Our Commitment to LGBTQ Healthcare Equity

Did you know there are more than 9,000 lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) residents in Frederick County? And that number is rising.

Frederick Health  is committed to making our facilities and our healthcare services accessible to all. Every day, we strive to provide an inclusive environment where everyone is treated with respect, compassion, and dignity. Our organization is dedicated to safe, respectful, and equitable healthcare for all.

Every day, our LGBTQ friends, family, coworkers and neighbors face stigma and discrimination. These negative experiences lead to multiple health disparities and gaps in the quality of the healthcare they receive, compared to cisgender individuals (a person whose gender identity aligns with the gender they were assigned at birth). This is counterintuitive to our Mission, Vision and Core Values.

When walking through the doors of any of our locations, we want our all patients and families to say that they felt safe and welcomed, that staff communicated with them using their name and gender pronouns, treated them with respect, and were sensitive to their need for confidentiality. When they leave our facilities, we want them to say that our staff, physicians and partners provided competent, high quality health services.

Frederick Health  has joined hospitals and health systems across the country to become better equipped to manage the healthcare needs of this growing population, along with other populations that experience health disparities.

Health disparities have been well documented among the LGBTQ community, and one cause is the lack of confidence in their health provider or staff because of stigma, bias, or failure to help. This is not unique to Frederick County—many transgender patients across the country, for example, have reported being harassed in a doctor’s office, been denied medical care, or avoided seeking healthcare fear of being mistreated.

Facing such stigma and discrimination often leads to barriers to healthcare, which cause reduced trust of healthcare and acute chronic stress leading to poor physical health, mental health, access to care, and quality of care.

People who identify as LGBTQ also face stigma, bullying, and isolation.

• LGBTQ youth are two to three times more likely to attempt suicide—and up to 40% of homeless youth identify as LGBTQ. (This number may be even higher due to the lack of sexual orientation and gender identity data in medical records and government systems.)
• More than 30% of LGB people have been physically attacked or threatened.
• 61% of Transgender individuals have been physically assaulted or threatened.

As a result, some of the health disparities the LQBTQ community faces include:

• Higher rates of depression, anxiety, violence, and victimization
• Higher rates of substance abuse and smoking
• Higher rates of unhealthy weight control/perception
• Lower rates of mammography and PAP smear screenings
• Higher rates of HIV and other sexually transmitted infections

Other social determinants affect the health of LGBTQ individuals are related mainly to fear, oppression and discrimination. These include:

• Lack of laws protecting against bullying
• Lack of social programs targeted to and/or appropriate for LGBTQ
• Legal discrimination in access to health insurance, employment, housing, marriage, adoption, and retirement benefits
• Shortage of healthcare providers who are knowledgeable and culturally competent in LGTBQ health
• Failure to collect census data on Sexual Orientation and Gender Identity plays a major role in the lack of funding, legislation and resources to address the social determinants that impact the LGBTQ population.

What does LGBTQ stand for?

• L – Lesbian (a woman who is emotionally, romantically, or sexually attracted to other women)
• G – Gay (a person who is emotionally, romantically, or sexually attracted to members of the same gender)
• B – Bisexual (a person emotionally, romantically, or sexually attracted to more than one sex, gender, or gender identity though not necessarily simultaneously, in the same way, or to the same degree)
• T – Transgender (an umbrella term for people whose gender identity and/or expression of their gender identity is different from cultural expectations based on the sex they were assigned at birth. Being transgender does not imply any specific sexual orientation. Therefore, transgender people may identify as straight, gay, lesbian, bisexual, etc.)
• Q – Queer and/or Questioning (a term often used to express fluid identities and orientations, or a term used to describe people who are in the process of exploring their sexual orientation or gender identity)

Included in Frederick’s LGBTQ are a growing number of aging citizens who still are afraid to disclose their sexual orientation and/or gender identity. The isolation, as their friends and loved ones pass away, grows more intense. Some find it difficult to age in place, but discrimination and bias in housing, long term care, and nursing homes is still being reported.

Imagine what it was like in the mid-1900’s for LGBT Americans. Many families disowned them, communities shunned them, and like other minorities, being different made them a target for every group, every race, religion and the United States Government. Fear of being publicly outed includes a fear of being open with their healthcare providers, especially in smaller communities.

Some older generations were even subjected to “reparative therapies” in the past, which were controversial programs using extremely dangerous psychological and physical practices - including electroshock treatments or castration - to convert someone with “homosexual tendencies” to “normal.” (Conversion Therapy, another name for reparative therapies, is still legal in many states.) These and other practices have been disavowed by most medical communities, but other forms of bias and discrimination are reported.

Many routine and general health services can be provided by a primary care provider, but Transgender patients require specialty care lacking here in Frederick County at the moment. Primary care providers and specialists can work hand in hand to care for any unique LGBTQ healthcare requirements, but a welcoming office, staff and policies are important.

Frederick Health  has joined with the Frederick Center and other Frederick County health allies to cultivate an LGBTQ competent health community. It’s important to take steps to ensure all members of the LGBTQ community find primary care providers, specialists, and other healthcare professionals they can trust.

How Is Frederick Health Committed to Care & Support for the LGBTQ Community?

Equity is at the heart of our health system’s mission. We are dedicated to ensuring that all lesbian, gay, bisexual, transgender, and queer or questioning patients, visitors, employees, and friends receive the high-quality care, inclusive treatment, and respect they deserve. We believe that every person deserves to be healthy and feel safe, and we’re committed to making FRHS that place for all people—not only our cisgender community members.

We accomplish this by supporting staff development and:

• Cultivating a culture of inclusion by training all staff members—from receptionists to medical assistants to nurses to physicians to administration—on welcoming practices for LGBTQ patients and their families
• Providing a safe environment in which to ask questions about individual healthcare and hold discussions for learning
• Following best practices in greeting, registering, and interacting with LGBTQ patients and their families
• Avoiding assumptions and taking an open, non-judgmental approach to holistic care
• Communicating our patients’ preferences to all healthcare providers and staff in our network with whom they may interact
• Treating everyone with dignity and respect, inclusive of their sexual orientation, gender identity or expression, in accordance with our core values
• Caring about all patients—teaching our clinicians to ask culturally appropriate, sensitive questions to get to know each patient and the impact that social, structural, and interpersonal challenges has on their health and wellbeing
• Implementing nondiscrimination policies that include sexual orientation, gender identity, gender expression, among others

We’re always improving, and there’s always more we can do. How can we improve our access to care for the LGBTQ community in Frederick County, enhance healthcare resources in our community, update our electronic health records to be more inclusive, and improve the overall Frederick Health experience for LGTBQ healthcare equality? Let us know.