Primary Care Providers’ Attitudes, Practices, and Knowledge in Treating LGBTQ Communities

Abstract

Introduction: Cultural competency in lesbian, gay, bisexual, transgender, and queer (LGBTQ) healthcare has been found to be lacking within various medical specialties, but no studies have compared competency among primary care providers. Methods: The authors compared 127 primary care providers' cultural competency regarding LGBTQ health using a survey that assessed providers' attitudes, practices, and knowledge. Results: Overall, 78.0% of respondents agreed that they were comfortable treating LGBTQ patients. Yet many providers did not feel well informed on specific LGBTQ health needs, on clinical management of LGBTQ care, nor on referring patients with LGBTQ issues. Overall accuracy on LGBTQ knowledge questions was 51%. There were significant differences in attitudes, practices, and knowledge across medical specialties. Conclusions: This study revealed a lack of cultural competency among primary care providers. There is a need for greater LGBTQ-specific education to increase providers' comfortability and competency in the needs, management, and referrals within LGBTQ healthcare.

Evaluation of the four national lesbian, gay, bisexual, transgender, and queer (LGBTQ)-competent provider directories in the United States

“…On both the GLMA Provider Directory and OutCare Health OutList, which serve the general LGBTQ population, providers may list their particular subspecialties, e.g., having the ability to specify transgender expertise. Given that past research has shown that providers' funds of knowledge differ between general LGBTQ education and populationspeci c pro ciency (e.g., the transgender population) [12], it is paramount that provider directories specify…”

“…The etiology of such LGBTQ disparities is multifaceted and appreciably a function of insu cient provider cultural competency. For example, both students and providers have been shown to harbor biases [8,9] and negative attitudes [1,2,10], infrequently inquire about sexual orientation and gender identity [11][12][13], and demonstrate shortcomings in education [12][13][14][15][16]. In addition, many LGBTQ patients encounter high rates of refusal of care and exposure to verbal and physical violence during healthcare physical examinations, which can subsequently lead to postponement of healthcare needs, delay in receiving medication, and avoidance of obtaining routine and urgent healthcare services altogether [1,17].…”

Intersectional Effects of Sexual Orientation Concealment, Internalized Homophobia, and Gender Expression on Sexual Identity and HIV Risk Among Sexual Minority Men of Color: A Path Analysis

“…The lack of provider trust and access to affordable screening and treatment exponentially increases the degree of HIV risk in the sexual networks of SMM. Lack of culturally and medically competent providers on issues relating to lesbian, gay, bisexual, transgender, queer, asexual, intersex, and others (LGBTQ+) health ( Institute of Medicine, 2011 ; Nowaskie & Sowinski, 2019 ) and individual-/community-level factors, such as heteronormative assumptions stemming from group-based, cisgender, heterosocial hierarchies ( Parrott, 2009 ; Ray & Parkhill, 2021 ), have resulted in mistrust and misinformation about health risks ( Jaiswal et al, 2020 ; Ramos et al, 2019 ) and have perpetuated racism and discrimination among minoritized groups ( Arscott et al, 2020 ; Quinn et al, 2019 ), leading to experiences of internalized homophobia.…”

Educating health and social care practitioners on the experiences and needs of older LGBT+ adults: Findings from a systematic review

“…Gaps in knowledge and cultural competency of health and social care practitioners working with LGBT+ older adults need attention but are yet to be prioritized (Bell, Bern‐Klug, Kramer, & Saunders, 2010; Greene et al, 2018; Nowaskie & Sowinski, 2019).…”