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New Book Guides Clinicians Through Providing Care To LGBTQIA+ Patients

Book Published Ahead Of Biden Administration's Policy To Protect Against Health Care Discrimination For LGBTQIA+ Community

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Equality March for Unity and Pride participants march past the White House in Washington
In this Sunday, June 11, 2017 file photo, Equality March for Unity and Pride participants march past the White House in Washington. The Biden administration says the government will protect gay and transgender people against sex discrimination in health care. That reverses a Trump-era policy that sought to narrow the scope of legal rights in sensitive situations involving medical care. Carolyn Kaster/AP Photo

The Biden Administration announced Monday that it’s reinstating protections against discrimination in health care based on gender identity and sexual orientation — after a Trump-era policy removed those protections.

Linda Wesp, a clinical assistant professor at the University of Wisconsin-Milwaukee College of Nursing and Zilber School of Public Health, said she’s seen firsthand how these protections at state and federal levels have tremendous impacts on members of the LGBTQIA+ community getting access to care.

She said with these protections, patients feel a sense of relief at being able to use their insurance to cover identity-specific health care needs.

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Wesp is a co-editor of Clinician’s Guide to LGBTQIA+ Care: Cultural Safety and Social Justice in Primary, Sexual and Reproductive Healthcare, a recently-published book that seeks to provide clinicians with tools to be understanding, compassionate and empathetic providers. The hope is to minimize and eliminate reports of humiliation, harassment and denial of service by people who identify as LGBTQIA+.

LGBTQIA+ stands for lesbian, gay, bisexual, trans, queer, intersex, asexual and more. Wesp said using accurate language is important because it helps clinicians understand the contexts for which their patients are seeking care.

“I think for us as clinicians, it’s important to understand identities — to understand what our patients might be navigating,” she said.

The guide book focuses on specific tactics, such as helping clinicians look past names on insurance cards, ask patients open-ended questions and try to avoid assumptions, and mirror a patient’s preferred language relating to body parts and pronouns.

One easy approach to correctly identifying a patient is to check charts, Wesp said.

“Just (how) we make sure we have the right patient by checking a name and date of birth, you check and see that person’s pronouns and what name they go by in the chart,” she said. “That should just become routine practice.”

Wesp said clinicians can ask respectfully what their patients prefer, and can start that conversation by sharing their own names and the pronouns they prefer.

“You know, ‘My name is Linda. I’m your provider today. My pronouns are she and hers. What name do you like to go by and what are your pronouns?’” she said as an example.

Wesp said one of the biggest challenges for members of the LGBTQIA+ community is that their identities have become “pathologized,” explaining that for a long time, anything except heterosexual orientation was considered a mental illness. She pointed, as a recent example, to gender dysphoria being listed in the Diagnostic and Statistical Manual of Mental Illnesses.

“Just in general, Western medicine kind of categorizes into healthy and sick,” she said. “And that can be difficult when … this is just who someone is.”

She said stereotypes relating to the LGBTQIA+ community are multilayered, but likely stem from both systemic discrimination, where systems are set up in ways to erase or marginalize certain members of the community, and implicit bias.

Wesp said when a patient meets with a doctor, there’s a power imbalance and it’s incumbent on the provider to listen to what the patient is saying.

“There’s nothing better in the world than to feel seen and to be able to see people for who they are,” she said.