community have access to nonjudgmental, quality and compassionate care. Right now we\u2019re not really there yet.<\/p>\n<p>Obviously I want to improve health outcomes, such as decreasing rates of substance abuse, HIV, tobacco use, violence, sexual assault, mental health concerns, cancers and so on. However, access to a non-biased and accepting medical system is essential before we can achieve some of these beneficial outcomes.<\/p>\n<h2>Health equity at MultiCare<\/h2>\n<p>MultiCare is working to improve health equity \u2014 the ability for everyone to have access to quality health care and live a healthy life, regardless of factors such as sexual orientation, gender identity, religion, socioeconomic status and race.<\/p>\n<p>As part of that work, MultiCare has been working with the Rainbow Center to provide LGBTQ+ competency training for all staff. We also recently signed the American Hospital Association&#8217;s #123 for Equity Pledge to Act Campaign to accelerate progress toward eliminating health disparities, increasing quality of care and advancing diversity and inclusion in health care.<\/p>\n","protected":false,"gt_translate_keys":[{"key":"rendered","format":"html"}]},"excerpt":{"rendered":"<p>We talked to Joseph Angel, MD, about challenges faced by the LGBTQ community when it comes to health care.<\/p>\n","protected":false,"gt_translate_keys":[{"key":"rendered","format":"html"}]},"author":123,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[15,155,79],"tags":[],"class_list":["post-4703","post","type-post","status-publish","format-standard","hentry","category-community","category-health-equity","category-profiles-stories"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.6 (Yoast SEO v27.6) - 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