Changing the dynamics of LGBT health

Penn Medicine is looking to change the face of healthcare for LGBT patients.

The University of Pennsylvania Health System announced last week the creation of its new Program for LGBT Health, an initiative dedicated to tailoring health care practices to the specific needs of the LGBT community. The program aims to improve LGBT health care in five key areas: institutional climate, education, research, patient care and community outreach.

The Program for LGBT Health is one of only a few that academic health institutions across the country have started in order to serve LGBT communities.

The initiative — which will be introduced across the medical, dental and nursing schools, as well as Penn Medicine hospitals — is a response to the “increasing national need to address health care disparities” within the LGBT community, said Baligh Yehia, the program’s director.

“It’s a confluence of two big factors: the growing national attention devoted to LGBT health and the social and political movements that have brought the population into the spotlight,” Yehia added.

Researching and implementing better methods for educating health care professionals about issues related to LGBT health are major parts of the program. Most medical schools across the country currently lack this type of comprehensive education; a 2011 study in the Journal of the American Medical Association found that the average medical student receives less than five hours of LGBT health training in a four-year curriculum, and most of that training concentrates on HIV/AIDS.

In recent years, however, medical institutions have recognized that issues that particularly affect LGBT individuals go far beyond just HIV and AIDS. According to data from the Gay and Lesbian Medical Association, lesbians are more likely to have risk factors for breast cancer but are less likely than heterosexual women to get screened for these factors. Additionally, lesbians and gay men use tobacco and abuse substances at higher rates than heterosexuals.

By filling the educational gap, Yehia and his team seek to foster a new climate within the health care industry that welcomes diversity and encourages an open dialogue between patients and physicians.

“Most of the issues relate to how to communicate with patients and be able to treat them with respect and compassion,” Yehia said. “Communication is half the battle.”

Jesse Ehrenfeld, co-director of Vanderbilt University’s Program for LGBT and Intersex Health, emphasized that knowledge of a patient’s sexual identity can impact the type of preventative care that a doctor administers.

“It is so important for people to come out to their physicians because it is the only way that we can provide the best individualized care,” Ehrenfeld explained. “Part of that is making sure that it can happen in a comfortable and honest setting.”

He noted as an example that “all gay men under the age of 27 should be offered the HPV vaccine … [but] this is not something we do unless we know the patient’s sexual orientation.”

Since the UPHS program was announced, it has received support from the rest of the community, said Neil Fishman, the program’s faculty advisor. Fishman added that this reception is a “stark contrast” to the way that Penn responded to efforts to create an HIV/AIDS program in the 1990s.

“Penn’s early response to the AIDS epidemic was fear,” Fishman said. “We’ve really come a long way because we really had to fight for it back then.”

LGBT Center Director Bob Schoenberg, who has been at Penn for over 30 years, called the program “a significant advancement” that will “enhance Penn’s reputation as being receptive to the needs of the LGBT community.”

In the LGBT community, “things are changing practically daily, so it is very timely that health care should follow,” Schoenberg said.

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