Social exclusion, discrimination, stigma and marginalisation are some of the issues experienced by LGBTI people accessing health care . Not only do these factors increase the risk of adverse impact on their health and mental health, they also create barriers to accessing health and social care services.
As part of our efforts to improve health equity, WA Primary Health Alliance (WAPHA) is actively involved in advocating for and facilitating safe, inclusive, and culturally appropriate primary care services for LGBTI people.
To inform our work, we surveyed a group of LGBTI people about their healthcare experiences.
Overall, the responses indicated that LGBTI consumers want to be treated as ‘substantively equal’ to their heterosexual counterparts and that they seek health providers who are inclusive, non-judgemental and well-informed about issues related to LGBTI health.
They indicated a high degree of loyalty to their local general practice, with 88 per cent of respondents saying they always visit the same practice for their primary care, and 58 per cent saying they always try to see the same GP.
Not only does this confirm that GPs are well placed to influence the health and wellbeing of LGBTI people, it also confirms that many practices are already effectively engaging with and treating their LGBTI patients in safe and welcoming practices.
In closing, WAPHA urges everyone involved in the healthcare of LGBTI people to pause and think about how they can improve their understanding of the issues and respond sensitively and effectively. We have included below some ways that you can contribute to achieving that goal.
Three ways you can make your practice LGBTI friendly
Visual displays: A simple yet effective way to show that your practice is LGBTI inclusive is by displaying a welcoming sign or poster. Another option that we are implementing is to register for ACON’s Welcome Here project, a national initiative that enables organisations to register as a safe place for LGBTI people. Visit the Welcome Here Project for more information.
Training in gender diversity and transgender health: In order to further support general practices, WAPHA is seeking to understand requirements and preferences for training in gender diversity and transgender health among primary care clinicians in WA and we encourage you to visit Primary Health Exchange and have your say in our brief survey.
While this will allow us to develop a WA specific training module, if you need to access training sooner, we recommend North Western Melbourne PHN’s Trans GP training.
Transgender Health and Diversity Health Pathway: Our HealthPathways WA team benefits from the expertise of clinical editor, Dr Irene Dolan, a GP with a passion for LGBTI health. Dr Dolan is seeking input from fellow GPs to inform a localised Transgender Health and Diversity Health Pathway. Visit HealthPathways WA to register your interest in taking part in the working group.
Feedback received about key factors for an LGBTI inclusive practice included:
- Frustration with heteronormative assumptions made by doctors including assumptions about gender, partner gender and sexual practices.
- The need for bulk-billed, conveniently-located services.
- The inclusion of transgender patients in regular health screenings e.g. pap smears for trans men and prostate checks for trans women.
- Offering LGBTI-specific mental health and suicide prevention services.
- Intake forms including options for those who are non-binary, intersex and/or transgender and allowing them to state their preferred pronouns.
- The importance of LGBTI awareness training for all medical practitioners.
- Issues related to HIV/AIDS e.g. better screening and full PBS coverage of PEP, PREP and anti-retroviral medication.
- The importance of a practitioner affirming their support for the LGBTI community, for example by advertising as LGBTI-friendly or by displaying a rainbow flag.
- The difficulty in finding medical practitioners knowledgeable about transgender issues such as gender reassignment surgery and hormone replacement therapy.
Read this and more the May edition of GP Connect.