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For providers Health equity in telehealth

Telehealth for LGBTQ+ Patients

Telehealth appointments are a safe, convenient way for LGBTQ+ patients to access healthcare. Telehealth can also be a necessary lifeline for some patients who do not have LGBTQ+-affirming healthcare available nearby. Understanding the medical, emotional and social issues unique to LGBTQ+ patients will help providers give quality healthcare in a virtual setting.

Best practices for LGBTQ+ telehealth care

It is important to make sure your practice is inclusive, both in person and through telehealth. Inclusivity builds comfort and trust, which helps your patient get the best care possible.

Make sure your intake and online forms are inclusive

Check to make sure your online or email intake forms or health assessments are updated to be inclusive for sex assigned at birth, gender identity, and sexual orientation. This allows you to collect accurate information you will need as part of your telehealth care and it also lets your LGBTQ+ patients know that you prioritize their health and wellbeing.

Review and modify your forms to move away from cis-gendered, heteronormative language. Suggested changes include:

  • “Caregiver” or “parent” instead of “mother” or “father”
  • “Spouse” instead of “husband” or “wife”

Also allow space for your patients to write in their own answers if the multiple choice options do not apply to them.

Examples of inclusive gender identity include:

  • Female
  • Male
  • Non-binary
  • Transgender
  • Transmasculine
  • Transfeminine
  • Genderqueer
  • Something else (please specify)

Examples of sex assigned at birth could include:

  • Male
  • Female
  • Intersex
  • Something else (please specify)

Examples of sexual orientation include:

  • Straight
  • Gay/Lesbian
  • Bisexual
  • Pansexual
  • Something else (please specify)

Encourage your colleagues and staff to take LGBTQ+ health education training as part of your telehealth workflow

Educating yourself and your staff on LGBTQ+ health care will ensure you are providing the highest quality telehealth care to communities that are often marginalized in traditional health care settings. This especially includes people of color, transgender youth, and people living with HIV/AIDS. There are also large communities of people that fit into several of those categories, which can lead to further marginalization.

Specialized training could include information about LBGTQ+ youth, behavioral and mental health, HIV/AIDS treatment and counseling, and transgender health care.

Read more:

National LGBTQIA+ Health Education Center exit disclaimer icon 

LGBT Training Curricula for Behavioral Health and Primary Care Practitioners — Substance Abuse and Mental Health Services Administration (SAMHSA)

Recommendations for Collecting SO/GI Patient Data exit disclaimer icon  — Fenway Health

Use proper pronouns and terms

Familiarize yourself with your patient’s pronouns, gender identity, and sexual orientation before your telehealth appointment.

Common pronouns include:

  • She/Her
  • He/Him
  • They/Them
  • Ze/Hir

Some patients may prefer you not use any pronouns at all and stick to their name instead.

Taking a moment to review this information before logging on to your telehealth visit will help your patient with comfort and trust, and lead to more open communication.

Quick facts: Proper LGBTQ+ terminology

Gay: A term used by men, women, and some non-binary people who are attracted to people of the same gender

Lesbian: A term used by women and non-binary people who are attracted to other women

Bisexual: People who are attracted to two or more genders

Non-binary: People who do not identify as male or female, or who identify as both male and female, or somewhere in between

Transgender: A person who identifies and expresses themselves as a different gender than what they were assigned at birth. This is not to be confused with sexual orientation. Transgender people may be straight, gay, bisexual or another orientation

Cisgender: A person whose gender identity aligns with their sex assigned at birth

Read more: Health Equity Guiding Principles for Inclusive Communication — from the Centers for Disease Control and Prevention (CDC)

Telehealth workflow and LGBTQ+ healthcare

There are several ways you can make your telehealth workflow more inclusive to the LGBTQ+ community. These tips will improve the health care of your LGBTQ+ patients:

  • At the start of the telehealth appointment, ensure your patient has privacy and feels safe to speak openly.
  • Assure your patient that whatever they tell you is confidential, just as it would be if they were in person.
  • Ask or confirm their pronouns and preferred name.
  • If you are using telehealth to treat LGBTQ+ patients who are located outside of your own locale, offer to help them find LGBTQ+-friendly physicians and medical facilities if they need to be seen in person.

Treating LGBTQ+ patients through telehealth

Telehealth is a great way to deliver necessary, even life-saving, health care to LGBTQ+ patients who live in rural areas or other locations without access to inclusive, non-discriminatory providers, facilities, or treatments.

There are several ways to offer LGBTQ+-specific telehealth care:

Prescriptions

This could include depression and anxiety medication or pre-exposure prophylaxis( PrEP). Providers can also prescribe gender-affirming hormones for for patients whose gender does not align with their sex assigned at birth, such as transgender and gender non-binary people.

Counseling and therapy

LGBTQ+ Americans, especially LGBTQ+ youth, have markedly higher rates of suicide than their heterosexual, cisgender counterparts. But there aren’t always LGBTQ+-focused providers in less populated areas. Inclusive behavioral telehealth care can change lives and save lives.

HIV/AIDs management and treatment

There are fewer numbers of HIV specialists in rural areas. Telehealth can offer patients a variety of HIV/AIDs prevention, treatment and management options:

  • Prescriptions for PrEP and post-exposure prophylaxis (PEP)
  • Lab orders for testing
  • HIV case management
  • Prevention counseling
  • HIV/AIDs counseling and therapy

Read more: Telehealth for HIV Prevention and Care Services — from the CDC

More resources:

Development of Telemedicine Infrastructure at an LGBTQ++ Clinic to Support HIV Prevention and Care in Response to COVID-19, Providence, RI — from the National Institutes of Health

LGBT Behavioral Health Equity — from SAMHSA

Last updated: October 8, 2021

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