Educational Strategies to Help Students Provide Respectful Sexual and Reproductive Health Care for Lesbian, Gay, Bisexual, and Transgender Persons

Abstract

Graduate medical, nursing, and midwifery curricula often have limited amounts of time to focus on issues related to cultural competency in clinical practice, and respectful sexual and reproductive health care for all individuals in particular. Respectful health care that addresses sexual and reproductive concerns is a right for everyone, including those who self-identify as lesbian, gay, bisexual, or transgender (LGBT). LGBT persons have unique reproductive health care needs as well as increased risks for poor health outcomes. Both the World Health Organization and Healthy People 2020 identified the poor health of LGBT persons as an area for improvement. A lack of educational resources as well as few student clinical experiences with an LGBT population may be barriers to providing respectful sexual and reproductive health care to LGBT persons. This article offers didactic educational strategies for midwifery and graduate nursing education programs that may result in reducing barriers to the provision of respectful sexual and reproductive health care for LGBT clients. Specific ideas for implementation are discussed in detail. In addition to what is presented here, other educational strategies and clinical experiences may help to support students for caring for LGBT persons prior to entrance into clinical practice.

Advancing health equity for lesbian, gay, bisexual and transgender (LGBT) people through sexual health education and LGBT-affirming health care environments

“…34 Some obvious challenges exist with regard to incorporating these best practices for sexual health care, including, in particular, the focus on sexual orientation and gender identity, into an effective educational methodology and implementation of this learning into clinical practice. 33 Sexual histories are by no means conducted routinely, 35 despite their importance in understanding risk of sexually transmissible infections (STIs). Although time constraints are a factor that many cite as a reason for not taking a history of sexual health, so are lack of experience and comfort talking about sexual orientation and gender identity with patients who identify in ways that may be different from the clinician.…”

“…This is particularly true because optimal LGBT education is best integrated throughout the clinical curriculum, rather than grouped into a single unit, using cases to illustrate the relevance of sexual orientation and gender identity. 33 Providing affirmative and welcoming care for LGBT people also involves going beyond educating students and faculty to ensure that healthcare organisations have policies and programs in place to guarantee that LGBT patients, students, faculty and staff feel affirmed, and that students, faculty and staff can feel comfortable to maximally contribute to the organisational mission. 13,14 The National LGBT Health Education Center has identified several key points for organisations seeking to create a truly welcoming and caring environment for LGBT people.…”

“…[30][31][32] Notable are sexual orientations outside the often-described concepts of 'straight', 'lesbian', 'gay' and 'bisexual' and their accompanying behaviours, as well as gender identities that reject the binary paradigm of only 'male' and 'female', thus providing alternative concepts and terminology to describe additional identities that occur along the entire gender spectrum. 24 These components can all be incorporated into a comprehensive history of sexual health, which would also include discussion of sexual practices, frequency and any desire to have biological children (of particular importance in reproductive planning for patients before beginning genderaffirming hormones), 33 as well as the experience of intimate partner violence. 34 Some obvious challenges exist with regard to incorporating these best practices for sexual health care, including, in particular, the focus on sexual orientation and gender identity, into an effective educational methodology and implementation of this learning into clinical practice.…”

Current Resources for Evidence‐Based Practice, November/December 2017

“…Now, in the most ambitious research effort to date on the health of LGBTQ people living in the United States, the Population Research in Identity and Disparities for Equality (PRIDE) study is recruiting participants . The PRIDE study is the first longitudinal study of the health of LGBTQ individuals in the United States.…”

“…The PRIDE study is the first longitudinal study of the health of LGBTQ individuals in the United States. Just as the famous Framingham Heart Study changed the way we understand cardiovascular risk factors, the PRIDE study has the potential to revolutionize the way we understand the development of health risks in the LGBTQ community . If you know people in your personal or professional life who identify as LGBTQ, share the PRIDE study link with them and encourage them to participate.…”