LGBTQIA Cultural Competency Medical Education - Healthcare Guild

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Mental and Medical Healthcare Code of Ethics


Healthcare Guild Codes of Ethics Resources


The Gay and Lesbian Medical Association (GLMA) (A Division of the American Medical Association)


GLMA's mission is to ensure equality in healthcare for lesbian, gay, bisexual and transgender (LGBT) individuals and healthcare providers.  The GLMA has a list of providers nationwide, and also provides top 10 topics that you should discuss when you visit your healthcare provider....


10 things Lesbians Should Discuss with Their Healthcare Provider

10 Things Gay Men Should Discuss with their Healthcare Provider

10 Things Bisexuals Should Discuss with their Healthcare Provider

10 Things Transgender Persons Should Discuss with their Healthcare Provider



GLMA Guidelines for Care of Lesbian, Gay, Bisexual, and Transgender Patients.  Studies show that lesbian, gay, bisexual, transgender and (LGBT) populations, in addition to having the same basic health needs as the general population, experience health disparities and barriers related to sexual orientation* and/or gender identity or expression. Many avoid or delay care or receive inappropriate or inferior care because of perceived or real homophobia, biphobia, transphobia, and discrimination by health care providers and institutions.

Homophobia in medical practice is a reality. A 1998 survey of nursing students showed that 8–12% “despised” lesbian, gay, and bisexual (LGB) people, 5–12% found them “disgusting,” and 40–43% thought LGB people should keep their sexuality private. Health care providers can take positive steps to promote the health of their LGBT patients by examining their practices, offices, policies and staff training for ways to improve access to quality health care for LGBT people.





American Medical Association (AMA) Gay, Lesbian, Bisexual, Transgender (GLBT) Advisory Committee


The AMA Advisory Committee on Gay, Lesbian, Bisexual and Transgender issues provides the following resources to assist you in your professional career as an GLBT physician and/or in your medical practice caring for GLBT patients...

Create an LGBT-friendly practice
See if your practice is listed in the GLMA Provider Directory, find recommended standards of practice with LGBT patients and view more resources geared towards making your practice LGBT-friendly.

Know how to communicate with LGBT patients
View a free set of training modules from the Fenway Institute, a tutuorial video on taking a proper sexual health history and more tools to improving communication between you and your LGBT patients.

Understand important LGBT health issues
View reports, articles and AMA policy on LGBT health.

Take steps to spread awareness of LGBT health issues
Find resources that can help you make others aware of current LGBT health issues, including a complete Grand Rounds presentation.

Meet the major organizations in LGBT health
Find out more about the major organizations involved with LGBT health issues.


On-Line Video.  Meeting the Healthcare Needs of Lesbian, Gay, Bisexual and Transgender Populations: An End to Invisibility.  Presented byJennifer Potter, MD   Dr. Jennifer Potter of the Harvard Medical School spoke on the subject of health care issues facing the LGBT community at the U of L Department of Medicine's Grand Rounds on April 8, 2010.



Patient Sexual Health History: What you need to know to help (online video, American Medical Association).  The AMA has recently developed a video to educate physicians on best practices when taking a sexual history. Many healthcare providers know and understand the importance of taking a proper sexual history. Often times, it is the sexual history that reveals additional important facets about the patients, such as their sexual orientation or gender identity. The video, Patient Sexual Health History: What You Need to Know to Help, offers recommendations and considerations when treating LGBT patients.


AMA Virtual Mentor - Journal of Ethics - Pertaining to Sexuality


AMA News for LGBT Physicians


American Medical Association NonDiscrimination Policy:  Our physicians and staff support the American Medical Association nondiscrimination policy, in that: This office appreciates the

diversity of human beings and does not discriminate based on race, age, religion, ability,

marital status, sexual orientation, sex or gender identity....Download Placard


Podcast: “Expanding into the Gay and Lesbian Market: What Savvy Medical Practices Know”. From the Journal of Medical Practice Management comes an informative, half-hour long discussion with Ellen Kahn, Director of the Human Rights Campaign Foundation's Family Project. The interview is lively and contains concrete examples of how to customize your practice to become more GLBT-friendly.


AMA Bibliography & Resources for Clinicians on LGBT Health Topics.   Clinicians who are competent in GLBT care can better meet their patients' often complex healthcare needs. Below is a compilation of some of the top resources and literature on GLBT healthcare issues.

- General Clinician LGBT Health Resources

- General LGBT Patient Health Resources

- GLBT Demographics in the United States

- Treating Transgender Patients

- GLBT Youth and Adolescents

- Treating Older LGB Patients

- Disparities and Gaps in GLBT Care/Research

- Mental Health

- STDs, HIV and AIDS in the GLBT Population

- Substance Abuse

- Coming Out/Clinician Disclosure

- Same-sex Partnership/Marriage

- GLBT Health Policy Resources

- GLBT Parenting



Patient Sexual Health History & Risk Reduction Counseling


CDC - A Guide to Taking a Sexual History


Mountain Plains (HRSA) - A Quick Reference Guide - STD/HIV Risk Reduction Patient Counseling




The National Coalition for Lesbian, Gay, Bisexual, Transgender (LGBT) Health


The Coalition is committed to improving the health and well-being of lesbian, gay, bisexual, and transgender individuals through federal advocacy that is focused on research, policy, education, and training. The LGBT community includes individuals of every sexual orientation, gender, gender identity, race,
ethnicity, and age; regardless of disability, income, education, and geography. Our members are dedicated to effecting change by uniting this rich diversity at the national level.


