Jonas Mary Cabell, Egan Keith, Sheu Yi-Shin, McCarthy Richard J, Horberg Michael A
Mid-Atlantic Permanente Research Institute, Rockville, MD 20852, USA.
Mid-Atlantic Permanente Medical Group, Rockville, MD 20852, USA.
Healthcare (Basel). 2023 Oct 24;11(21):2816. doi: 10.3390/healthcare11212816.
When accessing medical care, lesbian, gay, bisexual, transgender, queer/questioning plus (LGBTQ+) individuals face many known challenges, including stigma, discrimination, and health disparities. Transgender and nonbinary individuals often encounter physicians and staff who are not knowledgeable about gender-affirming services and the transition journey. Finding an affirming physician can be a trial-and-error process, causing concern and uncertainty. In 2021, Kaiser Permanente Mid-Atlantic States (KPMAS) researchers published a study examining the gaps in care and experience for transgender and nonbinary patients within the KPMAS healthcare system. KPMAS realized an opportunity to both close the gaps in care identified by transgender and nonbinary patients and enhance services for the broader LGBTQ+ patient community by creating Pride Medical at Capitol Hill-an additional and optional care site for individuals who identify as LGBTQ+. During the analysis timeframe of 30 June 2021 through 30 November 2022, 586 patients accessed care through 763 visits. A total of 675 visits (88%) were for primary care and 88 (12%) for OB/GYN. Over 50% ( = 384) of total visits were conducted virtually. The plurality of patients seen identified as a man (35%; = 204) and gay (30%; = 176). Postvisit survey results showed that 92% of survey respondents strongly agreed that the physician treated them with courtesy and respect, and 72% of survey respondents rated their overall care as excellent. Survey results show high acceptability of this program among the patients served. Pride Medical does not carve out care. The program offers patients access to a more specialized team of physicians-a similar model to other specialties-that is easily found by the division name Pride Medical. Layering additional specialty divisions on top of existing care, for interested patients, could be an option for other medical groups and health systems seeking to offer additional options of care for interested LGBTQ+ patients.
在寻求医疗服务时，女同性恋、男同性恋、双性恋、跨性别、酷儿/疑问者及其他群体（LGBTQ+）面临着许多已知的挑战，包括污名化、歧视和健康差距。跨性别者和非二元性别者经常遇到对性别肯定服务和过渡过程缺乏了解的医生和工作人员。找到一位支持性的医生可能是一个反复尝试的过程，会引发担忧和不确定性。2021年，凯撒医疗集团中大西洋各州（KPMAS）的研究人员发表了一项研究，调查了KPMAS医疗系统中跨性别和非二元性别患者在护理和就医体验方面的差距。KPMAS意识到，通过在国会山创建骄傲医疗中心——一个为LGBTQ+身份认同者提供的额外的可选护理场所，可以弥合跨性别和非二元性别患者所指出的护理差距，并为更广泛的LGBTQ+患者群体加强服务。在2021年6月30日至2022年11月30日的分析时间段内，586名患者通过763次就诊获得了护理。总共675次就诊（88%）是为了初级保健，88次（12%）是为了妇产科。超过50%（=384次）的就诊是通过虚拟方式进行的。就诊的患者中，多数被认定为男性（35%；=204人）和同性恋者（30%；=176人）。就诊后调查结果显示，92%的调查受访者强烈同意医生以礼貌和尊重的态度对待他们，72%的调查受访者将他们的整体护理评为优秀。调查结果表明该项目在接受服务的患者中具有很高的可接受性。骄傲医疗中心并没有划分出专门的护理领域。该项目为患者提供了接触更专业医生团队的机会——这与其他专科类似的模式——通过骄傲医疗这个科室名称很容易找到。对于有兴趣的患者，在现有护理基础上增加额外的专科部门，可能是其他医疗团体和医疗系统为有兴趣的LGBTQ+患者提供更多护理选择的一个选项。
