It’s National Coming Out Day today , and in celebration I thought I’d post some tips and guidelines on how to make yours a LGBT-friendly practice, since the AMA believes that “the physician’s nonjudgmental recognition of sexual orientation and behavior enhances the ability to render optimal patient care in health as well as in illness.” (Note: most of these tips are taken from The ABCs of Sexual Health , in the BMJ, and Creating a Safe Clinical Environment for Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) Patients , an excellent guide (pdf) free from GLMA .) These are not monumental, folks. It’s the little stuff that counts. Trust me.

Above all, listen, don’t make assumptions, and always be respectful.

Creating a Welcoming Environment:

• Lesbian, gay, bisexual, transgender, and intersex (LGBTI) patients often “scan” an office for clues to help them determine what information they feel comfortable sharing with their health care provider.
• Post a visible non-descrimination policy.
• Put up a small rainbow or pink triangle. (I know, I hate them too, but seriously, a little goes a long way for LGBT patients.)
• On the intake form, try “partner” instead of “spouse.” And include choices on the “Sex” category besides just “M” and “F.”

On Interviewing:

• Try using gender-neutral words. “Are you currently in a relationship?” as opposed to “Are you married?”
• “Do you have a girlfriend or a boyfriend?”
• “Is there another parent?” as opposed to “Is there a father?”
• If a patient comes out to you, recognize that you are glad they felt comfortable mentioning it, and that it’s not an easy thing to do.
• Assess how the process is going–you may be the first person they’ve ever told.
• Again, listen. Follow the patient’s lead.
• Ask about sexual history honestly and openly. If you’re unsure on what or how to ask, try to let the patient explain–and let them know about your ignorance.
• Just because someone is in a same-sex relationship doesn’t mean violence doesn’t happen.

On Counseling:

• Be honest with yourself; if you are uncomfortable with gay people refer the patient to someone else.
• If an adolescent is confused about his or her sexuality try to help the patient to adjust.
• Do not have preconceived ideas.
• If you don’t know the answer to a question, find out for the patient.
• Know what LGBT resources are available in your area.

If you have questions or comments, please post them here; it’d be great to have an open forum to figure these issues out if you’re unsure about them.

Update: Two more great resources from AMSA : Do Ask, Do Tell , and the June 2001 issues of the AJPH .

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