National Coalition for LGBT Health - Guiding Principles for LGBT Inclusion in Healthcare


National Coalition for LGBT Health - Report on the USA Universal Periodic Review on Sexual Rights (Nov 2010)


National Coalition for LGBT Health - LGBT People of Color


National LGBT Cancer Network - LGBT Cultural Competence Training

The National LGBT Cancer Network's mission is to improve the lives of LGBT people with cancer and those at risk. We educate the LGBT community, train healthcare providers and advocate for LGBT inclusion in national cancer organizations, research and the media.


National LGBT Cancer Project - Out With Cancer

The National LGBT Cancer Project – Out With Cancer is our country’s first and leading Lesbian, Gay, Bisexual and Transgender cancer survivor support and advocacy nonprofit organization. Out With Cancer is committed to improving the health of LGBT cancer survivors with peer to peer support, patient navigation, education and advocacy.



NATIONAL COALITION FOR LGBT HEALTH - RESOURCES:


Affordable Care Act page


Changing the Game: What Health Care Reform Means for LGBT Americans (Center for American Progress)


The Affordable Care Act and LGBT Americans from www.healthcare.org


The Affordable Care Act and the LGBT Community: An LGBT-focused Analysis


LGBT Priorities in Healthcare Reform Implementation 


Guiding Principles for Healthcare Reform


Pre-existing Condition Plans


The Affordable Care Act at Six Months 


The Affordable Care Act: New Benefits and the LGBT Community 



American Psychological Association Recommendations to Healthcare Providers:  Avoiding Heterosexist Bias in Language, and Addressing Sexual or Gender Microaggressions




Goals for Reducing Heterosexist Bias in Language


  1. 1.Reducing heterosexual bias and increasing visibility of lesbians, gay men, and bisexual persons. Lesbians, gay men, and bisexual men and women often feel ignored by the general media, which take the heterosexual orientation of their readers for granted. Unless an author is referring specifically to heterosexual people, writing should be free of heterosexual bias. Ways to increase the visibility of lesbians, gay men, and bisexual persons include the following:

    a.  Using examples of lesbians, gay men, and bisexual persons when referring to activities (e.g., parenting, athletic ability) that are erroneously associated only with heterosexual people by many readers.

    b.  Referring to lesbians, gay men, and bisexual persons in situations other than sexual relationships. Historically, the term homosexuality has connoted sexual activity rather than a general way of relating and living.

    c.  Omitting discussion of marital status unless legal marital relationships are the subject of the writing. Marital status per se is not a good indicator of cohabitation (married couples may be separated, unmarried couples may live together), sexual activity, or sexual orientation (a person who is married may be in a gay or lesbian relationship with a partner). Furthermore, describing people as either married or single renders lesbians, gay men, and bisexual persons as well as heterosexual people in cohabiting relationships invisible.

    d.  Referring to sexual and intimate emotional partners with both male and female terms (e.g., "the adolescent males were asked about the age at which they first had a male or female sexual partner").

    e.  Using sexual terminology that is relevant to lesbians and gay men as well as bisexual and heterosexual people (e.g., "when did you first engage in sexual activity" rather than "when did you first have sexual intercourse").

    f.  Avoiding the assumption that pregnancy may result from sexual activity (e.g., "it is recommended that women attending the clinic who currently are engaging in sexual activity with men be given oral contraceptives," instead of "it is recommended that women who attend the clinic be given oral contraceptives").

  2. 2.Clarity of expression and avoidance of inaccurate stereotypes about lesbians, gay men, and bisexual persons. Stigmatizing or pathologizing language regarding gay men, lesbians, and bisexual persons should be avoided (e.g., "sexual deviate", "sexual invert"). Authors should take care that examples do not further stigmatize lesbians, gay men, or bisexual persons. An example such as "Psychologists need training in working with special populations such as lesbians, drug abusers, and alcoholics" is stigmatizing in that it lists a status designation (lesbians) with designations of people being treated.

  3. 3.Comparisons of lesbians or gay men with parallel groups. When comparing a group of gay men or lesbians to others, parallel terms have not always been used. For example, contrasting lesbians with "the general public" or "normal women" portrays lesbians as marginal to society. More appropriate comparison groups might be "heterosexual women," "heterosexual men and women," or "gay men and heterosexual women and men.'

Full article at:  American Psychological Association:  http://www.apa.org/pi/lgbt/resources/language.aspx


Sexual Orientation or Gender Identity Microaggression Themes


Subtle and covert forms of heterosexism within the therapy environment could potentially come across in the form of microaggressions. Microaggressions are communications of prejudice and discrimination expressed through seemingly meaningless and unharmful tactics. They may be delivered in the form of snubs, dismissive looks, gestures, and tones (Constantine, 2007; Constantine & Sue, 2007; Sue, Capodilupo, et al., 2007). The intention of a microaggression is to deliver a hidden denigrating, hostile, or negative message about a person or a group (Sue, Capodilupo, et al., 2007).


