LGBTQ+ youth comprise a patient population that needs a culturally competent approach from thoughtful healthcare providers. If we can provide high-quality, unbiased nursing care for LGBTQ+ youth, we can more readily meet the needs of this group vulnerable to health disparities.

Previous experience of prejudice can be a deterrent to seeking care. Fear of stigma and encountering discrimination is a key factor that can contribute to LGBTQ+ youth avoiding contact with the healthcare system.

Nurses are in a unique position to create more equitable care for LGBTQ+ youth. As the largest segment of the healthcare workforce, nurses have more points of contact with patients than other providers.

Nurses can seize the opportunity to bridge the gaps of care, tapping into the potential for connection, trust, patient engagement, and decreased negative outcomes. Keep reading to find out more about how to care for LGBTQ+ youth.

Health Disparities for LGBTQ+ Youths

According to the National LGBT Health Education Center, such youth experience:

  • Double to triple the likelihood of suicide attempts
  • Increased likelihood of homelessness
  • Higher incidence of bullying
  • Higher risks of being infected with sexually transmitted infections (STIs) and HIV

There is also a higher risk of LGBTQ+ youth becoming victims of human trafficking. LGBTQ+ youth may also experience abuse by their parents or guardians.

The Center for American Progress further identifies common health disparities:

  • Lower rates of screening for certain diseases
  • STIs
  • Risk factors such as the misuse of alcohol, tobacco, and illicit drugs
  • Sexual abuse and violence
  • Social isolation
  • Anxiety and depression
  • Altered body image and eating disorders

Barriers to Care for LGBTQ+ Youths

Many barriers stand in the way of LGBTQ+ patients and youth accessing healthcare services, which can contribute to health disparities. Barriers to accessing care include:

  • Being refused care based on perceived or actual sexual orientation or gender identity
  • Difficulty finding providers
  • The cost of care and lack of health insurance
  • Stigma
  • Lack of access to affordable transportation
  • Fears regarding privacy and lack of confidentiality
  • Previous experiences of discrimination, dismissal, bullying, or criticism

In terms of providing information to LGBTQ+ youth regarding the availability of care, barriers include:

  • Mistrust of the healthcare system
  • A lack of sufficient relevant data on the LGBTQ+ youth population experience
  • Misunderstanding on the part of providers regarding the correct use of inclusive, respectful language (such as pronouns, identifiers, etc.)
  • Printed and online materials using outdated and incorrect language that excludes patients' own identified culture or group

For LGBTQ+ youth of color, the barriers are intensified when discrimination based on race or racial identity is superimposed over the barriers already faced by all LGBTQ+ youth.

Best Practices for Nurses Caring for LGBTQ+ Youths

Nurses and their colleagues can learn from others who have already blazed the trail in terms of best practices when it comes to nursing care for LGBTQ+ youth.

When practices based on previous success are adopted, crucial inroads can be made to decrease avoidable health disparities that affect LGBTQ+ youth. For instance, nurses should be aware of issues such as the cost, side effects, and access to certain medications and other treatments, like hormone blockers.

The following five best practices provide excellent ground in caring for LGBTQ+ youth.

Helpful LGBTQ+ Resources for Nurses

  • The Trevor Project

    The Trevor Project is dedicated to the prevention of suicide among LGBTQ+ youth. Through 24/7 crisis intervention and counseling via chat, call, and text, as well as its resource center and 400,000-member online youth community, The Trevor Project is the largest organization of its kind in the world.
  • CDC Additional Resources for Health Care Providers

    This Centers for Disease Control and Prevention-sponsored listing offers information for healthcare providers who work with LGBTQ+ patients. Resources include training, clinical protocols, information on billing and insurance, and links to topics such as legal issues and human rights.
  • Fenway Institute

    The Fenway Institute offers education, resources, and consultation for healthcare organizations that seek to improve care for the LGBTQ+ community. Webinars, publications, continuing education, conferences, videos, and learning modules are all available for interested providers and organizations.
  • American Nurses Association Position Statement on Nursing Advocacy for LGBTQ+ Populations

    This position statement by the flagship nurses organization in the U.S. provides specific guidance regarding the ANA Code of Ethics and its recommendations on the provision of culturally competent care for these vulnerable populations.
  • Indian Health Service LGBT Provider Resources

    This online resource published by the IHS includes provider resources on LGBTQ+ cultural competency, guidance on gender and pronouns, and the care of families and children. It also has information about HIV/AIDS, elder populations, transgender health, and LGBTQ+ youth.
  • Advancing Health Equity: A Guide to Language, Narrative, and Concepts

    Created by the American Medical Association in partnership with the Association of American Medical Colleges Center for Health Justice, this guide offers comprehensive language and communication guidance for physicians and other healthcare professionals working with minority and marginalized communities.

Sources

• Focus on forms and policy: creating an inclusive environment for LGBT patients. (n.d.).
https://www.lgbtqiahealtheducation.org/wp-content/uploads/2017/08/Forms-and-Policy-Brief.pdf

• Hadland, S, et al. (2017). Caring for LGBTQ youth in inclusive and affirmative envornoments.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5119916/

• Krehely J.(2009). How to close the LGBT health disparities gap.
https://www.americanprogress.org/article/how-to-close-the-lgbt-health-disparities-gap/

• Providing inclusive services and care for LGBT people. (n.d.).
https://lgbtqiahealtheducation.org/wp-content/uploads/Providing-Inclusive-Services-and-Care-for-LGBT-People.pdf

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