April is STD Awareness Month and the 2018 theme is “Treat Me Right,” which focuses on the relationship between healthcare providers and patients.
The Centers for Disease Control and Prevention (CDC) has published a variety of resources for providers and patients. These resources, especially the provider resources, emphasize that patients may have diverse sexual orientations and gender identities that cannot be assumed. One particularly thorough resource, Sexual Health and Your Patients: A Provider’s Guide, outlines questions that all providers should be comfortable asking their adult and adolescent patients. Some key points from the guide include:
Assess your own comfort discussing sex with various patient groups and identify any biases that you may have. If you are uncomfortable talking about sex and sexuality, your patient will be too.
Use neutral and inclusive terms (e.g., “partner”) and pose your questions in a non-judgmental manner.
Avoid making assumptions about your patient based on age, appearance, marital status, or any other factor. Unless you ask, you cannot know a person’s sexual orientation, behaviors, or gender identity.
Try not to react overtly, even if you feel uncomfortable or embarrassed. Pay attention to your body language and posture.
The guide also offers scripts for comprehensive, non-judgmental sexual history taking; for adolescents, these include questions like, “What questions do you have about your body/sex?” and “Your body changes a lot during adolescence, and although this is normal, it can also be confusing. Some of my patients feel as though they’re more of a boy or a girl, or even something else, while their body changes in another way. How has this been for you?”
There are a variety of guidelines in this resource that explicitly focus on treating LGBTQ patients, such as the reminder to screen for cervical cancer in female-to-male transgender patients who still have a cervix according to the guidelines for cisgender women. There is also a list of common questions that patients may ask and appropriate, comprehensive answers. In addition to resources like this one, CDC recommends cultural competency training for all providers engaging with diverse populations.
You can access the STD Awareness Month page here: https://www.cdc.gov/std/sam/index.htm
You can access Sexual Health and Your Patients: A Provider’s Guide here: https://nationalcoalitionforsexualhealth.org/tools/for-healthcare-providers/document/ProviderGuide.pdf
You can learn more about the LGBTQ competency training services offered by QSPACES here: https://www.qspaces.org/lgbtq-training/