Theme 1: Assumption that sexual orientation is the cause of all presenting issues


Theme 2: Avoidance and minimizing of sexual orientation


Theme 3: Attempts to over-identify with LGBQ clients


Theme 4: Making stereotypical assumptions about LGBQ clients


Theme 5: Expressions of heteronormative bias


Theme 6: Assumption that LGBQ individuals need psychotherapeutic treatment


Theme 7: Warnings about the dangers of identifying as LGBQ


The power of sexual orientation microaggressions rest in their ability to stealthily debilitate the therapeutic environment for the purpose of continued indoctrination of systemic oppression. Correctly recognizing and labeling the confusion, resentment, and silence sexual orientation microaggressions leave in their wake is not an easy task for clients or therapists. However, acknowledgement of the existence of sexual orientation microaggressions and taking the risk to challenge microaggressions can set a therapeutic tone to foster enhanced conversations regarding power, privilege, and sexuality, likely improving the quality of the therapeutic relationship. As multiculturalism and qualitative research methodologies are designated as the fourth and fifth forces of psychology, psychology and counseling are primed to develop and use clinical interventions and research methodologies that disarm the power of sexual orientation microaggressions and truly encourage the growth and prosperity of LGBQ clients.


Excerpt From: Shelton, K. & Delgado-Romero, E.  (2011).  Sexual Orientation Microaggressions: The Experience of Lesbian, Gay, Bisexual, and Queer Clients in Psychotherapy.  The Journal of Counseling Psychology, 58(2), 210–221. 



Fenway Health Institute for LGBT Populations


The mission of Fenway Health is to enhance the wellbeing of the lesbian, gay, bisexual and transgender community and all people in our neighborhoods and beyond through access to the highest quality health care, education, research and advocacy.


The Fenway Institute, part of Fenway Health, is one of the national leaders in GLBT health awareness and outreach. Take a look at the more comprehensive Sample New Patient Intake Form that they recommend for use with GLBT patients and see how it compares to what your practice currently uses.


Fenway Institute on-line training modules for LGBT Health

The Fenway Institute has created a free set of learning modules designed to introduce healthcare professionals to the LGBT population. Each module has corresponding literature, role playing scenarios, and handouts. Start with Module 1, which, “offers an introduction to LGBT populations and their healthcare needs. Topics include: terminology related to LGBT populations; LGBT population demographics; approaches to culturally appropriate care for LGBT populations, and; ways to create a safe and welcoming environment for LGBT patients.”


Fenway Health Resources for Working with Bisexual Identities


Fenway Institute - Talking About Safer Sex with Your Patients


Fenway Health Resources for Working with Bisexual Identities


Fenway - Safer Sex for Bisexuals and Their Partners


Fenway - Safer Sex Brochure



On-Line Video Presentation.  Meeting the Health Care Needs of Lesbian, Gay, Bisexual, and Transgender (LGBT) People: The End to LGBT Invisibility.  Presented by Harvey J Makadon, MD, Clinical Professor of Medicine, Harvard Medical School.  Sponsored by the Fenway Institute and The American Medical Association




On-Line Video Presentation.  The Origins of Diversity of Sexual Orientation and Gender Identity and How Discriminations Impact Health.  Findings from the Literature and how orientation is sexual orientation development is currently conceptualized.






Network for LGBT Health Equity - Making Life Easier Newsletter (Fenway)








American Academy of Pediatrics - Family Rejection as a Predictor of Negative Health Outcomes in White and Latino Lesbian, Gay, and Bisexual Young Adults


Higher rates of family rejection were significantly associated with poorer health outcomes. On the basis of odds ratios, lesbian, gay, and bisexual young adults who reported higher levels of family rejection during adolescence were 8.4 times more likely to report having attempted suicide, 5.9 times more likely to report high levels of depression, 3.4 times more likely to use illegal drugs, and 3.4 times more likely to report having engaged in unprotected sexual intercourse compared with peers from families that reported no or low levels of family rejection. Latino men reported the highest number of negative family reactions to their sexual orientation in adolescence.... Providers who serve this population should assess and help educate families about the impact of rejecting behaviors. Counseling families, providing anticipatory guidance, and referring families for counseling and support can help make a critical difference in helping decrease risk and increasing well-being for lesbian, gay, and bisexual youth.


Recommendations for Practice

Pediatric providers can help decrease family rejection and increase support for LGB young people in several ways:


1. Ask LGB adolescents about family reactions to their sexual orientation and gender expression and refer to LGB community support programs and for supportive counseling as needed.


2. Identify LGB support programs in the community and online resources to educate parents about how to help their LGB children. Parents need access to positive parental role models to help decrease rejection and increase family support for their LGB children.


3. Advise parents that negative reactions to their adolescent’s LGB identity may negatively influence their child’s health and mental health.


4. Recommend that parents and caregivers modify highly rejecting behaviors that have the most negative influence on health concerns, such as suicidality.


5. Expand anticipatory guidance to include information on the need for support and the link between family rejection and negative health problems in LGB young people.


* Ryan, C., Huebner, D., Diaz, R., Sanchez, J.  (2009). Family Rejection as a Predictor of Negative Health Outcomes in White and Latino Lesbian, Gay, and Bisexual Young Adults.  Pediatrics, 123, 346-352. DOI: 10.1542/peds.2007-3524




American Academy of Family Physicians - The Proactive Sexual Health History & Care for Women


Family physicians must proactively address the sexual health of their patients. Effective sexual health care should address wellness considerations in addition to infections, contraception, and sexual dysfunction. However, physicians consistently underestimate the prevalence of sexual concerns in their patients. By allocating time to discuss sexual health during office visits, high-risk sexual behaviors that can cause sexually transmitted diseases, unintended pregnancies, and unhealthy sexual decisions may be reduced. Developing a routine way to elicit the patient's sexual history that avoids judgmental attitudes and asks the patient for permission to discuss sexual function will make it easier to gather the necessary information. Successful integration of sexual health care into family practice can decrease morbidity and mortality, and enhance well-being and longevity in the patient.

