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Local Organizations Provide LGBTQ-Friendly Training to Healthcare Providers

“It's not something that has traditionally been included in medical schools and/or residency training programs, although more and more are doing this work,” said Dr. Lee.
doctor with clipboard
stock photo from Pexel

This content was originally published by the Longmont Observer and is licensed under a Creative Commons license.

In Boulder County, local organizations are working to improve the quality of healthcare for LGBTQ patients through educational programs and outreach.

According to Invisible: The State of LGBT Health in Colorado, a 2011 report from One Colorado, almost 9 out of every 10 transgender-identified respondents reported a community fear or dislike of LGBT persons to be a problem when receiving health-care services. Additionally, 53 percent of transgender respondents and 21 percent of all LGBTQ respondents have been refused services by a health-care provider or their staff.

In another report from One Colorado in 2013, Becoming Visible: Working with Colorado Physicians to Improve LGBTQ Health, physicians responding to the survey showed an interest in making their office more LGBTQ-friendly, with 43 percent saying they were very interested, and 25 percent being somewhat interested.

In response to those findings and a general need for LGBTQ-friendly healthcare providers, Out Boulder County and the OASOS (Open and Affirming Sexual Orientation and gender identity Support) youth program of Boulder County Public Health, are working with local healthcare providers on cultural competency and making their services more LGBTQ-friendly.

“There are a lot of hospitals and health care facilities around here, and they often will reach out to us for advice on how to ask sensitive questions, especially around gender identity, as well as sexual orientation,” said Michal Duffy, education and program manager at Out Boulder County. “Allowing Out Boulder County to do some of that education can go a really long way, I think, in building trust and being able to be culturally competent.”

Duffy said that, in addition to responding to requests directly from medical providers, Out Boulder County also assists LGBTQ individuals who had a negative experience with a healthcare provider. Rather than the patient self-advocating, which Duffy encourages, or educating their provider themselves, individuals can contact Out Boulder County, and they will reach out to the healthcare provider and offer to help them address those concerns.

“I think that most agencies and clinics or whomever, are really happy to have a resource come in, because they often don't know what to do and are afraid to mess up and don't know what resources are available,” said Duffy. “We are here for that process to try to help bring folks along and have those conversations with us as an organization rather than with patients.”

OASOS also offers similar cultural competency training and consultations to healthcare providers. Originally OASOS offered a free, full-day, in-house seminar called the Transgender Healthcare Conference. But in 2016 they switched to providing on-site visits with healthcare providers upon request.

“What we realized by offering it in-house and day-long was that it wasn't super accessible for medical providers,” said Heather Crate, OASOS program coordinator. “We typically had 50 to 60 participants at each one we hosted, which was great, but the majority of them ended up being mental health provider just because, being out of the office an entire day or spending an entire day in a training without the ability to receive continuing education official credits that are recognized by the medical associations, you know, I don't think it had the right incentives that medical providers were looking for.”

Now, Crate explained that trainings last for one or two hours at the provider’s office and include things like, reviewing forms, helping update electronic health records to include preferred names and gender identity, and looking at signage and the physical space. But Crate feels that, while participating in these trainings is great, going through it once just isn’t enough.

“One of the issues that we sometimes have with just training is if the training isn't offered in an ongoing manner, or it's not built upon, or it's not built into new employee orientation,” said Crate. “So if you did a training three years ago, that's great. But the field has changed a lot probably in three years, the LGBTQ community grows and shifts and you likely add new people into your practice, or people may have moved on, so staying up to date is a piece of that.”

And, in addition to cultural competency training, providers need medical training to understand LGBTQ health concerns. But neither OASOS nor Out Boulder County provide medical trainings. In fact, medical training on LGBTQ health topics is difficult to come by.

Dr. Rita Lee, an internist and primary care provider with UCHealth, explained that many health care providers specializing in LGBTQ health are self-trained through literature review, reading up on LGBTQ health needs and by caring for people in the community.

“It's not something that has traditionally been included in medical schools and/or residency training programs, although more and more are doing this work,” said Dr. Lee. “So those of us that are out practicing needs to learn how to use inclusive language, as well as read up on the specific clinical needs of the LGBTQ population.”

One example of health care providers working at implementing changes to be more LGBTQ-inclusive and educated is UCHealth.

The health care system updated their electronic medical records in January to include sexual orientation and gender identity fields. Now it’s easier for patients to document the pronouns they use, their current gender identity, their sex assigned at birth and more. It also includes an organ inventory, which allows providers to document the organs that are present in the patient so they can provide better clinical care.

“In the past, it has been a bit of a structural barrier to properly identify our patients, as well as ensure that they're getting treated with respect throughout the system,” said Dr. Lee. “Now, this systematically allows everybody to see that, so we can address patients in a way that is respectful, ideally, across the system.”

Additionally, according to Dr. Lee, UCHealth is currently developing system-wide trainings for all clinical staff on how to use inclusive language and create an inclusive environment for all of our patients, specifically around LGBTQ health. UCHealth’s Integrated Transgender Program, based in Aurora, will also hold an education day specific to transgender health this fall for healthcare providers. This is the second year the education day has been offered.

“Most patients really just want an LGBTQ friendly provider,” said Dr. Lee. “If you look at what they were saying, it's basically acknowledging who they are, using inclusive language and to recognize their relationship status, their gender identity, their pronouns that they use, their preferred name, etc. and then being knowledgeable about specific health issues that might be facing the LGBTQ community.”

Local healthcare providers looking for more information on cultural competency training programs can contact Out Boulder County or Heather Crate at the Boulder County Public Health OASOS youth program. For details on UCHealth’s education day this fall, contact the Integrated Transgender Program.