Royal College of General Practitioners - Online Learning Environment

The 2018 National LGBT survey found that LGBTQ+ people are generally more dissatisfied with health services, compared to those who are not LGBTQ+. Issues included the assumption of heterosexuality among healthcare providers, a feeling that there was inappropriate curiosity shown by healthcare staff towards trans people, and a lack of knowledge about pre and post exposure prophylaxis for HIV. We cannot control problems such as long waiting lists for mental health and gender identity clinics, but we can look at how welcoming our practices are to people who are LGBTQ+, how well informed we are about issues that affect this population, and the language that we use.

This hub contains a collection of eLearning courses specifically related to LGBTQ+ issues. Inequality in LGBTQ+ health gives an introduction to the size of the LGBTQ+ population in the UK, the legal and political progress that has been made and the current inequalities, biases and issues of discrimination. This information is presented in a module and a short screencast. Creating an inclusive LGBTQ+ environment discusses simple and practical steps which a practice can take to be welcoming. This includes not having a heteronormative approach, recognising different genders, and communicating in an inclusive way. Practical steps could be as simple as having visible posters or other affirmative symbols in the waiting room, or could involve changes to registration procedures allowing for self-identification of gender. Staff should also be trained in issues such as terminology, pronouns and how to make changes to notes when a person transitions. This course includes a screencast about understanding the non-binary patient.

The next four courses focus on clinical areas of relevance to this population. Areas covered in the first two modules include mental health, suicide prevention, bridging prescriptions and screening issues, with an explanation of how those who transition may not be automatically recalled for screening relevant to the organs that they still have, and what practices can do to mitigate harm from this and to provide cervical screening for trans men in a sensitive way to reduce the risk of worsening gender dysphoria. The final two courses look at the needs of the older LGBTQ+ population, and the sexual and reproductive health needs of this community. Case study approaches are used to discuss issues such as reluctance to access healthcare due to previous bad experiences, actual or perceived homophobia or transphobia in care homes, and the long-term impacts of hormonal treatments used to transition .

The hub also contains two podcasts which go into more detail about being an inclusive practice and issues around sharing and disclosure, including why some patients might not feel comfortable about sharing their status. Legal issues and communication with secondary care are also discussed. Finally, there is a short screencast about the use of inclusive language.

References:

• https://assets.publishing.service.gov.uk/media/5b3cb6b6ed915d39fd5f14df/GEO-LGBT-Survey-Report.pdf