The American Academy of Family Physicians (AAFP) supports civil marriage for same-gender couples to contribute to overall health and longevity, improved family stability, and to benefit children of gay, lesbian, bisexual, transgender (GLBT) families. (2011 COD) (2012 COD) 


For the most part, lesbians and bisexual women face the same health issues as heterosexual women, but they often have difficulty accessing appropriate care. Physicians can improve care for lesbians and bisexual women by acknowledging the potential barriers to care (e.g., hesitancy of physicians to inquire about sexual orientation and of patients to disclose their sexual behavior) and working to create a therapeutic physician-patient relationship. Taking an inclusive and nonjudgmental history and being aware of the range of health-related behaviors and medicolegal issues pertinent to these patients enables physicians to perform relevant screening tests and make appropriate referrals.


Updated Recommendations from the World Professional Association for Transgender Health Standards of Care [Editorials] (01/15/2013)


Transgender Care Resources for Family Physicians [Editorials] (09/15/2006)


Primary Care for Lesbians and Bisexual Women (07/15/2006)


Health Care Screening for Men Who Have Sex with Men (05/01/2004)


Transgender Health Resources From AAFP

Clinical Guidelines

Vancouver Coastal Health Transgender Care Program Guidelines for Transgender Care --Comprehensive care guidelines developed for primary care providers in British Columbia by the Transgender Health Project with local and international clinicians expert in transgender care and transgender community members. These are consistent with the Harry Benjamin Standards of Care, but are more detailed. Includes a guideline for adolescent health.


Tom Waddell Health Center Protocols for the Hormonal Reassignment of Gender (22-page PDF file; About PDFs) --Clinical guidelines for hormone therapy developed using harm reduction principles by a transgender-focused clinic in San Francisco, California. The authors of the document welcome questions and comments about their protocols.


Endocrine Society Clinical Practice Guideline--Recommendations for treatment, including comprehensive descriptions of the evidence that is available and assessments of the quality of the evidence. Includes a discussion of the recommendations for the treatment of adolescents.


Medical care for gender variant young people: Dealing with the practical problems (9-page PDF file; About PDFs) --Comprehensive discussion of the evaluation and treatment of gender variant children and young adults developed for the UK with experts from England and the United States. Includes a section on family responses to gender variance.


Medical Therapy and Health Maintenance for Transgender Men: A Guide For Health Care Providers by R. Nick Gorton MD, Jamie Buth MD, and Dean Spade Esq --Textbook focusing on the care of transgender men, including detailed descriptions of medications and procedures available at the time of publication (2005), background information, and clinical recommendations. Available in PDF, Open Office, and Microsoft Word formats.


World Professional Association for Transgender Health (WPATH) Standards of Care --The Standards of Care (SOC) are intended to provide "flexible directions for the treatment of persons with gender identity disorder" and many of the available clinical guidelines are based on the SOC. The SOC do not provide detailed clinical guidelines, but provide an overview of when particular therapies may be appropriate.


UCSF Center of Excellence for Transgender Care Guidelines and Best Practices --In addition to the clinical guidelines listed above, UCSF identifies specific resources on best practices for HIV/AIDS related prevention and care in transgender individuals.


Discussion Groups

WPATH Transmedicine Discussion Listserve (Members Only)--Many members of WPATH use this transgender medicine-specific listerve, and are willing to answer questions.


American Academy of Family Physicians LGBT Listserve (Members Only)--Though this listserve is not specific to transgender care, many members have experience with transgender primary care and are willing to answer questions.


International Journal of Transgenderism--This scholarly journal is a quarterly WPATH publication and addresses many aspects of transgender care. The first 7 volumes are available free of charge at the link above, though more recent articles require a subscription (included with WPATH membership).


UCSF Center of Excellence for Transgender Health: National and International Organizations--The organizations listed here address a wide range of concerns and although contacting them with specific clinical questions may not be appropriate, the list includes links to individuals and organizations providing trans-competency trainings and engaging in transgender advocacy.


Facts and Patient Education

Vancouver Coastal Health Patient Education Materials (Search "transgender")--Free printable PDF booklets and handouts on transgender advocacy, overall fitness for transgender individuals, getting trans-competent care, and transition services (i.e., changing speech, hormones, surgery, etc). Includes a booklet for trans and questioning youth.


UCSF Center of Excellence for Transgender Care: Community and Patient Education--Includes links to first-person accounts by transgender individuals, as well as a range of free PDF materials addressing important sexual health topics.


Fenway Health Glossary of Gender and Transgender Terms (16-page PDF file; About PDFs)--Includes definitions to a wide range of terms used by transgender individuals and those that care for them. The authors note the importance of using the language clients and patients use to describe themselves.


Transgender Law Center Healthcare Resources--Includes a guide to clinic organizing and advocacy and fact sheets addressing common legal and insurance issues facing transgender patients.




American Academy of Physician Assistants - LGBT PA Caucus


The LBGT PA Caucus, an AAPA constituent organization, is dedicated to LGBT health equity and has been proudly serving the PA profession for more than 30 years.  The LBGT PA Caucus provides education, advocacy, and professional networking. Efforts we believe are essential to Healthcare Equality for LGBT patients, and achieving our full potentials as LGBT people.  All PAs and PA students will achieve their full potential; and health outcomes will be independent of social determinants, not limited by age; sex; kinship networks; racial, ethnic, gender or sexual orientation identity groups; religious affiliations; social classes; geographic regions; occupation; (dis)ability; and HIV or marital status.


