The LGBT youth patient experience

Transcription

1 The LGBT youth patient experience Objectives Remi Newman-Espinoza, MA, CHE II Define LGBTQQI Identify health disparities and barriers to care for LGBT youth Learn tools to better serve LGBT youth Improve health outcomes for LGBT youth members Barriers to culturally competent care for LGBT members LGBTQQI: What does it all mean? Invisibility Heterosexism Homophobia and transphobia Limited research Lack of knowledge and sensitivity related to LGBT healthcare issues Lesbian Gay Bisexual Transgender Queer Questioning Intersex LGBT Youth defining themselves HRC s report, Growing Up LGBT in America, is a groundbreaking survey of more than 10,000 LGBT-identified youth ages

2 identity: how people experience their gender; how they see themselves expression: how people express their gender identity personally and in public Nonconforming: People who do not follow the cultural stereotypes of gender in their environment Generally are not seeking hormone therapy or surgery queer: People who reject the binary system of gender. Some define themselves as androgyne, bi-gender, gender neutral, third gender May use new pronouns: ze, xe, zhe, hir, zir Trangender: People who experience their gender as incongruent with the gender assigned at birth dysphoria: Transgender identity + Marked discomfort Terms Transsexual: originally defined by Harry Benjamin in The Transsexual Phenomenon (1966) FTM or Transman MTF or Transwoman identity disorder (GID) Going stealth and defining oneself simply as male or female Identity Disorder- DSM-IV Strong and persistent cross-gender identification Persistent discomfort with one s sex or sense of inappropriateness in the role of that sex Causes clinically significant stress or impairment 2

3 Kaiser care path for youth in transition Transgender pediatric clinic in Oakland has interdisciplinary team of pediatricians, endocrinologists and psychotherapists If at least one parent is supportive, child can receive services Degree of success in treating GID is directly correlated to the degree of acceptance by parents and family LGBT Youth Stigma, bullying and hate crimes: The home is the first battleground Many LGBT youth are rejected by family Many experience verbal and physical harassment by family members Some run away; some are forced to leave home High risk for substance abuse, sexual assault, STI s, prostitution, suicide LGBT Youth at high risk Adolescents who report same sex attraction or relationships are at more than 2 times the risk for suicide attempts. 1/3 of attempts in teen boys are related to issues of sexual orientation or gender identity Adolescent sexual orientation and suicide risk: evidence from a national study, American Journal of Public Health, August 2001 Psychosocial Issues Protective factors that promote resilience: Having a personal talent Having a positive connection to an adult (not necessarily a family member) Being enrolled in school (provides a safety net and structure) Inclusive/permissive questions can include a lot of teens wonder if the sexual feelings they have been having are normal--is that something you have been wondering about? What is culturally competent care? Assess your own comfort level Be welcoming Build trust Provide continuity of care Assure confidentiality Recognize partners Don t make assumptions Show RESPECT Make it a team effort, from registration, to the exam room, to the pharmacy, the laboratory, the blood pressure clinic, etc. Create a supportive environment for LGBT youth Redecorate have reading materials that are inclusive and specific to LGBT persons in the waiting and exam rooms Display LGBT inclusive images in facility Keep list of resources for LGBT members Zero tolerance for homophobic or transphobic remarks from any staff member throughout the medical center 3

4 Create a supportive environment for trans youth Be inclusive Pronouns and names matter! Be affirming! If you must ask sensitive questions, explain why the info is necessary Let them know their privacy is protected Build a strong rapport before conducting a physical Allow patients to remain clothed to the greatest extent possible Appropriate intake forms -neutral restrooms Identify yourself as LGBT friendly Be Supportive At KP Santa Rosa/Rohnert Park we keep a confidential list of providers who are knowledgeable on LGBT Healthcare needs to facilitate referrals and care. To add your name to this list contact: Karen Latiker, New Member Service Keep a copy of the KP Provider Handbook on culturally competent LGBT care in your office LGBT Resources youth tgnbsupport@gmail.com--mtf local support group local support group Transgender standards of care LGBT youth; parents of trans youth LGBT youth suicide prevention The Gay and Lesbian Medical Association (GLMA) Medical Resources Medline Plus Gay and Lesbian Health ndlesbianhealth.html 4

5 Local Resource for LGBT Youth, Trans Adults and Parents of trans youth Thank you! Sonoma County s Center for Queer Youth & Young Adults Positive Images 312 Chinn Street, Santa Rosa, CA