What should be included in a comprehensive LGBTQ hospital health policy?

Comprehensive LGBTQ Hospital Health Policy Components

A comprehensive LGBTQ hospital health policy must include gender identity as part of nondiscrimination and antiharassment policies, inclusive definitions of family, patient-determined visitation rights, comprehensive transgender healthcare services, and mandatory cultural competency training for all staff. 1

Core Policy Components

Nondiscrimination and Antiharassment Policies

• Include gender identity, independent and fundamentally different from sexual orientation, in all nondiscrimination and antiharassment policies 1
• Ensure these policies apply to all medical schools, hospitals, physicians' offices, and other medical facilities within the healthcare system 1
• Prohibit denial of care based on LGBTQ status, addressing the concerning statistic that 19% of transgender persons report being denied medical care due to their transgender status 1

Inclusive Family Definition and Visitation Rights

• Define "family" inclusively to encompass those who maintain ongoing emotional relationships with patients, regardless of legal or biological relationships 1
• Allow all patients to determine who may visit and who may act on their behalf during their stay, regardless of sexual orientation, gender identity, or marital status 1
• Ensure visitation policies comply with Centers for Medicare & Medicaid Services Conditions of Participation and The Joint Commission standards 1

Comprehensive Healthcare Services

• Provide comprehensive transgender healthcare services through public and private health benefit plans 1
• Ensure all covered services are provided to transgender persons as they would be to all other beneficiaries 1
• Address specific healthcare needs of transgender patients, including hormone replacement therapy and appropriate cancer screenings 1

Medical Records and Data Collection

Electronic Health Records Adaptation

• Include gender identity and sexual orientation as components of patients' medical records 1
• Standardize information in electronic health records to include anatomy present, preferred name, and pronouns 1
• For paper medical records, implement flagging systems (e.g., stickers) to alert staff to use patients' preferred names and pronouns 1

Research and Data Collection

• Support collection of demographic data on the LGBTQ population 1
• Research potential causes of LGBTQ health disparities and best practices in reducing these disparities 1
• Use collected data to create tailored plans to decrease health disparities in the LGBTQ community 1

Education and Training

Staff Training Programs

• Incorporate LGBTQ health issues into medical school, residency, and continuing medical education curricula 1
• Develop knowledge base in cultural and clinical competency for all healthcare providers 1
• Train providers to approach transgender patient treatment by respecting gender identity while providing prevention, treatment, and screening appropriate to present anatomy 1

Recruitment and Support

• Implement programs to recruit LGBTQ persons into the practice of medicine 1
• Offer support to LGBTQ medical students, residents, and practicing physicians 1
• Address concerns that sexual orientation or gender identity may affect selection into medical programs or acceptance by peers 1

Physical Environment and Communication

Creating Welcoming Spaces

• Design clinical environments that are safe and welcoming for LGBTQ patients 2
• Make physical changes to the environment that signal inclusivity and safety 3
• Ensure clean and confidential systems for all patients 2

Communication Guidelines

• Establish simple clinical practice guidelines: ask appropriate questions and be open and nonjudgmental about answers 1
• Train providers to inquire about life situations, be concerned about family and important relationships, understand support systems, and make appropriate referrals when necessary 1
• Use inclusive language throughout all written and verbal communications 4

Implementation Considerations

Organizational Buy-In

• Secure support from key stakeholders before initiating policy changes 3
• Engage multidisciplinary teams including healthcare providers, legal professionals, and information technology experts 5
• Collaborate with the LGBTQ community in developing policies 5

Policy Evaluation

• Regularly review and update policies based on emerging research and best practices 6
• Monitor health outcomes for LGBTQ patients to assess policy effectiveness 6
• Track preventive care metrics, which show improved outcomes when patients have access to affirming providers 6

Common Pitfalls to Avoid

• Failing to distinguish between gender identity and sexual orientation in policies 1
• Assuming providers are knowledgeable about transgender health without specific training 1
• Implementing policies without input from the LGBTQ community 5
• Neglecting to address the specific needs of LGBTQ individuals who are also members of racial or ethnic minority groups 1
• Using outdated terminology or non-inclusive language in communications 4