The American Academy of Physician Assistants is the national professional society for physician assistants. It represents a profession of more than 86,500 certified PAs across all medical and surgical specialties in all 50 states, the District of Columbia, the majority of the U.S. territories and within the uniformed services.  The AAPA is committed to identifying and eliminating health disparities. AAPA's Health Disparities Work Group leads the organizational effort in conjunction with AAPA leadership. Read more in the AAPA’s Health Disparities position paper






Bisexual Resource Center (BRC)


Bisexuals experience high rates of being ignored, discriminated against, demonized, or rendered invisible by both the heterosexual world and the lesbian and gay communities.  The Bisexual Resource Center envisions a world where love is celebrated, regardless of sexual orientation or gender expression. Because bisexuals today are still misunderstood, marginalized and discriminated against, the BRC is committed to providing support to the bisexual community and raising public awareness about bisexuality and bisexual people.


Inclusivity: The BRC uses bisexual as an umbrella term for people who recognize and honor their potential for sexual and emotional attraction to more than one gender (pansexual, fluid, omnisexual, queer, and all other free-identifiers). We celebrate and affirm the diversity of identity and expression regardless of labels.


Five Simple Reasons Why the “Binary” Argument Holds No Water

1.) Historical context is important, so it's critical to note that, similar to “homosexuality” and “lesbianism,” “bisexuality” is a word reclaimed by the bisexual movement from the medical institution (specifically the DSM III which pronounced it a mental disease). The bi community itself had little to no influence over the formation and structure of the word, and simply did what gays and lesbians did: empowered their communities by claiming the word for themselves. Of course, no one would say that miserable people can't be "gay" because they're not happy or upbeat all the time. Nor are lesbians restricted to women who hail from the Greek island of Lesbos.

2.) For many bisexuals, the "bi" in "bisexual" refers not to male plus female, but to attraction to genders like our own, plus attraction to genders different from our own. In other words, it's the ability to move in two directions along a continuum of multiple genders.

3.) The bisexual movement emerged around the same time as the transgender movement. Thus, in its early stages, no language was available for the description of attraction to non-binary sexes and genders.

4.) The bisexual community cannot oppress the trans community (which is part of what these misconceptions claim) because we are not privileged among queers. In other words, we ourselves are being erased, just as is the trans community.

5.) Historically (and very much currently), the bisexual community has been one of the most accepting places toward transgender and genderqueer people. Our communities have always shared a very strong alliance.

Bisexual Support and Advocacy Groups.  Find a support or social/advocacy group.


The Bisexual Resource Center brochure

Find out about the oldest national bisexual organization. Includes the organization's mission, goals and objectives.

 

Books on Bisexuality: An Annotated Listing

The BRC's newest brochure includes short synopses of the classic bi books you should have on your shelf. Perfect resource for an LGBT center or a bi support group.

 

Starting or Growing Your Bisexual Support Group - Have you been wanting to start up a new bi support group in your area? Or are you trying to revitalize an already existing group? This brochure provides tips on logistics, publicity, confidentiality issues and more.

 

How to Be an Ally to a Bisexual Person - Ever wonder how you can be an ally to a bi person? Or maybe you'd like a quick and easy way to inform someone you know how they could be more supportive of you. Either way, the BRC has a great brochure for you. Tip #1: Believe that I exist.


Bi Zone has created a directory of bisexually-aware therapists which is listed alphabetically by state. We don't know how current the listings are, but we hope they can be of use to you... BiZone's therapist listing

The Network/La Red, an organization working to end abuse in lesbian, bisexual women's and transgender communities, distributes handouts specifically targeting the bisexual community. Download and use these publications in your own community to educate others about how bi/pan/fluid people can be effected by partner abuse. Visit www.tnlr.org to learn more the organization's services and resources and how to order copies. Handout on bi partner abuse.   Spanish language handout on bi partner abuse

Rainbow Health Ontario produces a poster and postcard campaign, This Is Our Community: Bisexual Anti-Stigma Campaign, which focuses on biphobia and highlights four groups within the bi community that have been particularly marginalized: bisexual mothers, trans bisexuals, bisexuals of color and bisexual youth.

Rainbow Health Ontario also produces a fact sheet about bisexual health that details some of the health disparities and suggests more areas research is needed into bisexual health.

The Stonewall organization in Great Britain produces a range of resource materials for the LGBT community. They publish a wonderful report entitled Bisexual People in the Workplace: practical advice for employers, which includes issues for bisexual staff, tips on how to develop effective policy and procedures, and how to engage bisexual employees. PLUS, now there is a Spanish language version, Personas Bisexuales Trabajo.

The LGBT Advisory Committee of the San Francisco Human Rights Commission produced an incredible report in 2011, Bisexual Invisibility: Impacts and Recommendations. This report gives the community at large important information about how bisexual invisibility is perpetuated and how it detrimentally effects the community's mental and physical health.

Visit the Radical Bi blog and find gems like The Monosexual Privilege Checklist.

The National Intimate Partner and Sexual Violence Survey (NISVS) was released in January 2013 and gives the most detailed data ever on how partner violence affects women's lives, with results broken down by sexual orientation. The numbers don't lie: Nearly half of bisexual women, 1 in 8 lesbians, and 1 in 6 straight women have experienced rape at some point in their lifetime. These statistics are significant because we can see how bi women's experience is distinct from women of other orientations and the urgent need to address partner violence within the bi community.

