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Cynthia Gutierrez, PharmD, MS, BCPP
CPNP Program Committee Chair

This session can be purchased in CPNP University.

Health care disparity is a serious issue for many populations, including the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community. LGBTQ patients face unique challenges when seeking care for mental health, despite an increased risk for mental illness, substance abuse and suicide. Health care providers can help by providing a safe environment for LGBTQ patients. Dr. Lea Mollon, PharmD, shared her knowledge and experiences to demonstrate ways to improve cultural sensitivity in her session Caring for Patients in the Community of LGBTQ: Increasing Cultural Awareness.

During this session, Dr. Mollon presented up-to-date information on culturally sensitive communication with LGBTQ patients, and provided a glossary of appropriate terminology related to LGBTQ issues. She also described concerning statistics on the rate of mental illness in the LGBTQ community, which is two to three times higher than in the general population. Mood disorders, depression, and anxiety are common, and are seen in adult LGBTQ population as well as gay and lesbian youth. Substance abuse, including tobacco, alcohol, and illicit substances, is reported more frequently in the LGBTQ community, with 20 to 30% reporting substance abuse versus 9% in the non-LGBTQ population. Suicide is a major concern in LGBTQ individuals, as suicide is a leading cause of death in LGBTQ aged 10 to 24. In transgender individuals, up to 65% experience suicidal ideation, and 40% have reported a suicide attempt, most before the age of 25. Contributing factors include lack of support, harassment, substance abuse, and mental health disparities.

In a survey, over 50% of lesbian, gay and bisexual individuals, and over 70% of transgender individuals, report discrimination in health care, including outright refusal to provide treatment. Lesbian, gay and transgender persons have reported harsh language from health care providers and being blamed for their health status. Some reported that health care providers refused to touch them. During visits, health care providers may focus more on sexual orientation and gender identity. Further, LGBTQ persons are less likely to seek medical care for fear of discrimination. Additionally, LGBTQ individuals are less likely to have health insurance or afford medical care.

Despite this, many health care professional programs do not include topics related to LGBTQ health. Improving communication skills, including psychosocial training, is a benefit caregivers and patients alike by allowing the provision of culturally affirming care. Good communication skills include use of appropriate gender pronouns and knowledge of LGBTQ identities and terminology, while avoiding stereotypes. It is important for health care professionals to recognize that sexual orientation is not the same as sexual behavior. Providing a welcoming environment can be very helpful to having a fruitful visit. Dr. Mollon provided a case example to demonstrate appropriate ways to communicate with LGBTQ patients to improve open dialogue and obtain vital patient information. At the end of the session, many helpful resources for health care providers including web addresses were provided.

Take Home Points

  • Despite increased prevalence of mental health issues including mood disorders, substance abuse, and suicide, members of the LGBTQ community are less likely to seek health care treatment.
  • Discrimination (or fear of), lack of financial resources and health care insurance, and the tendency for providers to focus on sexual orientation, contribute to health care disparity in the LGBTQ community.
  • Culturally sensitive communication skills and a welcoming environment can reduce fear of discrimination and improve dialogue between patient and provider.


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  7. National Alliance on Mental Illness. LGBTQ.
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