The celebration of Pride Month has focused a spotlight not only on the important voices and critical progress made by the LGBTQ+ community but also on issues that still must be addressed to create a more inclusive, equitable and supportive society. Equity and inclusiveness in health care settings remain a significant challenge for LGBTQ+ patients, many of whom report negative experiences with caregivers that create barriers to their ability to receive adequate care.
UCLA Health is breaking down those barriers through its LGBTQ+ Health Initiative and the Urology department-sponsored Gender Health Program, which seek to increase education and heighten awareness and sensitivity about LGBTQ+ community health concerns.
Dr. Jesse Mills, an associate clinical professor of Urology, director of The Men’s Clinic at UCLA and a physician in the Gender Health Program, offers insight into how LGBTQ+ individuals can navigate the health care setting and shares common concerns seen by physicians.
What should you expect from your provider when meeting him/ her/ them for the first time?
You should expect the same level of respect and compassion that any patient would receive. At UCLA Health, we provide equitable health care to all patients regardless of sexual orientation or gender identity. Should this be relevant to your specific medical needs, we engage in those conversations in a sensitive and compassionate manner. For example, when seeing transgender patients or gender non-binary patients who are seeking genital gender-affirming surgery, our clinicians may need to ask more personal questions regarding sexual preferences and practices.
What is UCLA doing to improve care for LGBTQ+ patients?
The Gender Health Program was developed to provide comprehensive, compassionate and affirming care for transgender individuals. We have made improvements to our electronic medical records to allow us to capture patients’ preferred gender pronouns, sexual orientation, gender identity and there is a new LGBTQ+ fellowship program to train interested physicians about providing care for this population. Our medical school has programs to educate the next generations of doctors and promote awareness and inclusivity, including faculty webinars to talk about specific topics in LGBTQ+ health care. UCLA is also committed to working with local and national organizations and health systems to advance and advocate for LGBTQ++ health equity.
What are some of the common health concerns of LGBTQ+ patients?
Although there are no LGBTQ+-specific diseases, research has shown that there is a disproportionately high prevalence of HIV/AIDS, mental health concerns, substance misuse and co-morbidities among the LGBTQ+ community. Members of the LGBTQ+ community are also more likely to experience difficulty accessing health care. At UCLA Health, we welcome the opportunity to collaborate with our LGBTQ+ patients to identify their unique care needs and follow a “whole person” approach to care.
The Men's Clinic at UCLA is an inclusive clinic that serves a diverse population of people with sexual health and fertility issues. Good sexual health is a cornerstone of good physical health, and that is no different for the LGBTQ+ population. As is true in all patient populations, it is important to address mental health concerns. Appropriately managing lifestyle factors such as stress reduction, nutrition and exercise habits is equally important to the LGBTQ+ population.
What are the reproductive health concerns of the transgender community?
Reproductive health in the LGBTQ+ population offers unique opportunities to help achieve the parenting goals. We are able to provide fertility counseling specific for LGBTQ+ patients. Advances in reproductive medicine allow us to offer the chance for gay cis-men and women to be biological parents and for trans-men and women as well. Being proactive and banking sperm and eggs prior to gender-affirmation hormones and surgery is, of course, critical to achieving these goals.
What unique concerns has the COVID-19 pandemic presented for the LGBTQ+ community?
The pandemic has forever changed the way we deliver health care to all communities. Telehealth, for example, has become a very important tool. Because of experiences in the past, many LGBTQ+ patients are reluctant to come in for a traditional office visit. In that regard, we see the expanded use of telehealth as a huge advantage for the LGBTQ+ population. A center of excellence such as UCLA Health can expand its geographic reach to treat and counsel patients in areas that might not have the medical infrastructure or physician enthusiasm to care for this population.
How can someone find a health care provider who is knowledgeable about LGBTQ+ concerns?
All providers at UCLA Health can be approached with any concerns that patients have, regardless of sexual orientation or gender identity. We are committed to serving and caring for our patients. With that being said, patients can find a “LGBTQ+ Champion” by searching through our provider directory and looking for a “rainbow U” next to that person’s name. LGBTQ+ Champions are self-identified providers that have experience directly caring and addressing LGBTQ+ patient concerns or who are interested in learning and providing LGBTQ+ competent care. At UCLA, our LGBTQ+ Health Initiative has the mission to deliver compassionate, inclusive and equitable care to support our diverse LGBTQ+ community. We encourage anyone who are searching for a provider to visit uclahealth.org/lgbtq-champions.