Working Towards LGBTQ Health Equity

In health care, we inherently understand that care must be tailored to individuals, as patients have different needs. For example, if a patient walks in with an ear infection and another patient comes in with a broken arm, we treat each patient differently, according to their needs, in order to provide the best care possible.

For some reason this logic fails us when we are working with patients across marginalized identities, including lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals. This, mostly unconscious, bias in favor of majority identities perpetuates health disparities. For example, LGBTQ individuals are “significantly less likely than others to have health insurance, are more likely to report unmet health needs, and, for women, are less likely to have had a recent mammogram or Papanicolaou test.”

When training health professionals, I’ve heard folks at various levels (medical assistants, nurses, providers, etc.) say that they don’t need training on LGBTQ patient care, because they treat all patients “equally.” Yet this equality framework fails to acknowledge that LGBTQ patients have different needs than cisgender and straight patients and that we cannot provide excellent care without adjusting appropriately.

Instead of continuing to use the equality framework, I propose we utilize a health equity approach to care, which simply means that we tailor our care to our patients needs. Equitable care is provided when we adjust our care appropriately so LGBTQ individuals have equal outcomes compared to their straight/heterosexual and cisgender counterparts.


Image credit: Interaction Institute for Social Change

Learn more about the fascinating history of this image here!

How can we improve health equity for LGBTQ patients?

Providing equitable care for LGBTQ individuals means health care professionals need to know who their patients are, how they identify, who their support systems are, and how their relationships and identities impact their well-being.

As a health professional, the only way to improve care for LGBTQ patients is to understand how their lived experiences differ from straight and cisgender patients. LGBTQ identity/ies can impact:

  • Access to Care
  • Preventative Services
  • Family Building
  • Relationships
  • Family Support
  • Safety (Intimate Partner Violence and Domestic Violence)
  • Work
  • HIV Exposure
  • and more!

The first step towards providing equitable care for your LGBTQ patients is to simply identify who they are. Here are a few ways you can identify LGBTQ patients and make them feel safe and comfortable in clinical spaces.

Don’t assume the name in the chart is the name your patient wants you to use.

Your initial introduction can make or break the entire encounter. Transgender and gender non-binary patients in particular will take note if you make assumptions about their name and/or pronouns, as electronic medical records may or may not align with the name they use and their gender.

Here’s an example of an inclusive introduction:

You: “Hi, I’m [insert your name] and I will be working with you today. How would you like me to address you today?”

Patient: “Hi, [your name].  Please call me [patient’s name].”

You: “Lovely to meet you, [insert patient’s name here]. What pronouns do you use? For example, I use [insert your pronouns, ex: she/her].”

Do ask about sexual orientation and gender identity (SOGI).

The only way to find out who your LGBTQ patients are is to ask.

In addition to typical medical and social health history questions, ask every patient the following:

  • “How do you identify your sexual orientation?”
  • “What was your sex assigned at birth?”
  • “What is your gender/gender identity?”

If your straight and/or cisgender patients are uncomfortable with these questions, take a teaching moment to share why these are important questions for all patients.

Trust your patients and learn from them.

Our patients know themselves and their lives best. Believe what they tell you and take the time to learn about their identities and their health care needs between visits. Self-reflection and cultural humility are critical skills when working with all patient populations. Remember that working towards equitable and inclusive care is an ongoing process, so be patient with yourself and expect to make mistakes as you learn.

I have an LGBTQ patient! Now what do I do?

Great question! The next step in providing equitable care is to critically assess how your patient’s identity/identities impact their health needs.

Keep following this series and the GLMA Nursing blog to learn more about how to assess your patients’ needs and improve your clinical management of LGBTQ individuals.

Can’t wait? Check out GLMA’s archived webinars to learn more about providing LGBTQ-inclusive care.

CookTiffanyETiffany E. Cook is the Training and Professional Development Program Coordinator at NYU School of Medicine’s Office of Diversity Affairs. She received her undergraduate degree in General Studies with a minor in Women’s and Gender Studies from the University of Idaho and is currently applying to nursing school with plans to become a Family Nurse Practitioner. She serves on the GLMA Nursing Section’s Web Team and can be found on Twitter at @TiffanyECook.


A warm hello from Patti Zuzelo, your GLMA Nursing Section Recorder!

I attended my first GLMA conference this past September and it was a powerful and uplifting experience. Attendees were friendly and passionate about their areas of interest and expertise. Quite honestly–it was one of the best conferences that I have attended in my 30+ years of conference-attending! I am privileged to serve on the first GLMA Nursing Section leadership team and, as a new and first Recorder, am still learning the ropes (you may interpret this information as an ongoing request for feedback, suggestions, and directions Smiley  color head shot 2I thought that it might be helpful to introduce myself a bit–I am on the faculty of Drexel University’s College of Nursing & Health Professions as a Clinical Professor in the Doctoral Department of the Graduate Nursing Program ( Recently, I have focused on developing my understanding of LGBTQ health concerns and contributing to advancing health equality and equity. I have a lot to learn but my delightful LGBTQ colleagues are helping me along (particularly Dr. Peggy Chinn–what an inspiration!). I serve on the American Academy of Nursing’s LGBTQ Expert Panel and am credentialed as an Adult Health CNS and as an Adult NP.

Now that I have shared a brief introduction–I have a request of each of you. Spread the word about GLMA and about GLMA’s newly created Nursing Section. Make certain that your friends, colleagues, and family know about the many varied opportunities to contribute to GLMA’s mission ensuring “equality in healthcare for lesbian, gay, bisexual and transgender (LGBT) individuals and healthcare providers.” Let me be candid–there is a lot of work that must be done in nursing education and practice. This work requires the combined efforts of LGBTQ individuals and straight allies. There are many opportunities to engage and these opportunities are life-changing and life-enhancing. In my role as professor, I am increasingly sensitive to the gaps in nursing education’s lived curricula. There are gaps in what we teach…or what we do not teach…that must be addressed. Please spread the word that GLMA and its Nursing Section are wonderful opportunities to learn and contribute–even if you are not GLBTQ or have no particular expertise–just a passion for health equality and a desire to contribute in large or small ways. Go Phillies

Please stay in touch! If you are involved in nursing education and would like to explore ways to become engaged and connected to LGBTQ and health equality opportunities–I would enjoy hearing from you!