The UK's Open University published a report in 2012, The Bisexuality Report: Bisexual Inclusion in LGBT Equality and Diversity, that informed UK policy and practice on LGBT equality in relation to the inclusion of bisexuality and issues specific to bisexual people. The report includes key recommendations to enhance bi representation in education, workplace, sports, media, and other important areas.

George Mason University releases new study showing that bisexual women suffer more from health risk factors than males. Researcher Lisa Lindley is looking for the reasons behind this disparity. “Bisexuals are often invisible,” she says. “There’s a lot of prejudice against them. They’re told ‘You’re confused — pick one.’ There tends to be this expectation or standard that a person picks one sexual identity and sticks with it. I think there’s a lot of misunderstanding about bisexuals. I think their risk has a lot more to do with stigma.”

Northwestern University researchers released findings in 2011 that updates and contradicts earlier research that suggested that bisexual men couldn't be sexually aroused by more than one sex. The new research made a more concerted effort to recruit men who identified strongly as bisexual and had been in relationships with men and women. The New York Times led the media frenzy created by the new findings. Though obviously pleased that the information was positive this time, the Bisexual Resource Center and others in the community already feel very confident that bisexual men exist. This article in the Northwestern University student paper has some great reactions from bi-identified students on their campus.




GLBT Health Access Project


The Gay, Lesbian, Bisexual, and Transgender (GLBT) Health Access Project is a community-based effort first funded by the Massachusetts Department of Public Health (MDPH) in 1997. The GLBT Health Access Project works with GLBT populations – and those who serve them – across the Commonwealth to respond to needs in a timely and targeted manner. We provide training, technical assistance and materials to agencies across the state (and, due to past success, across the nation) to help service providers learn more about the health care needs of GLBT populations and create welcoming environments for staff and clients.


The GLBT Health Access Project, part of the Massachusetts Department of Public Health, has produced, “Community Standards of Practice for the Provision of Quality Health Care Services to LGBT Clients”, a set of recommendations designed to “improve GLBT access to quality care and to assist clinicians and their facilities in creating responsive environments.”


GLBT Health Access Project - Massachusetts Department of Public Health


GLBT Health Access Project - Community Standards of Practice for the Provision of Quality Health Care Services to LGBT Clients




Institute of Medicine Report: The Health of Lesbian, Gay, Bisexual, and Transgender People


According to the Institute of Medicine of the National Academies, “At a time when lesbian, gay, bisexual, and transgender individuals—often referred to under the umbrella acronym LGBT—are becoming more visible in society and more socially acknowledged, clinicians and researchers are faced with incomplete information about their health status. While LGBT populations often are combined as a single entity for research and advocacy purposes, each is a distinct population group with its own specific health needs. Furthermore, the experiences of LGBT individuals are not uniform and are shaped by factors of race, ethnicity, socioeconomic status, geographical location, and age, any of which can have an effect on health-related concerns and needs. Researchers still have a great deal to learn and face a number of challenges in understanding the health needs of LGBT populations”.....Click here to Download - IOM LGBT Health 2011 Report Brief.pdf


According to the Center for Disease Control and Prevention, “There is a need for culturally competent medical care and prevention services that are specific to the LGBT population. Social inequality is often associated with poorer health status, and sexual orientation has been associated with multiple health threats. Members of the LGBT community are at increased risk for a number of health threats when compared to their heterosexual peers. Differences in sexual behavior account for some of these disparities, but others are associated with social and structural inequities, such as the stigma and discrimination that LGBT populations experience”....Click here to Read the CDC Article.




Joint Comission (JCAHO) Field Guide: Advancing Effective Communication, Cultural Competence, and Patient-and Family-Centered Care for the LGBT Community


The role of effective communication and patient-centeredness in providing safe and high-quality health care to diverse patient populations is well accepted. Effective patient–provider communication has been linked to an increase in patient satisfaction, better adherence to treatment recommendations, and improved health outcomes.


Patient-centered care “encompasses qualities of compassion, empathy, and responsiveness to the needs, values, and expressed preferences of the individual patient.” (p.48)  Combining the elements of effective communication and patient-centeredness into care delivery has been shown to improve patients’ health and health care.




Every patient that enters the hospital has a unique set of needs—clinical symptoms that require medical attention and issues specific to the individual that can affect his or her care. As patients move along the care continuum, it is important for hospitals to be prepared to identify and address not just the clinical aspects of care, but also the spectrum of each patient’s demographic and personal characteristics. The nation’s hospitals traditionally focus on meeting the

clinical needs of their patients; they seek to prevent errors and avoid inaccuracies that negatively impact the safety and quality of care. However, patients also have specific characteristics and nonclinical needs that can affect the way they view, receive, and participate in health care. A growing body of research documents that a variety of patient populations experience decreased patient safety, poorer health outcomes, and lower quality care based on race, ethnicity, language, disability, and sexual orientation.



Medical Health Education for Lesbian, Gay, Bisexual, Transgender Cultural Competency



In the Journal of the Association of American Medical Colleges article: Making Excellence Inclusive: Higher Education’s LGBTQ Contexts, Kathryn Peltier Campbell, editor of Diversity & Democracy, states, “In the past forty years, higher education has made great strides in building campus and classroom spaces that are more fully welcoming of Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) people, as well as of academic explorations related to gender and sexuality. The past few years alone have seen the founding of the advocacy and support group LGBTQ Presidents in Higher Education, the Expanding the Circle conference on Creating an Inclusive Environment for LGBTQ Students and Studies, and new programs and courses on gender and sexuality throughout college curricula. Combined with important policy changes, initiatives like these are not only creating warmer climates for LGBTQ students, faculty, and staff, but also shaping healthier environments for robust discourse among students across diverse identity groups and shifting terminologies.


