LGBTQIA+ Patients

HPSM is committed to providing high-quality care and services to members of every sexual orientation and gender identity. These tips are intended to support providers in offering inclusive, supportive care to LGBTQIA+ patients.

These suggestions are informed by the National LGBTQIA+ Health Education Center.  

Refrain from making assumptions about a person’s sexual orientation or gender identity based on appearance 

Making assumptions about a patient’s sexual orientation can put them on the spot to “come out” to you. Use neutral language when asking questions and take your lead from the individual person. Ask patients how they would like to be addressed, what name they would like to be called and which pronoun is appropriate. Some ways to ask this are “What is your current gender identity?” Or “What is your current sexual orientation?”

Revising intake forms can support this process by ensuring that providers and clinic staff have accurate information on a patient’s current sexual orientation, gender identities and pronouns. Health care providers can also make it their protocol to use gender-neutral language with patients in the exam room or at the front desk, ask for their pronouns and implement “bedside” inclusivity.

Note: Providers should facilitate disclosure of sexual orientation and gender identity, but be aware that disclosure or “coming out” is an individual process and it’s not always easy. You can help create a safe environment by asking for information pertinent to medical care only, as you would with any other patient.

Listen to and reflect patients’ choice of language when they describe their own sexual orientation and gender identity

Ensure that all clinic staff are trained to reflect a patient’s choice of gender identity or sexual orientation when addressing the patient. Reflecting a patient’s choice of language also includes how they refer to their relationship or partner. Referring to a significant other as a “husband,” “wife” or “partner” after the patient has used such language can contribute to a welcoming environment.

If you make a mistake, acknowledge it and apologize. For example, you could say, “I’m sorry I didn’t get that right. I meant to say       .” Or if you need help recalling, you could say “Can you please tell me again so I can make sure that I have the correct information?” 

Ensure cultural competency from check-in to check-out

A patient’s health care experience goes beyond the examination room. It’s important to make sure that their whole experience is positive. This includes providing gender-neutral bathrooms and making all administrative processes identity-affirming. Health care providers should consider requiring all clinic staff to participate in annual trainings that explain LGBTQIA+ health disparities and affirming communication. San Mateo Pride Center can be a resource for training and resources.

Provide welcoming visual cues

Entering a health care facility, patients look for signs and clues of diversity and openness to LGBTQIA+ identities. Assess the physical environment of your building with attention to what kind of messages may be communicated to patients. Once clinic staff are trained on supporting patients with affirming and supportive language, consider providing visual cues that your office is a welcoming space. This could include brochures and educational materials addressing LGBTQIA+ health concerns, publicly posting a nondiscrimination statement and displaying posters from LGBTQIA+ or HIV/AIDS nonprofit organizations. 

Stay up to date with the latest LGBTQIA+ health research and be knowledgeable about the needs of LGBTQIA+ patients

Partner with your patients to understand their health care priorities and offer up-to-date information on topics like hormone replacement therapy or how patients can live with HIV/AIDS. This can take the burden of educating their providers off of patients’ shoulders. 

Take routine and inclusive sexual health histories for all adolescent and adult patients 

Taking a routine history of sexual health should be part of the comprehensive history for all adolescent and adult patients. Start the conversation by stating that you ask all patients these questions in order to provide appropriate care. This opening helps to normalize the conversation. Asking inclusive questions that avoid assumptions (such as “Are you in a relationship?” and “What is the gender or genders of your sexual partners?”) invites patients to feel more comfortable disclosing sexual behavior and any related questions or concerns.