When trying to start a nurse practitioner fellowship that focuses on LGBTQ healthcare, nurses at Callen-Lorde Community Health Center in New York City discovered something interesting. They found out that their fellowship would be the first of its kind to offer this type of specialized training for nurse practitioners.
Nurse Practitioner Catherine Trossello, a nurse at the Callen-Lorde Community Health Center, says that health education related to LGBTQ individuals is very low in a country with 11 million people who identify as LGBTQ. Catherine and her team found out that the amount of time nurses, physicians, and physician assistants spend learning how to provide healthcare to LGBTQ individuals is very low at between one and 40 hours unlike other advanced medical certification courses.
She notes that many healthcare workers are entering the clinical field without an in-depth understanding of critical aspects of LGBTQ health issues including HIV prevention, hormone therapy, and a higher risk for certain diseases among other health issues.
Callen-Lorde Health Center focuses on providing care to LGBTQ patients. The demand for their services is so high that they have a long waiting list of patents from all over the United States who require their services.
The one-year fellowship opened in January 2020 to two nurse practitioners. The fellowship hopes to increase this number to four in the second year. The two nurse practitioners will take three to four lectures every week starting in September 2020. The focus of these lectures will be specialized care for LGBTQ patients, general primary care, and HIV prevention and management. The nurse practitioners will also offer patient care alongside instructors and take care of patients on their own.
Caroline Dorsen, an assistant professor at NYU, explains that New York University’s College of Nursing is a pioneer in teaching about LGBTQ care. Students learn about healthcare differences for this population plus a higher risk to their health that is attributed to alcohol, tobacco, and drug use. Students are also taught about other healthcare issues including mental health, suicide, and cardiac diseases. Students explore why these differences exist in a bid to find solutions to these problems.
A common problem for the LGBTQ community is marginalization and stigma. Both of these breed new problems such as lower health insurance coverage rates and lower access to healthcare compared to the rest of the population.
Dorsen conducted a study on implicit bias and how it affects the level of services offered by nurses. She found that nurses who had biases could not provide the right level of care for LGBTQ patients. She discovered that some nurses were having problems aligning their religious and cultural beliefs to their need to provide healthcare services for LGBTQ patients.
Dorsen concludes that all nurses should be aware they have biases because if they do not, they will not address them and will continue to provide substandard care, which often happens unintentionally.
While there are healthcare differences among many LGBTQ individuals, each group within this population has unique needs.
Paula Neira is a Navy veteran, a nurse, and a lawyer. While working as a nurse educator at the Johns Hopkins Hospital, she met surgeons who were interested in providing services to transgender patients. These surgeons wanted to perform gender-affirming surgeries at the facility and Naira worked with a task force that focused on bringing transgender services to the hospital. The taskforce conducted online surveys and sat down with focus groups to get a better understanding of transgender healthcare needs.
The Johns Hopkins Center for Transgender Health was opened in 2017. In addition to offering other nurse practitioner benefits, the center allows nurses to care for over 2000 patients including children, adults, adolescents, and senior adults.
Neira says that the reception has been so good, with patients interested in getting help with hormone medication management, gender-affirming surgery, gender-affirming treatments or primary health care. The center also offers support for parents looking for care for children who are exploring their gender identity.
Neira has also advocated for adding gender identity and sexual orientation to each patient’s records. Because most patients prefer to enter this information on their own, Johns Hopkins has worked to make this possible. Patients can now share information about their gender identity, sexual orientation, chosen name when it is different from their legal name, the sex they were assigned at birth, and their preferred pronouns.
By providing this information to healthcare workers, Neira hopes that services to transgender patients can improve. She also hopes to keep providing access to the health care facilities and support that transgender people need, even at a time where there is a lot of anxiety in the LGBTQ community due to the current political climate.
