Last week, I attended my 17-year-old son’s band and theater high school award ceremony. In addition to the cultural diversity of these gifted teenagers, there were a number of award recipients from the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community. Each individual was celebrated and cheered on by their peers and recognized for their unique talents. As I left the auditorium, my heart was filled with joy knowing that there is room for everyone to share their gifts. This event was so much more enlightened compared to my high school experience over 30 years ago.

I am thrilled that the public high school in our community is taking steps to increase inclusivity for the LGBTQ+ community, but we have a long way to go in making other public spaces and health care settings welcoming for all.

According to an article recently published in ADCES in Practice, “Know Thyself, A Cultural Humility Framework for Diabetes Education for LGBTQ+ Individuals”, authored by Katie Savin and Theresa Garnero, the LGBTQ+ population continues to experience worse health outcomes than their heterosexual and cis counterparts. This discrimination is amplified in communities of color.

Health and Diabetes Disparities

In their article, Garnero and Savin highlight that members of the LGBTQ+ community are less likely to have health insurance and experience higher rates of food insecurity. LGBTQ+ adults are also vulnerable to poor physical and mental health. Membership in a stigmatized community puts LGBTQ+ adults of all ages at greater risk for engaging in behaviors such as smoking, substance misuse and binge eating. Experts suggest that the Minority Stress Model, which includes the LGBTQ+ community, increases sexual and gender minorities risk for mental illness, anxiety, depression and risky health behaviors.

Actions diabetes professionals can take to provide more inclusive care

Create health care settings that send a message of welcomeness to the LGBTQ+ community. There are many small and big ways to send a message of inclusion.

• Making sure the health intake forms include more than just Male and Female when asking people to check their gender.
• Bathroom door signs that welcome all genders.
• Placing pride symbols in the waiting and exam rooms, especially during Pride month.
• Practicing cultural humility when providing care
• Get comfortable with the language of LGBTQ+

Cultural humility asks health care providers to develop critical self-awareness of personal implicit or explicit values that and behaviors that may contribute to health care disparities.  Cultural humility acknowledges the role of power and privilege within the patient-provider dynamic and within the health care system itself.  Cultural values and behaviors emanating from the provider actually have the power to shape the encounter and may minimize the values of the person seeking care. By taking a closer look at our own biases during interactions, we can start becoming more intentional and align with the individual’s needs and values when providing care.

Get comfortable with the language of LGBTQ+

Inclusive language creates a bridge and the foundation of trust between health care provider and participant.  Challenge yourself to adopt inclusive language practices by taking time to learn the terminology. Make sure intake forms include same-gender parenting, same-gender partnerships and non-binary gender options.

To get more comfortable with the language culture of LGBTQ+ community members, consider challenging your healthcare setting to integrate LGBTQ+ cultural events and practices in the work setting.

As individuals, we can visit a local LGBTQ+ Center, attend a pride march, drag show or other event that provides acculturation to the community’s customs. Plus, you’re likely to have fun in the process.

Increasing exposure to the LGBTQ+ community helps decrease discomfort and improves the quality of your interactions when providing care. In addition, since members of the LGBTQ+ are at higher risk for mental health distress, make sure to assess for anxiety, depression and drug misuse.

We enrich our practice when we welcome people from diverse communities and backgrounds. Let’s make sure to let our LGBTQ+ community know they are safe with us.

List of Resources

ADCES Inclusive Care for LGBTQ+ People with Diabetes Handout – this handout provides definitions, terms to avoid, and a cultural competency checklist to help you move towards improving inclusivity within your practice.

All Gender Restroom Sign PDF

Diabetes Prevention and Management for LGBTQ+ People Handout – this handout includes research of diabetes within the LGBTQ+ community, along with clinical considerations, programs, and resources for diabetes educators to use within their practice.

Policies on Lesbian, Gay, Bisexual, Transgender & Queer (LGBTQ+) issues – this resource by the American Medical Association lists all the current healthcare policies in place for the LGBTQ+ community.

Helio’s LGBTQ+ Health Updates Resource Center – this is a “collection of news articles and features that provide the latest information on the unique health needs of individuals in the LGBTQ+ community.”

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