We can't expect to get appropriate care from our health providers if we don't come out to them. Conversely, our providers have to be well-versed in the healthcare needs of LGBT people. Aside from our spouses, significant others, or romantic partners, our providers are the people who most need to be aware of our gender identity, sexuality, and sexual behavior.
The reason for this is simple: As lesbians, gay men, bisexuals, and transgender people, we face unique health challenges, and the only way our providers can give us the best care possible is if they are aware of issues impacting us that range from coming out to the desire to raise a family.
Although it makes little sense to talk about LGBT people as if we form one monolithic community, it is true that LGBT people as a group face stigma and discrimination -- and even bias within the healthcare system -- that negatively impacts health. In childhood and adolescence, lesbian, gay and bisexual youth are at an increased risk for suicide attempts and depression, and evidence is emerging that the same holds true for youth who are transgender. Up to 40 percent of youth who are homeless and living without a parent or adult guardian are LGBT.
In early and middle adulthood, LGBT adults experience more mood and anxiety disorders than the general population, and gay and bisexual men are at least 44 times more vulnerable to HIV infection than the general population. It is estimated that the rates of HIV among transgender women is nearly 20 percent, and greater than 50 percent in transgender women of color. Transgender adults also face higher rates of homelessness, unemployment, and violence than the general population.
In order to give care that is personalized to your needs, or make referrals to specialists who are LGBT-friendly, your healthcare provider needs to know your sexual orientation and your gender identity. But quality health care isn't just about treating or preventing illness; it is also about comprehensive care that supports you in mind, body, and spirit. It means having conversations about your intimate relationships, conversations about parenting, and conversations about marriage.
Having such frank discussions with a professional you may only see a few times a year in a clinical setting isn't easy. This is why the National LGBT Health Education Center at The Fenway Institute launched its "Do Ask, Do Tell" campaign with tips on how to come out to healthcare providers. We've created brochures in English and Spanish (scroll down to the "Patient Handouts" section) detailing the importance of making discussions about sexual orientation and gender identity as routine as discussions about aches and pains and exercise regimens. Beyond our website, you can also find the brochures at health clinics and doctors' offices across the country.
It's important to remember that conversations with your clinician are confidential, and there are laws and policies in place in every state to keep your medical information private. If you still have privacy concerns, you always have the option of asking your provider not to enter some of the personal information you disclose into your medical record.
One critical tip about coming out to your provider: Be patient. If your healthcare provider uses the wrong terms or pronouns in reference to you or your spouse, simply let them know how you describe yourself and what terms you and your partner(s) prefer, and they should start to use those words. Although you should not necessarily be in the position of having to teach your healthcare provider, sometimes that is simply going to be the case. Most providers will be grateful for the education and apply it elsewhere in their practice.
To get the care you deserve, you need to take charge. Coming out to your healthcare provider is an important step in that process.