This is important as 40% of LGBT New York State residents believed there were not enough health professionals who were adequately trained and competent to deliver healthcare to them ( Frazer, 2009). Improving LGBTQI health will require physicians competent in providing care for these communities. In a survey of LGBT cancer survivors, many expressed fear of substandard care if they came out to their providers ( Margolies & Scout, 2013). These disparities may contribute to mistrust of health care systems. For example, 9% of white LGBT people reported refusals of care while 22% of Latino, 18% of black, 32% of indigenous, and 14% of mixed race LGBT people reported refusals, suggesting further marginalization among these groups ( Frazer, 2009_). Disparities are amplified in communities of color 6. Denials of care are as common as 19% for transgender people ( Grant et al., 2011). In a recent survey of New York State residents, 32.9% of transgender people lacked insurance, compared to 14.5% of non-transgender people ( Frazer, 2009). Women who have sex with women are less likely than other women to have insurance, a primary care provider, or recent cancer screening ( Kerker, Mostashari, & Thorpe, 2006). Another group at risk is intersex 5 people whose chromosomes or anatomy do not match medical definitions of male or female.Äisparities in health care received by LGBTQI people were also recognized by the American Medical Association as early as 1996. Lesbian, gay, bisexual, and transgender (LGBT) 4 people experience disproportionate levels of mental illness tobacco, alcohol and other drug use suicidality discrimination and violence ( IOM, 2011). The medical community has long acknowledged that people who are not heterosexual or do not identify with the gender they were assigned at birth have significant disparities in health outcomes compared with cisgender 3 and heterosexual people (American Medical Association, 1996 Institute of Medicine, 2011 Coker, Austin, & Schuster, 2010 Lambda Legal, 2010 Makadon, Mayer, Potter, & Goldhammer, 2015). Community input could improve medical education interventions to reduce health disparities in marginalized communities. Limitations, particular of sampling, were considered. Community-derived competencies 1 stressed the importance of collaborative patient-physician partnerships, particularly in the setting of hormone prescription for transgender patients prioritized addressing social determinants of health and focusing on marginalized subpopulations 2 and stigmatized needs of the community.
These core competencies differed in meaningful ways from competencies created by national organizations such as the Association of American Medical Colleges. Five overarching themes emerged regarding patients’ suggestions for providers: be comfortable with LGBTQI patients share medical decision-making avoid assumptions apply LGBTQI-related knowledge and address the social context of health disparities.
cities between October 2013 and April 2014. Six focus groups were conducted with LGBTQI people ( N=48) in four U.S. This qualitative study explored the experiences of lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI) people in health care and their recommendations regarding what physicians should know and do to be able to take care of them.