Quality & Patient Safety

Match quality of care with respect when treating LGBTQ patients

Patient Safety Monitor, October 24, 2017

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Match quality of care with respect when treating LGBTQ patients 

Every facility wants to give the best possible care to every patient who walks through its doors, regardless of sexual orientation or gender identity. But wanting to help people isn't the same as helping them or knowing what they need.

In 2016, 4.1% of the U.S. population identified as being lesbian, gay, bisexual, or transgender, and 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).

How HHS weighs in on LGBTQ rights
Section 1557 of the ACA prohibits discrimination in federal healthcare programs against groups covered by various anti-discrimination laws, such as the Civil Rights Act. Subsequent HHS regulations indicate the department considers these laws to apply to LGBTQ federal beneficiaries as well, and the language in a proposed HHS rule issued on September 8, 2015, suggests that a final rule will make this explicit: “We believe that discrimination on the basis of sex further includes discrimination on the basis of gender identity.”

Regulation affecting healthcare providers increasingly refers to LGBTQ needs. For example, the most recent meaningful use final rule includes a requirement that certified electronic health record (EHR) technology be used to “record a patient’s sexual orientation and gender identity (SO/GI) in a structured way with standardized data” as “a crucial step forward to improving care for LGBT communities.”

The language of “cultural competency” is well established in HHS sub-departments, says Perry, as shown by tools like the 2012 MLN Matters, “Cultural Competency: A National Health Concern,” and the Office of Minority Health’s “Think Cultural Health” page.

“The number of increasing health disparities in minority and disadvantaged communities has indicated that there is a need for providers who understand and are able to relate to the sensitive needs of the population,” she explains.

Given this trend, it behooves providers to make sure they’re equipped to provide a welcoming environment to LGBTQ patients.

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Patient Safety Monitor.

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