Sensitive Care for the LGBTQI Community

Why inclusive care is important and how we can get it.

“Love and compassion are necessities, not luxuries. Without them, humanity cannot survive.”

—Dalai Lama XIV

Let’s face it: Non-judgmental, thoughtful communications that foster open and honest delivery of healthcare is a human want and right for all, yet there is a clear and continued divide on how it is orchestrated and executed for the LGBTQI community.

Patients within any community demand a basic understanding of their values and ethics, and tend to surround themselves with others like themselves. This is a pure and comforting second nature. Specifically within the LGBTQI community is the need for physicians to dive deeper into our lifestyles and sexual practices with sensitivity and knowledge in order to truly affect positive change. The importance of medical providers who understand the intricacies and nuances of gender, sex, and all aspects of sexual relationships is paramount to the success of this deliverance.

What should my doctor know?

Asking the right questions, spending the quality and well-deserved time, and leading the discussion with a high-level awareness of continued sensitivity is crucial to enhanced services for patients.

It’s imperative for physicians and specialists to have an understanding of:

• The intricacies of anal intercourse and minimization of injury

• Yearly preventative evaluations and maintenance

• Knowledge of the myriad types of relationships and the inherent risks of each

• The best methods to approach safe encounters

• Utilization and management of PrEP with diverse knowledge on its appropriate indications and the controversial ethics

These topics and more all lead to cohesive and expansive discussion—and are just a part of the important sensitivities and niche knowledge that is required not only by practicing LGBTQI physicians, but all, in order to serve the community’s needs to the fullest.

What should I be asking my doctor?

As members of the LGBTQI community, it is also our responsibility to be asking all the right questions to our primary physicians, including the following:

• What medical training or cultural sensitivities do you harbor as a physician taking care of a gay or bi male or female?

• How do you tailor your care to individualized homosexuality and, more importantly, a modern family and all of its dynamics?

• Based on the sexual activities I engage in, what should I be concerned with and what preventative measures should I be taking?

• What tests should I be getting if I’m a top, bottom, or versatile?

How can I comfortably approach a “tabú” topic with my doctor?

Despite the general consensus of sex, especially as it relates to LGBTQI relationships, being a taboo and often unapproachable subject, it’s important that we take the necessary steps to familiarize our physicians with the subject in an effort to increase awareness and improve healthcare, while also destigmatizing the subject in general. While it’s impossible to guarantee that your doctor will be comfortable speaking to the subject and will approach the subject with sensitivity and lack of judgment, the more we openly discuss the topic and advocate for affirmative healthcare, the more normalized it will become. Persistence is key and though it’s about taking small step after small step to achieve the greater goal, progress is being made.

How does this relate to the healthcare industry as a whole?

Providing sensitive care doesn’t come without shortcomings or making mistakes, but analyzing these failures and addressing the issues allows for the humane side of the elevated doctor-patient relationship to develop—a lost art, yet the most crucial. This all sounds amazing in theory, but how do we do it or become a part of it? It’s not an easy fix when the problem lies in the current model of healthcare.

High-quality care with thoughtful communications equals elevated costs, and with decreasing levels of insurance and the loss of government funding, how does one continue to provide these much-needed services? When you deliver care through a volume-based model, the delivery becomes clinic-oriented with single-pathology office visits that only allow for a snippet of time and corrective, mostly reactive planning. Within these clinics there are enormous amounts of moving parts—the more parts, the more errors. The more errors, the more patients who come to receive subordinate care. So, what about the aforementioned example of the quality model—the one that hits all the marks? The reality is that only a small subset of people can actually afford that model. Of course, it’s the model everyone desires, but this leaves us open to ongoing affordability issues and the argument of class wars.

Can doctors and healthcare services deliver appropriate, elevated community care at all levels with the sensitivities and understanding we all need?

It’s still to be answered, but education continues to be of utmost importance to all that are involved in delivering healthcare, and it’s imperative that it goes further than just the provider.

We talk so much about these sensitivities, but it needs to be understood that it starts from the second someone attempts to make an appointment with the receptionist, to the way they are greeted and addressed when arriving at the office. Being sensitive and understanding of all this community has to offer doesn’t have to be based on monetary value. Setting the appropriate tone of mutual respect with complete understanding allows for comfortable communications to be fostered. With comfort comes honesty and with honesty comes respect and positive change. There needs to be a clear line delineated between sensitive and community-specific care, with all providers and physicians being aware and educated in order to offer the best care around the nation, not just in major cities. We need this more than ever in this next unforgiving chapter of healthcare.

Header image illustrated by Marcy Gooberman

Must be looooooove on the braaaaain 🧠. Or was that s£x? 👀🤭 Our brains are our largest s£x organs and sometimes they get a little sad, hyperactive, anxious, or overwhelmed. You won’t always be in the mood for s£x and that’s okay! Keep communication with your partner open and ongoing, check in with yourself and your mental health, and lean on the support of a trusted therapist or doctor if you need some extra guidance. 🫶🏽 Anything you would add?

I mean 😏

It is not wrong nor should it feel shameful to ✨seek pleasure.✨ I think those of us who grew up more religious were taught that you should always be in service of others and giving of yourself rather than concerned with our own needs or passions. While it is wonderful to be generous with giving (and can in fact be a source of pleasure), it should be equally encouraged to pursue your own pleasure — it whatever form it may take! It may feel self-indulgent, but why is that a bad thing? Pleasure boosts our mental health. It helps us cope with a difficult world, with anxiety, depression, and stress. It makes us feel good! It gives us something to look forward to. Pleasure helps us connect with others and with ourselves. Pleasure (as long as it is not at the expense of someone else’s safety or well-being) should be a priority, for our joy and for our health. It really is so important! Where do you find pleasure? I personally love a good massage… 💆🏽‍♀️

It’s time for a talk, friend. Let’s be clear, you nor your partner ever has to do *anything* you’re not comfortable with. That said, if it’s something you enjoy and that’s pleasurable to you, it’s okay to ask your partner for it! They can say no, but if they invalidate your pleasure, much less expect you to do something they won’t do?? The ball is then in your court to decide if this is the partner for you. You deserve someone who cares about and prioritizes your pleasure. Who is thrilled to be acquainted with your body, all of it! S-x can be vulnerable to talk about, but when you do…it’s so much better. 👅 included. Ask your partner what their hesitations are and have a *conversation.* Maybe they’re nervous, intimidated, or struggling with shame. Maybe they’re down to try other things you would enjoy and build up to it. The point is, it shouldn’t just be automatically dismissed. You can decide what’s right for you and what makes you feel aroused, validated, and appreciated. Whatever you do, don’t internalize their rejection. Your body is beautiful, desirable, and definitely worthy of pleasure. 😋🥰

A UK study published in the International Urogynecology Journal found that only 46% of participants correctly identified that a female has 3 holes in the external genitalia. 😬 Not great. We’re taught so desperately little about our bodies and so discouraged from exploring them that we don’t even know what we’ve got going on down there! Understanding your own anatomy (and getting educated on your partner’s anatomy) can boost pleasure 1000x!! So take a mirror, use your hands, and get comfy exploring! 🪞🕵🏽‍♀️ And if you really want to get informed (and inspired 😉), head to our website for our basics on pleasure and anatomy. What do you think? Could YOU correctly label a diagram of what lies beneath?

Modern sex essentials

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