Providing inclusive, equitable access to health care to members of the LGBTQ+ community is a consistent commitment at Penn State Health, not just during Pride Month but every day. Meeting the diverse needs of this community requires a comprehensive approach, just as it does for people of every community, no matter their background or culture.
June 20, 2024
And those needs often are universal, said Dr. Claire Roden, director of the Gender Health Program at Penn State Health Children’s Hospital. “When we treat patients who have felt rejected by their families, the one constant we hear is that they want love and support, especially from their families, who are the most important people in their lives.”
Equity in health care is about equal access to health care for everyone, added Dr. Hannah Wenger, an internal medicine specialist at Penn State Health. “It means creating safe spaces for folks walking in the door to access health care like anyone else. At its core, health equity is about safety.”
Safety issues trigger specific needs
Beyond safe spaces, marginalized groups often face the challenges of specific health care needs. Research shows that members of the LGBTQ+ community are at greater risk for anxiety, substance use disorders, suicidal thoughts and eating and mood disorders.
These conditions are often caused by how members of minority communities are treated. The national Trevor Project, a suicide prevention and crisis intervention nonprofit organization for youths identifying as LGBTQ+, notes that “LGBTQ+ young people are not inherently prone to suicide risk because of their sexual orientation or gender identity but rather placed at higher risk because of how they are mistreated and stigmatized in society.”
Comprehensive care
While the LGBTQ+ community is part of every race, ethnicity, religion, age and socioeconomic group, its youth are also at higher risk for sexually transmitted diseases, cancers, cardiovascular diseases, obesity, bullying and the effects of isolation, including depression, compared to the general population, according to the National Institutes of Health. LGBTQ+ adults are more likely to have HIV/AIDS, higher rates of breast cancer and HPV infections or report their health as poor while receiving less social support.
Significant health care advancements address these concerns. Penn State Health’s Department of Infectious Diseases offers comprehensive treatment services for people living with HIV/AIDS, which affects individuals of all populations, not just those identifying as LGBTQ+. Of particular importance, treatment today can include PrEP, or pre-exposure prophylaxis, which has transformed HIV prevention since its introduction 10 years ago.
The health system also offers care for transgender and gender-diverse individuals focused on creating an environment of acceptance, understanding and mutual respect. Additional key services include cancer treatment, mental health programming and care for comorbidities.
Treating the individual
An emphasis on equitable care incorporates respect and understanding. Assumptions about identity or gender based on appearance can send negative messages. Using correct pronouns is equally important to ensure all patients feel heard, valued and respected.
In addition, media attention may sensationalize gender incongruence and dysphoria, said Roden, also an assistant professor of pediatrics at Penn State College of Medicine. Gender dysphoria is a condition where a person’s biological sex doesn’t match their gender identity, causing them distress. Recent College of Medicine and Penn State research, co-authored by Roden, found that “many adolescents with gender-specific needs, are capable of asserting specific treatment goals. Most do not desire genital surgery. Most patients had a goal of initiating hormone therapy (97.4%) and eventual surgery (87.1%). Of those who had a surgical goal, most (87.5%) desired surgery of the chest or breast” [Penn State Health does not perform gender-affirming surgery on minors].
The 2022 U.S. Trans Survey found that 98% of respondents then receiving hormone treatment for their gender identity or transition “made them either ‘a lot more satisfied’ (84%) or ‘a little more satisfied’ (14%) with their life.” However, nearly one-third reported being verbally harassed in the past year because of their gender identity or expression, and 40% had considered moving to escape discrimination.
Those findings, said Roden, underscore the importance of treating and respecting each person as a unique individual.
“In primary care,” Wenger noted, “you see all sorts of medical needs. The special care that a transgender person needs, for example, is really very similar to the care I provide to all patients. In the end, you try to be a good physician, a good person and see the person in front of you and respect them for who they are.”