The National LGBT Cancer Network is making cancer screenings more available to a high-risk, underserved population.
Imagine that you find a lump under your skin, or that you’re having trouble breathing, or are in pain. You’re afraid you might have a serious health problem — possibly cancer — but you’re also reluctant to go to the doctor.
Why might you postpone or avoid contact with the health care system? Maybe you can’t afford health insurance or a have a history of negative experiences with hospitals and doctors.
So you keep putting off that doctor’s appointment, and, potentially, you keep getting sicker.
Patients with cancer who are also a part of the LGBT community often face barriers when it comes to the care and treatment for their disease.
Upon receipt of a cancer diagnosis, bias and judgement from medical providers should not be a concern for patients.
However, research has shown that patients who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ) regularly experience increased anxiety and fear discrimination in medical situations. LGBTQ cancer survivors consistently report lower satisfaction with medical care, and gay, bisexual and transgender men who survive cancer appear more likely to experience depression or relationship difficulties.
Barriers to care exist in these communities, as well.
by Roy Edroso
A pending law in the District of Columbia underlines your obligation to proactively guard against discrimination against lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) patients — or risk alienating patients or even legal trouble.
On Feb. 2, the D.C. Council passed the LGBTQ Cultural Competency Continuing Education Amendment Act of 2015, requiring health care professionals licensed in the district to acquire two continuing education credits “on cultural competency or specialized clinical training focusing on patients who identify as lesbian, gay, bisexual, transgender, gender nonconforming, queer or questioning their sexual orientation or gender identity and expression (‘LGBTQ’).”
The Act, which at press time awaits Congressional approval, includes a waiver for providers with only limited patient engagement and authorization for the District to arrange funding for cultural competency training vendors.
The legislation is a sign that competency in the special needs of LGBTQ patients is increasingly expected of providers. While “there is not a [federal] legislative mandate that addresses this specifically, many providers are being sued because of a lack of cultural competence and appropriateness,” says Venessa Marie Perry, president/CEO of Health Resource Solutions LLC in Washington, D.C. Some cases, such as Taylor v. Lystila involving a transgender patient whose provider refused to give her hormone replacement therapy, have explicitly referenced the Affordable Care Act (ACA).
I applaud the recent news out of D.C.; their City Council unanimously approved a bill requiring that all continuing education programs for licensed health care professionals include LGBT-related "cultural competency" training.
Before we rush to train health care providers, I recommend we slow down and ask the big questions. What do we mean by LGBT cultural competence? (We are not all employing a clear or identical definition.) What are our training goals and how can we know if we achieved them? (A huge roar of applause is not an evaluation method.) What, (if anything) is it reasonable to expect to achieve in a two-hour training? Is "learning about LGBT people" going to make any difference in the multiple health disparities in our community?