Every individual deserves to receive the best possible care so they can live a long, happy, and healthy life. However, it has been found that certain groups of people—including particular races/ethnicities and genders—experience unique challenges in the health care setting. Every June, during Pride Month, when the nation celebrates LGBTQ+ (lesbian, gay, bisexual, transgender, and queer) communities, Summit Health does its part to raise awareness and promote sensitivity in discussing gender and sexuality as well as encouraging both understanding and inclusion.

“Health care providers should be aware of patients who identify as LGBTQ+ so that they may address the specific physical and mental health issues that may face these patients,” adds Marnie Dardanello, MD, a pediatrician and Chair of Pediatrics at Summit Health. “Pride Month is a time to raise awareness and offer support and recognition for the unique issues facing LGBTQ+ members of our community.”

As a multispecialty medical group, Summit Health employs a number of providers with expertise in treating LGBTQ+ youth and adults, like family medicine physician Danit Brahver, MD. At the leadership level, Summit Health has demonstrated a deep commitment to social justice, establishing a Diversity, Equity, and Inclusion committee last year.

Health Disparities in LGBTQ+ Populations

LGBTQ+ patients may have a fear and mistrust of the health care system. They are often concerned about societal stigmas and discrimination. To help alleviate these concerns, Dr. Dardanello says it is important that health care providers are comfortable discussing topics of gender and sexuality with all patients in a respectful manner.

Research shows that several physical and mental health conditions disproportionately affect LGBTQ+ populations. This group of people is subject to higher rates of:

• Mental health disorders including anxiety, depression, and suicidality
• Eating disorders and obesity
• Breast and cervical cancers
• Sexually transmitted infections including HIV and human papillomavirus (HPV)
• Substance use and abuse disorders such as alcoholism and smoking

Health care providers can reduce these disparities by being well-versed in population health. For example, research shows that cisgender (a person whose gender identity matches their sex assigned at birth) lesbians have higher rates of cancers than cisgender heterosexual women. As a result, Dr. Brahver, says it is important to make sure that breast, cervical, and colon cancer screenings are up-to-date for lesbian patients.

“We can also work within our institutions with leadership and ancillary teams, our communities with community/spiritual leaders, schools, and local public health officials to understand and mitigate barriers to care,” adds Dr. Brahver. “In New Jersey, we can lobby for comprehensive, universal sexual health education in schools and work with faith-based leaders to promote responsible sexual health practices.”

Learning and respecting pronouns is an important part of caring for LGBTQ+ patients. Health care providers, parents, community leaders, and mentors have a responsibility to embrace transgender and gender non-conforming patients by honoring the pronouns that best represent them.

"It is extremely important to ask someone about their preferred pronouns because not all people’s genders—their identities as women, men, or gender non-conforming people—match their biological sex or their expressed gender,” says Dr. Brahver. “If you do not ask about pronouns and instead make assumptions about someone's gender identity based on how they look, you risk alienating and harming those people with gender incongruence.”

Addressing Physical and Mental Health in LGBTQ+ Youth

Raising awareness is particularly important for LGBTQ+ youth. “For pediatricians, providing a safe and welcoming environment for young persons to explore their gender and sexuality is the key to providing excellent health care,” explains Dr. Dardanello. “LGBTQ+ youth may be hesitant to discuss gender or sexuality with their health provider unless the topic is addressed directly, with respect and positive support at the heart of the discussion.” Studies show that LGBTQ+ youth face numerous health challenges. They are more likely to experience:

• Bullying, teasing, and harassment
• Acts of sexual and physical violence
• Fear of parental rejection
• Depression and thoughts of suicide
• Substance use including tobacco, alcohol, and other substances
• High-risk sexual behaviors like sexually transmitted infections

The good news, explains Dr. Brahver, is that parents and schools have the capacity to reverse these sobering statistics. The key is to embrace kids' LGBTQ+ identities and teach all children to reject hateful attitudes. “Studies have found that supportive and accepting parenting practices help LGBTQ+ children build confidence and self-worth, setting kids up to be successful, resilient adults,” says Dr. Brahver. “On the other hand, intolerant, dismissive parenting practices foster feelings of worthlessness and rejection that contribute to depression and substance abuse.”

“Schools play an equally important role in kids’ development,'' adds Dr. Brahver. “Schools with LGBTQ+ inclusive sex education and safe spaces like gay-straight alliances have lower rates of LGTBQ+ children struggling with school absenteeism and suicidality.” As children grow and develop, it is normal for them to explore their gender and sexuality. Health care providers play an important role in helping parents navigate these discussions with their children at every stage of growth, including adolescence. In addition, LGBTQ+ youth require sensitive and open counseling about safe sex practices to prevent sexually transmitted infections and mental health concerns.

It is important that parents both talk and listen to their children as they go through a period of gender identity and sexuality exploration, explains Dr. Dardanello. “LGBTQ+ youth can thrive with positive parent interactions. Providing a supportive environment for the child to ask questions is key. Staying engaged with the child to address potential bullying or self-esteem issues is also valuable.” Dr. Dardanello concludes, “A willingness to have the conversation and address the needs of specific persons in our community is part of our dedication to delivering kind and compassionate care to all our patients. At Summit Health, every patient is welcome and individual health care needs are important. We strive to create a medical setting where all persons, regardless of gender or sexual identity, are respected and given the best medical care.”