Much like most of the world, education around LGBTQ+ community when it comes to medical care is well behind the times. “It is not a topic that is thoroughly covered in most medical school and NP/PA programs yet.”
Quality care comes from those who sought out additional and specialized training. That’s why we here at Westside Family Medicine are proud to serve the LGBTQ+ community not just for pride month, but all the time.
Here to answer some questions and shed some light on our approach to this type of care is our own James Lauren, NP.
What does it take to specialize in primary care for LGBTQ+ patients?
While many primary care physicians are trained in LGBTQ+ care, specializing in care for the LGBTQ population requires some extra training, since it is not a topic that is thoroughly covered in most medical schools and Nurse Practitioner (NP) and Physician Assistant (PA) programs yet. There are continuing education self-teaching programs available online, many conferences that one can attend, and even specialized education programs.
“In order to become certified in this area, I did all of the above, including a yearlong fellowship at a world leading LGBTQ+ health center, Callen-Lorde, the Keith Haring Nurse Practitioner Postgraduate Fellowship in LGBTQ+ Health. Not everybody needs to do something like this in order to take care of the population, one only needs an open mind and willingness to learn new things. I did the fellowship in order to be able to teach others to do this work, which is what I’m getting the chance to do at Westside Family Medicine.”
How did this become a focus for you?
“I am a queer trans person who has had difficulty finding appropriate primary care even in a city as famously diverse as New York City. I was aware of a few specialty clinics that exclusively care for this population, but was hoping to go to a provider closer to where I lived. I was saddened to find out that many primary care clinics do not provide basic care for queer and trans people, such as non judgemental sexual health and gender-affirming hormone therapy. I called quite a few clinics who simply said ‘we don’t do that’ when I asked if they could refill my medications.”
My experience is nowhere near unique. I know that many people in the community face similar challenges. The healthcare disparities for the LGBTQ+ population, especially for trans individuals, are well known. These disparities are not the result of some innate physical differences but rather due to societal pressures and stigma, and a lack of knowledge among the medical professions as a whole. A quick search yields the following, and many more sources of a similar sentiment: “The biggest barrier to health care reported by transgender individuals is lack of access due to lack of providers who are sufficiently knowledgeable on the topic.” (Safer et al., 2016).
It became my goal to become the provider I wished that I had for myself. It’s also important to me to teach these skills to other providers, to help increase the amount of people who are comfortable doing this type of care outside of specialty clinics.
Is your approach different for different patients?
“Of course! I want queer and trans people to be treated like any other population.”
Everyone deserves care that reflects their individuality. Queer and trans people are people, and people come with a wide variety of medical needs and personal circumstances. I think it is important to work collaboratively with patients to find out what their goals are, and help them to meet those goals.
What are some of the most common conditions you see patients for?
My favorite part of primary care is the wide variety of patient visits I see on any given day. From headaches to gout, we get to treat so many different conditions that it is always interesting.
Some of the most common things I treat may change from season to season such as when cold and flu season hits versus the new year when many people come in to get their annual physicals. Year round, I am frequently treating people for anxiety and depression, sexual health including HIV prevention and STI treatment, and gender affirming hormone therapy.
Do you offer gender affirming hormone therapy (GAHT) at WFM?
Yes. One of my goals in working at Westside Family Medicine was to increase the amount of providers who can prescribe gender affirming hormone therapy. I am pleased that the owners of the practice share this goal.
I have gotten to do presentations to the other providers who are interested in starting people on their medical transition journey, which some people are excited to learn. All providers at this clinic can assist with the needs of trans patients who are on GAHT, and an increasing number of providers can start patients on their medical transition journey.
Why is it important to have a PCP, and what should patients look for?
“It is important to take care of your whole health and actively participate in preventive care, not just to play whack-a-mole with issues as they come up one by one. By forging a relationship with a PCP, you can have someone to rely on to help you be in the best shape to reach your individual health goals.”
Your PCP should be the point person for your overall health, making sure that someone is seeing the whole picture. If you go to different specialists, they don’t often speak to each other, there should be someone gathering all of this information together and that is what a PCP does. We also look at your genetic family history and lifestyle risk factors to set you up for the best possible long term health and minimize the possibility of any conditions developing down the road.
Patients should look for someone that makes them feel heard, and that they feel comfortable around and can trust.
What health advice do you have for LGBTQ+ patients?
Find a PCP who is someone that you trust, and who seems to really care about your health, and understand your goals. Speak up when you feel like you are not being heard. Write down questions before your appointments, sometimes it can be stressful seeing a new provider, especially if you’ve had bad experiences in the past, and you can forget in the moment what you wanted to say. Bring a friend to help you feel more comfortable if you would like.
The healthcare outcome disparities in the LGBTQ+ population are not due to real innate differences, they are mostly due to lack of appropriate care and screenings.
My advice is to engage actively in your health. Get your appropriate screenings and vaccinations. Find a provider you trust, and be honest with them about your life.
Looking to start with a new provider? Browse our providers here and book an appointment to start you on a better health journey.
Safer, J. D., Coleman, E., Feldman, J., Garofalo, R., Hembree, W., Radix, A., & Sevelius, J. (2016). Barriers to health care for transgender individuals. Current opinion in endocrinology, diabetes, and obesity, 23(2), 168.
