LGBT+ Inclusive Care Tips

Hi, everyone, and Happy Pride. My name is Meris, and I am a proudly bisexual nurse. I work in ER trauma and education. And I'm here to share with you a couple of tips on how to provide more inclusive care for your LGBT+ patients. Now, these are just basic tips. This is not an in-depth discussion. This is just a primer glossing the surface. If you want some more information, I would really encourage you to check out the webinar that I did, which is posted on our website, LevelUpRN.com. And that was an hour-long discussion about LGBT+ inclusive care basics. This is just going to be a quick couple of tips I hope can help in your daily practice, but I would absolutely encourage you to take an interest in this and do some more research, watch that webinar, and see how you can become a more competent provider for this community.

So to start, I want to say it's really important that you know the terminology. You've got to know the vocabulary so that you can have a conversation with your patient. For instance, you need to know what the difference is between sex, gender, and sexual orientation. And you need to know what it means when a patient tells you that they fall under a certain umbrella. So you need to know sex, gender, and sexual orientation, but you also need to know what the terms mean underneath those definitions. So, for instance, you need to know what a patient who's a cisgender, what that means, a transgender patient, nonbinary, pansexual, asexual, demisexual. All of those words you need to know in order to be able to have a conversation with your patient about this. So do the work. Figure out what kinds of words you already know and which ones are you struggling with. See if you can get those down pat so that you can have that conversation with your patient in a well-informed and respectful manner.

Now, the second thing I want to say is don't assume anything. Never assume that when somebody says that their partner is coming, that it's going to be somebody of the opposite gender. Don't assume that the person in the room with the patient is their romantic partner. Ask what the relationship is, right, right? Don't assume that your patient is straight or gay or lesbian based on their presentation, their outward expression of who they are. There is no way to tell who is and is not a member of the LGBT+ community without knowing for a fact that they are. There's no way to tell from someone's outward appearance, the way they talk, their haircut, anything like that. So don't make these assumptions about your patients because when you make those assumptions, inevitably, you're going to end up putting your foot in your mouth and possibly disrespecting your patient at the same time. We don't want that. So don't make assumptions. Instead, just ask. Ask the questions, right? Ask the question, "Who's this were with you?" Ask the question, not just, "Are you sexually active?" if that is an important question for you to know for medical purposes, but then, "With men, women, or both," right? Don't make an assumption that they are sexually active and it's with someone with the opposite gender. You need to ask these questions in a respectful manner when it is appropriate. You're not always going to need to know those sorts of things, but I'm hoping that you will use your clinical judgment to know when you should be asking about things like sexual activity.

The third tip I want to share with you is reflecting the patient's language. So if a patient says something to you like that they are a transfeminine lesbian. Okay. Use that terminology then when you are discussing them with other healthcare providers when you're giving shift change-- when you're giving a report at shift change when you're talking to the physician. If it's appropriate, use that language to describe your patient. When you are talking to them, and they say, "Oh, my partner is coming to visit me. She'll be here in about an hour," mirror that language back. "Oh. Well, when your partner gets here, have her check in at the front desk. They'll call me, and I'll bring her back." That mirroring of their language, first of all, allows you to not make those assumptions and not overstep and put your foot in your mouth, but additionally, it shows your patient that you are listening, you are taking in the information that they are giving you, and that you are respectful of who they are, their identity, their family, whatever the situation may be. So mirroring that language can really help you out and show your patient that you care about respecting their identity.

There are lots of other things that you can do. I personally would really encourage you to get a pronoun pin or some other way that you can show your pronouns at work. This doesn't have to be a really big flashy in-your-face thing and something that you talk about all the time. My badge for work, I have little tabs that stick up over the top, just a very small profile, little tabs that stick up, and they say she/her/hers. And that's it. And it's just a little thing right there. First of all, anybody who sees me can automatically see my pronouns if they're looking at my badge. And it also subtly signals to your patients in the LGBT+ community that, "Hey, I'm a safe person. I'm telling you about my pronouns. You can tell me your pronouns. We can have this conversation." I would encourage you to start introducing yourself with your pronouns to ask your patients for their pronouns. But if you're working up to that, having a pronoun pin or some other way of displaying your pronouns is a really great way to sort of test the waters, get comfortable with it, and people are going to ask you about it. People ask me about my pronouns at work all the time. They want to know, "What is that? Why do you have that there?" And then that gives me an opportunity to say, "Oh, this is so that my patients know that I use she/her pronouns. That way, nobody has to ask. It's right there. And that's what that's about." It's very easy. And people are going to ask you, but that's okay. That's good, right? If there's anything that you can do to signal to your patients that you are a kind, respectful nurse healthcare provider of any variety, that is always a good thing.

So just to briefly recap, I highly encourage you to get familiar with the vocabulary, to know the terms that you need to have to have a competent conversation about sex and gender and sexual orientation. I would encourage you not to make any assumptions about your patients, whether that be about their sexual activity, their sexual orientation, their gender, their partnerships, their family, anything like that. Don't make those assumptions. Instead, just ask respectfully and when appropriate. And of course, mirror their language. Say the words that they say to describe themselves and the people that are important to them. If you want to check out pronoun pins, see about getting something to add, like a sticker to your badge, something along those lines. It does not have to be over the top. But I guarantee you, as a person in the LGBT+ community, when I see somebody who's wearing a pronoun pin or who has a, "You're safe with me," sticker or anything along those lines, I automatically feel like I can breathe a little bit easier, that I know that I can have an honest discussion with them without feeling like I need to hide anything about who I am because I have a good feeling that they're going to be respectful, they will be kind, and they will not be judgmental. There's so much more to learn about how to be an inclusive healthcare provider for the LGBT+ community. I would again encourage you to check out the webinar that I did, which is available on our website, and seek out additional resources. There are lots of organizations out there doing incredible work for the community and trying to educate healthcare providers as well. I hope this helps, and I hope you have a great rest of your pride month. Thanks so much and happy studying.