And yet, as Warren Blumenfeld details in this issue of Diversity & Democracy, barriers to the full inclusion of LGBTQ people still exist throughout higher education. Likewise, programs and pedagogies that engage directly with questions of gender and sexuality may be located at the edges of the curriculum, implicitly marginalizing the issues and people they address. Such marginalization not only dampens the civic and educational participation of people who identify as LGBTQ, but also deprives all students of important opportunities to explore critical aspects of human experience. If higher education is to be the vibrant educational and democratic forum that society needs, it must become a safer and more welcoming place both for LGBTQ individuals and for studies of gender and sexuality. Fortunately, colleges and universities are recognizing this and implementing new programs and policies that aspire to these ends.


This issue of Diversity & Democracy explores how higher education is creating classroom and campus forums that engage with LGBTQ issues. Our authors seek answers to the following questions: What pedagogies can improve perspective taking among students while contributing to more LGBTQ-friendly climates? What programs and courses can provide opportunities for students to explore topics related to gender and sexuality? How are disciplinary and interdisciplinary studies creating pathways for students to contemplate timely and controversial topics related to LGBTQ issues? What can faculty across disciplines do to support LGBTQ students in their classrooms? The articles showcase pedagogies and programs that aim to make excellence inclusive across the spectra of gender and sexuality, making higher education more inclusive and engaging for all students in the process.


Seeking social justice for LGBTQ people is not simply a matter of improving things for the immensely diverse group of individuals who identify with that label, as Heather Hackman points out in this issue. Rather, it’s a matter of creating institutions that are more just for everyone—that eschew all types of discrimination, invite investment and engagement, and offer opportunities for everyone to succeed. This issue of Diversity & Democracy provides multiple points of reflection for institutions looking for ways to engage with LGBTQ issues in various contexts.”




Physicians Commitment to professional competence...

“Physicians must be committed to lifelong learning and be responsible for maintaining the medical knowledge and clinical and team skills necessary for the provision of quality care. More broadly, the profession as a whole must strive to see that all of its members are competent and must ensure that appropriate mechanisms are available for physicians to accomplish this goal...”

From: Medical Professionalism in the New Millennium: A Physician Charter.  Annals of Internal Medicine, February 5, 2002, vol. 136 no. 3 243-246



LGBT Health Research Percentages According to Journal of Homosexuality


According to an article in the special health edition (July 2012) of The Journal of Homosexuality, “...articles about the deviance of homosexuality still outnumber articles about improving health care provider interactions with LGBT patients (5% compared to 3% of all articles on LGBT topics)”



A Grand Challenge to Academic Medicine: Speak out on Lesbian, Gay, Bisexual, Transgender Rights

Academic Medicine 2009 Jun;84(6):788-92.  Dohrenwend A. - Internal Medicine Residency Program, McLaren Regional Medical Center, Flint, Michigan 48532, USA. anned@mclaren.org


“Social responsibility, a dearly held value in the medical community, requires that medicine use its influence to end discrimination and to reduce barriers that affect access to care. Although the gay, lesbian, bisexual, and transgender (GLBT) population has been identified as suffering from health care disparities and oppression, the medical community and its affiliated organizations have done little to lobby in defense of the GLBT population...And with regard to the specific issue of gay marriage, medicine has yet to raise its voice in that debate, even if only to correct unscientific, capricious, and slanderous depictions of GLBT relationships.... Closer to home, in medical schools and residencies, GLBT faculty and students are not provided with a safe and equal environment in which to work and learn. No credentialing provisions require residencies and their affiliate hospitals to include GLBT status in their nondiscrimination policies or to offer GLBT faculty and residents equal benefits....There is no assurance that those in power at peer-reviewed journals will use reviewers who are familiar with the research on sexual minorities to review manuscripts on GLBT topics, a situation that likely contributes to the community's status as an understudied population.... Medicine cannot fulfill its obligation to GLBT patients, students, and faculty without a considerable and determined commitment to change.... Some of the suggested remedies would require amending policy at the level of the Accreditation Council for Graduate Medical Education and the Association of American Medical Colleges.”...Click here to Download - A Grand Challenge to Academic Medicine-Speak Out on Gay Rights.pdf




Medical Education - Lesbian, Gay, Bisexual, Transgender


According to the Association of American Medical Colleges (AAMC), “When the AAMC released survey data in 2007 showing that one-fifth of respondents knew of mistreatment toward lesbian, gay, bisexual, and transgendered (LGBT) medical students, medical school officials were surprised.


Four years later, LGBT experts and advocates are working to change policies at medical schools, in the health care system, and in society at large. And while challenges remain, the future for LGBT medical students, physicians, and patients looks brighter.


LGBT issues have received extra attention lately as gay marriage, the repeal of the military’s “don’t ask, don’t tell” policy, and related matters gain national prominence. In the world of health care, Shane Snowdon, Ph.D., director of the University of California, San Francisco (UCSF) LGBT Resource Center, said longstanding perceptions of inequitable treatment at the clinic and hospital is another issue growing ripe for discussion”.... Read AAMC Article on Changing Times for LGBT Population



American Medical Student Association (AMSA) Gender and Sexuality Resources

Recognizing that discrimination based on gender and sexuality stems from common roots in sexism and heterosexism, the Gender and Sexuality committee is dedicated to assuring equal access to medical care and equality within medical education. We work to establish AMSA as a leader on issues affecting the health of women, intersex and the lesbian, gay, bisexual, and transgender (LGBT) communities and support initiatives to improve policy at the institutional, local, state, and federal levels.


