More than ever, expert and culturally competent health care is widely available to the LGBTQ community. The seeds of this flourishing forest can be found in a change of mindset in the health care industry as a whole, sparked by patient experience research.
When the “patient first initiative” concept made its way into the health care lexicon more than 10 years ago, health care groups nationwide and internationally gathered, conversed and restructured with the expressed goal of providing individuals with increased safety and quality assurance.
Patient First — Joint International Conference on Quality Assurance and Patient Safety, a 2012 health care conference in Glasgow, invited research paper submissions with this greeting:
Patient First aims to replace our current “Physician centered” healthcare system with the one that revolves around the patient — “Patient centered.” We need to move from “what’s the matter” with our patients to “what matters” to our patients, focusing on their concerns while assuring safety and effectiveness.
The cultural shift that came next was global, opening the door to better health care for all. This transformation in the conversation about health care aligned with new clinics opening to reach specific patient populations, such as the LGBTQ community.
26Health in downtown Orlando deliberately established services to custom fit the LGBTQ patient population.
“We weave cultural competency into the DNA of our organization. Also, one of the tenants that we stand on is being inclusive and diverse in regard to our recruitment and development of our staff members. Plus we provide training workshops to our team so they have the language to provide empathetic care,” says Robert Baker-Hargrove, co-CEO of 26Health.
26Health was founded in 2011 as a multidisciplinary health care system to meet the complete needs of the LGBTQ community.
“Our board is comprised of a minimum of 51% patients because when you think about health care, you want to be able to hear directly from the people you are impacting, that you’re serving, that you are reaching. We incorporate their voices into our approach to healthcare services,” Baker-Hargrove says.
Research shows that kind of representation yields great rewards for patients. Medical facilities that are closely tied to their patients through shared community and deliberate engagement do a better job than facilities that rely solely on data and big-picture trends.
Metro Inclusive Health, with locations throughout Tampa Bay, has seen exponential growth, offering more than 100 programs and services. “We are constantly adding services based on patient needs,” says Brian Bailey, Chief Marketing and Experience Officer at Metro.
The organization’s widespread Bay-area locations help combat the longstanding problem of inequitable treatment for LGBTQ patients, something it’s historically done in partnership with CAN Community Health. The not-for-profit is dedicated to the treatment, care and continual wellness of people living with HIV and owns and operates 34 medical clinics with a headquarters in Sarasota.
Empath Partners in Care, also known as EPIC with facilities throughout the Tampa Bay area, recognize the importance of LGBTQ-focused care as well. Susan Talbott, an LGBTQ Community Support Counselor with EPIC, says members who identify as a part of the community — especially members of the trans community — put off for years receiving care because of the stigma and discrimination so many experience.
“I have talked with patients who say they don’t want to spend half of their appointment educating their physician on what it’s like to be a trans woman,” Talbott says. “They don’t mind answering the questions the first time but need to see you made an effort to understand their world when they come back.”
Nationally, those living outside urban areas often have to travel to find trusted clinicians. Orlando’s Spektrum Health opened up a second clinic this year in the city of Melbourne, located in more conservative Brevard County.
“On the door of the Orlando clinic is a City of Orlando Safe Space sticker,” says Svetlana Victoria Dunn, office manager for Spektrum Health. “Brevard County doesn’t have that program and we found that there are so many people in Brevard County that are just hiding out because they’re in fear because they have this perception that Brevard County is this overwhelmingly conservative place, and on the outside it sure is, but I’m not so convinced on the inside.”
Dunn, who first lived in Brevard County when she moved to Florida, says she experienced firsthand the lack of LGBTQ resources available in smaller, more rural areas.
“Our goal being there really is to flip that,” Dunn says. “We want there to be more resources in Brevard County. We have been able to connect with Space Coast Pride and they have been phenomenal. We have been able to participate in a lot of events with them and really show the community that there is support for you, there are people who care about you and there are people who are willing to fight for you.”
Dunn, who is transgender, says the importance of having an LGBTQ-focused health care provider is more than just receiving care from someone who knows all the clinical terms, especially for individuals in the trans community. It’s about respecting who each person is.
“I recently just changed my name legally so the name on my ID doesn’t match me at all,” she says. “At another clinic, the dentist office or another provider they may dead name me all day long. With a clinic like ours, we go out of our way to make sure we are affirming who you are. We do not dead name, we always make sure that we use the right pronouns, we selected a computer system that specifically allows us to do that.”
Going to a clinic that promotes itself as LGBTQ-centric lets the patient know that whoever they speak to there about their health will be knowledgeable in LGBTQ specific health concerns.
“Not every medical organization is fluent in serving LGBTQ patients,” Solitaire Bonesteel, head of marketing and development at Crew Health in Southeast Orlando, says. “For example, many hospitals, clinics and doctor’s offices don’t know how to communicate about PrEP. Also, not everyone knows how to serve transgender men effectively. What we’re trying to do here is create a safe space for complete and inclusive health care. There are too many LGBTQ patients that just don’t go to the doctor because they are afraid they won’t be treated well, and that’s an area where we’re filling in the gaps.”
Some large hospital groups are making strides in serving LGBTQ patients, which can ultimately help people living in rural areas where specialized LGBTQ clinics may be less likely to be.
Orlando Health, St. Petersburg General Hospital and USF Health are some of the larger health care organizations in Central Florida and Tampa Bay that specify LGBTQ services on their websites such as transgender care, including gender affirming hormone therapy and transgender transition care. These large entities are an umbrella for doctors in far-reaching locales.
At Orlando Health, transgender care begins in adolescence, under their Arnold Palmer Hospital for Children arm. Because Orlando Health extends its reach through Physician’s Associates, a primary care group of more than 180 doctors, there is a ripe opportunity to serve LGBTQ patients who live far from the city center.
Without question, nontraditional sexual and gender identities experience significant health disparities. According to a 2020 article in Health Affairs magazine, “Compared to their heterosexual counterparts, LGBTQ patients have higher rates of anal cancer, asthma, cardiovascular disease, obesity, substance abuse, cigarette smoking, and suicide … Sexual minority women report fewer lifetime Pap tests, transgender youth have less access to health care, and LGBTQ individuals are more likely to delay or avoid necessary medical care compared to heterosexual individuals.”
While these disparities do linger, the imbalance doesn’t seem that it will last long. No matter where you live in Central Florida or Tampa Bay, new health care options for LGBTQ patients are available, and becoming even more available, from independent clinics to ever-expanding medical groups.
“I love it when one of our patients convinces a friend to come along with them to one of their appointments,” Dunn says. “I can hear them chit chatting in the lobby while I’m sitting there doing my work and I hear them saying things like ‘Why didn’t you tell me about this place,’ ‘it’s so amazing’ and ‘I didn’t know places like this existed,’ so the feedback has just been phenomenal. It’s really heartwarming to see the love in the community and we are just so happy to be able to give back.”
Additional reporting by Jeremy Williams and Ryan Williams-Jent.
