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Embrace the rainbow: Inclusion of the LGBTQI+ community in medicine

AGA Diversity Committee member Dr. Sonali Paul provides steps to create a safe and inclusive environment for patients and staff.
PrideMonth
PrideMonth

This article is brought to you by the AGA Diversity Committee as part of their work to educate and raise awareness of topics relevant to underrepresented AGA members and patients.

Sonali Paul, MD, MS
Sonali Paul, MD, MS

Assistant Professor of Medicine
Center for Liver Disease, The University of Chicago Medicine

June is Pride Month – a time celebrated amongst the lesbian, gay, bisexual, transgender, queer, intersex (LGBTQI) and “+” (representing other sexual and gender diverse people) community. Pride Month is dedicated to uplifting and supporting LGBTQI+ voices, culture and rights. However, such “pride” is often not felt amongst LBGTQI+ individuals in medicine as many experience overt discrimination, isolation, and harassment or more subtle microaggressions due to their sexual orientation or gender identity.1 In a 2015 survey of LBGTQI+ health care trainees and professionals, one out of five believed that their medical center did not provide a supportive environment for a successful career.2 This highlights the need for institutional policies and programs that allow for greater LGBTQI+ inclusion and visibility in medicine. Doing so creates a more diverse workforce, can help inform LGBTQI+ health advocacy and improve care of this underserved population.

How do we create this safe and inclusive environment? There are actions that can be taken on both an institutional and individual level.3 These initiatives also help build a more welcoming environment for our LGBTQI+ patients:

  1. Education on LGBTQI+ inclusivity and health. LGBTQI+ education surrounding knowledge, skills and attitudes should be integrated into staff orientation, sexual harassment and diversity training efforts. Institutional non-discrimination policies should include gender identity/expression and sexual orientation. Additionally, lectures on LGBTQI+ health and related disparities are needed to increase awareness amongst the workforce.
  2. Recognize key LGBTQI+ events. Announcements from leadership recognizing Pride Month and Transgender Day of Remembrance and other LGBTQI+ events reaffirm a safe workplace and promote equity. Additionally, displaying subtle signs that support the LGBTQI+ community (such as the redesigned pride flag) can also help support inclusivity of both LGBTQI+ staff and patients.
  3. Inclusive benefits packages. Employers should recognize individual family structures (i.e. same sex couples, LGBTQI+ headed families) when granting health insurance benefits in addition to medical, family and bereavement leave. Adoption benefits and health insurance policies that cover medical care and necessary procedures for transgender staff are also important.
  4. Use of inclusive language. Forms should reflect diverse family structures using spouse or partner (instead of husband/wife) and parent (instead of mother/father). Additionally, staff should be encouraged to add their preferred pronouns to their email signatures and identification badges. Use of pronouns transcend trans and non-binary equality, stops misgendering and heteronormative attitudes, and creates a safe space. At our institution, our internal medicine residents received internal funding to create personal pronoun badges to directly show their support for their LGBTQI+ colleagues and patients. 
  5. Be an ally! Allies have been and always will be vital to the LGBTQI+ community’s freedom of expression. By acknowledging their own privilege, allies help identify discrimination on both an institutional and personal level. Anyone can be an ally!

Although the above actions are by no means an exhaustive list, they are the first of many steps that can be taken so that we may truly embrace the rainbow and support a culture of LGBTQI+ inclusivity in medicine.

Happy Pride!

References

  1. Boustani K, Taylor KA. Navigating LGBTQ+ discrimination in academia: where do we go from here? The Biochemist 2020;42:16-20.
  2. Sánchez NF, Rankin S, Callahan E, et al. LGBT Trainee and Health Professional Perspectives on Academic Careers—Facilitators and Challenges. LGBT Health 2015;2:346-356.
  3. Holland H. Creating Inclusive Heatlh Care Envionrments for LBGT Patients & Staff. National LGBT Health Education Center; A Program of the Fenway Institute. 2014. Available at https://www.lgbtqiahealtheducation.org/wp-content/uploads/Creating-an-Inclusive-Health-Care-Environment.pdf. Last Accessed June 2, 2021.
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