对于LGBTQ人群, 朋友ly health care is important but can be hard to find

By Michael Merschel, 美国心脏协会 线上电子游戏飞禽走兽

Nadzeya Haroshka/iStock via Getty Images
(Nadzeya Haroshka/iStock via Getty Images)

When Lindsey Huie arrived at the hospital that day in 2019, she had already hit peak stress.

The inside of her chest felt ripped apart. She was thinking about her four kids and who would care for them if her wife had to come help her.

但后来, one of the first things Huie was asked in the emergency room was, “我们能联系你丈夫吗??" It wasn't even really a question, s他说, but an expectation.

这意味着, instead of focusing on treating what turned out to be a torn artery in her heart, 她发现自己不得不解释, “嗯, we have a whole different kind of life going on here, 朋友."

她活了下来. 但Huie, a former professional soccer player who now works as a coach and consultant in Yorba Linda, 加州, said that such affronts have happened regularly when she's needed care.

Lindsey Huie (right) with her children (from left) Kinsley, Rylie, Kaia and Mimi at the University of Portland, where the soccer player was inducted into the school's Athletic Hall of Fame in 2022. (图片由Lindsey Huie提供)
Lindsey Huie (right) with her children (from left) Kinsley, Rylie, Kaia and Mimi at the University of Portland, where the soccer player was inducted into the school's Athletic Hall of Fame in 2022. (图片由Lindsey Huie提供)

Experts in LGBTQ health say that's a too-common experience that has serious consequences. But they also say that health care professionals can find easy ways to be welcoming to LGBTQ patients – and that patients have resources to lead them to welcoming professionals.

LGBTQ people face the same issues as everyone else, including access to health insurance and a shortage of primary care doctors, 博士说. 小卡尔·斯特里德., an assistant professor of medicine at the Boston University Chobanian & Avedisian School of Medicine, but with an extra burden of discrimination.

A 2020 美国心脏协会 scientific statement, 是史崔德帮忙写的吗, said that more than half of sexual minority (a broad term for people who are not heterosexual) adults and 70% of gender minority (such as transgender) adults reported some form of discrimination from health care professionals.

与此同时, roughly 1 in 6 LGBTQ people say they have avoided medical care because they feared being discriminated against, 根据… 2017年的调查 conducted for NPR, the Robert Wood Johnson Foundation and Harvard T.H. 陈公共卫生学院.

A 2020年的报告 by the National Academies of Science and Engineering said that anti-LGBTQ discrimination has "direct negative consequences for health and well-being" and exacerbates disparities. 这些差异, 根据美国心脏协会的声明, include growing evidence that LGBTQ adults experience worse cardiovascular health than their heterosexual peers.

The effects of such discrimination can range from demeaning to life-threatening. Streed said he has worked with patients who, 出柜之后, were turned away from doctors and had access to vital medications cut off. 更常见的问题, 他说, might involve a medical office worker who refuses to use a person's chosen name or asks questions that are irrelevant to medical care.

Huie, 40, came out publicly around age 35.

Non-LGBTQ people may think that the stress of coming out happens one time, s他说. "But the reality is that you're coming out over and over and over and over and over again." For example, she's had to explain to many doctors why birth control is not a concern for her.

Dr. 塞萨尔冈萨雷斯, clinical director of the Transgender and Intersex Specialty Care Clinic at the Mayo Clinic in Rochester, 明尼苏达州, said health care professionals can take many steps to be welcoming to LGBTQ patients.

它可以从小线索开始, 冈萨雷斯说, such as having statements on the office's website or in the lobby that say all individuals are welcome. Similarly, intake forms should ask about gender identity and preferred pronouns.

Gonzalez, a clinical health psychologist who uses both he and they pronouns, co-wrote a 2021篇文章 in the journal Primary Care: Clinics in Office Practice that spelled out additional ways for health care teams to signal that they take LGBTQ patients seriously.

"In many regards, it's about trust," 冈萨雷斯说.

Simple measures can have big benefits, 冈萨雷斯说, who teaches medical residents and others about cultural competency. Students receive pins stating they understand LGBTQ health needs.

Attendees who wear the pins report back, "'Gosh, that has been incredible. People spontaneously tell me that they're trans, or they told me about their transgender child,’”冈萨雷斯说。.

Streed emphasized that training on such issues shouldn't stop with the physician. "Front desk staff need to be trained up about being competent, asking questions appropriately and keeping confidentiality in mind,他说.

The benefits of being conscientious that not everybody's families or bodies are the same can help a wide variety of people go beyond LGBTQ patients themselves, 冈萨雷斯说. The family member of a transgender child might need a safe space to discuss fatigue and depression from dealing with harassment. An adoptee might appreciate not having to explain that their family history is not the same as their genetic background. A woman who has been treated for ovarian cancer might not want to be subjected to questions about parts of her anatomy that she no longer has.

A health care team that shows awareness of all that, 冈萨雷斯说, tells a patient that "someone really has an understanding of what's going on with their health."

To find such care, both Gonzalez and Streed recommended starting with the LGBTQ+医疗保健目录. The free, searchable database lists LGBTQ-朋友ly doctors across the United States and Canada.

Streed said the Human Rights Campaign also offers 欢迎卫生系统的清单 由国家. Many cities have LGBTQ-specific health care centers, 他说. The Centers for Disease Control and Prevention offers 一个列表 这样的中心.

在农村地区,选择可能有限, 强调承认, but some clinics offer telehealth services, which could be important in states that have passed laws targeting gender-affirming care.

Huie said her current doctor is "very LGBTQ embracive." She has several tactics for finding such care.

She looks at websites that grade physicians, asks questions in a social media group and checks with LGBTQ allies. “那, 在我看来, is a little bit better than just trying to do it on your own or showing up and then hoping for the best."

Huie, 谁不再结婚了, thinks "we still have a pretty long ways to go" before LGBTQ people and their families are not consistently isolated and, 无意或无意, made to feel unwelcome by health care staff and society at large.

S他说 the problem is often not maliciousness, but ignorance. People in general "are just so uneducated that there are things outside of our norm. And that's the part where I feel like we need to do a better job."

美国心脏协会 线上电子游戏飞禽走兽 Stories

美国心脏协会 线上电子游戏飞禽走兽 covers heart disease, stroke and related health issues. Not all views expressed in 美国心脏协会 线上电子游戏飞禽走兽 stories reflect the official position of the 美国心脏协会. 语句, 结论, accuracy and reliability of studies published in 美国心脏协会 scientific journals or presented at 美国心脏协会 scientific meetings are solely those of the study authors and do not necessarily reflect the 美国心脏协会’s official guidance, 政策或立场.

Copyright is owned or held by the 美国心脏协会, Inc.,版权所有. 许可 被授予, at no cost and without need for further request, 为个人, 媒体, and non-commercial education and awareness efforts to link to, 报价, excerpt from or reprint these stories in any medium as long as no text is altered and proper attribution is made to 美国心脏协会 线上电子游戏飞禽走兽.

其他的用途, including educational products or services sold for profit, must comply with the 美国心脏协会’s Copyright 许可 Guidelines. 参见完整的使用条款. These stories may not be used to promote or endorse a commercial product or service.

HEALTH CARE DISCLAIMER: This site and its services do not constitute the practice of medical advice, 诊断或治疗. Always talk to your health care provider for diagnosis and treatment, 包括你的特殊医疗需求. If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. If you are in the United States and experiencing a medical emergency, call 911 or call for emergency medical help immediately.