Download - A Grand Challenge to Academic Medicine-Speak Out on Gay Rights.pdf


AMSA - Waiting to Come Out: Discrimination and Potential for it in Medical School


Download - An Established Medical School Human Sexuality Curriculum    Description And Evaluation.pdf


Download - Association of American Medical Colleges (AAMC) LGBT Recommendations.pdf


AAMC - Informational Guide to Effective Practices for GLBT Students and Patients


Download - The Human Sexuality Education of Physicians in North American Medical Schools.pdf


National Coalition for LGBT Health - LGBT Inclusion in Federal Health Surveys


Download - UCSF Core LGBT Competencies for Medical Students.pdf



Additional Healthcare - LGBT Population Resources



Association of American Colleges and Universities - Diversity & Democracy aims to support academic leaders and educators as they design and reshape their diversity programs, civic engagement initiatives, and global learning opportunities to better prepare students for principled action in today's complex world.  Topics include: Teaching LGBTQI Issues in Higher Education, Creating LGBT-Inclusive Classrooms, Queers Dual Meanings, Queer Theory’s Relevance to Student Learning, Safe Zone Dialogues at the University of Alabama,



American Journal of Public Health- advances public health research, policy, practice, and education and is the official journal of the American Public Health Association.  The Journal often covers issues on Lesbian, Gay, Bisexual, and Transgender concerns.




National Association of Community Health Centers - Reaching out to Special Populations (LGBT Patients).  This is the second of a series of Information Bulletins designed to provide guidance on furnishing services to “other” special populations. Aside from certain health centers that receive dedicated funding to serve a special population, every health center is expected to provide or arrange access to services for any population it serves that has particular health care needs.



 

Lesbian, Gay, Bisexual, Transgender Resource Center at UCSF


The Center has provided training on LGBT health concerns to current and future health professionals in every field. The Center has also convened multiple LGBT health conferences, and in October 2010 presented the National Summit on LGBT Issues in Medical Education for medical school faculty...

The Network for LGBT Health Equity - Fenway Institute


The Network for LGBT Health Equity is a community-driven network of advocates and professionals looking to enhance LGBT health by eliminating tobacco use, and other health disparities within our communities. We are one of six CDC-funded tobacco disparity networks and a project of The Fenway Institute in Boston.

Lesbian, Gay, Bisexual, Transgender Caucus for Public Health Professionals


The Lesbian, Gay, Bisexual, and Transgender (LGBT) Caucus is an association of public health professionals committed to furthering LGBT issues within the American Public Health Association (APHA) and the field of public health at large. Since its founding in 1975, the LGBT Caucus has provided a forum for educational exchange and networking among its members and their allies. The caucus is committed to combating discriminatory health policies and practices against lesbian, gay, bisexual, and transgender individuals and communities...

Lesbian Health & Research Center


At the Lesbian Health & Research Center we’re passionate about bringing people together for a greater purpose: to speed up the pace of research for the LBTQ community and to close the gap in LBTQ health disparities. We’re the only lesbian-focused health and research organization housed within one of the world’s premier health science institutions, the University of California, San Francisco (UCSF), where we’re part of the School of Medicine (National Center of Excellence in Women’s Health) and the School of Nursing (Institute for Health & Aging).


Lesbian Health & Research Center


LavenderHealth.org is a Resource Center for reliable LGBTQ health information and resources for health care professionals, educators, and consumers.   While we do not endorse or recommend particular treatments or approaches, we do analyze the infomation posted here for truthfulness, currency, and potential for benefit to LGBTQ communities.
 

The National LGBT Health Education Center - Fenway Institute



The
mission of Fenway Health is to enhance the wellbeing of the lesbian, gay, bisexual and transgender community and all people in our neighborhoods and beyond through access to the highest quality health care, education, research and advocacy.  The Fenway Guide to Lesbian, Gay, Bisexual, and Transgender Health is an invaluable reference for healthcare professionals seeking further knowledge and guidance on sexual minority health care.

Lesbian, Gay, Bisexual, Transgender (LGBT) Data Bank


LGBTdata.com
provides knowledgeable analysis, commentary and expert "how to" information on gathering such data effectively in scientific surveys, questionnaires and studies. Collected and categorized here you will find numerous datasets and links to rich data sources that are essential to LGBT health research, researchers, students, advocates and anyone interested in scientific-based information about LGBT people and populations...

American Medical Student Association (AMSA) Gender and Sexual Minority Health


Recognizing that discrimination based on gender and sexuality stems from common roots in sexism and heterosexism, the Gender and Sexuality committee is dedicated to assuring equal access to medical care and equality within medical education. We work to establish AMSA as a leader on issues affecting the health of women, intersex and the lesbian, gay, bisexual, and transgender (LGBT) communities and support initiatives to improve policy at the institutional, local, state, and federal levels.

Association of Gay and Lesbian Psychiatrists (AGLP)


We are a community of psychiatrists that educates and advocates on Lesbian Gay Bisexual and Transgender mental health issues. AGLP Strives to be a community for the personal and professional growth of all LGBT Psychiatrists, and to be the recognized expert on LGBT mental health issues.
 
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