1 National LGBT Health Education Center at The Fenway Institute, Fenway Health, Boston, Massachusetts.
2 Division of Infectious Diseases, Department of Medicine, University of California San Francisco School of Medicine, San Francisco, California.
LGBT Health. 2018 Nov/Dec;5(8):461-468. doi: 10.1089/lgbt.2018.0118. Epub 2018 Nov 7.
LGBT populations require expanded access to healthcare that meets their unique needs. This article presents the primary findings of a training and technical assistance needs assessment conducted with healthcare organizations in geographically diverse areas of the United States to help determine gaps in LGBT health familiarity, preparedness, comfort, and practices.
A total of 5980 staff members and 638 leaders from 18 healthcare organizations participated in online needs assessment surveys. Cross-sectional findings and significance were evaluated using descriptive statistics and two-sample t-tests.
Significantly more clinicians agreed that they were familiar with lesbian, gay, and bisexual health needs compared with being familiar with transgender health needs (81.7% vs. 68.3%, p = 0.005). The majority of clinicians rarely or never talked to their patients about sexual orientation (55.4%) or gender identity (71.9%), mostly due to believing that the topics were not relevant to care, concerns with making the patient uncomfortable or offending the patient, lack of experience, and not knowing the appropriate language for talking about the subjects. Nearly one-third of staff respondents did not know if sexual orientation or gender identity/expression was included in organizational nondiscrimination patient policies.
Although clinicians may self-report that they are familiar with LGBT health issues, gaps in practice and knowledge indicate the need for more training, especially in transgender health and in talking to patients about sexual orientation and gender identity. Healthcare organizations also need support in ensuring that their organizations create inclusive environments by educating staff and leadership on nondiscrimination policies.
LGBT 群体需要扩大获得满足其独特需求的医疗保健的机会。本文介绍了一项培训和技术援助需求评估的主要结果，该评估在美国地理上不同地区的医疗保健组织中进行，旨在帮助确定 LGBT 健康熟悉度、准备度、舒适度和实践方面的差距。
共有 18 家医疗保健组织的 5980 名员工和 638 名领导人参与了在线需求评估调查。使用描述性统计和双样本 t 检验评估了横断面研究结果和显著性。
与熟悉跨性别健康需求相比，更多的临床医生表示他们熟悉女同性恋、男同性恋和双性恋健康需求（81.7%比 68.3%，p=0.005）。大多数临床医生很少或从未与患者谈论过性取向（55.4%）或性别认同（71.9%），主要原因是他们认为这些话题与护理无关，担心让患者感到不舒服或冒犯患者，缺乏经验，以及不知道谈论这些话题的适当语言。近三分之一的员工受访者不知道性取向或性别认同/表达是否包含在组织的非歧视性患者政策中。
尽管临床医生可能会自我报告说他们熟悉 LGBT 健康问题，但实践和知识方面的差距表明需要更多的培训，特别是在跨性别健康以及与患者谈论性取向和性别认同方面。医疗保健组织还需要支持，通过教育员工和领导层了解非歧视政策，确保其组织创造包容的环境。
