Primary care
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Behavioral health concerns related to sexual and gender minority stress impair functioning and limit quality of life. With greater interest in implementing LGBTQ-affirmative health care practices, primary care providers likely will see larger numbers of LGBTQ individuals presenting with behavioral health concerns. Behavioral health and medical providers may not feel prepared to address the biological, psychological, social, and cultural minority stress factors that have an impact on LGBTQ patients. LGBTQ-affirmative behavioral health providers in primary care can offer a unique service by conducting tailored evaluations and individualized interventions targeting multifactorial influences that cause and perpetuate psychological distress in LGBTQ patients.
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Lesbian, gay, bisexual, transgender, queer, and other sexual and gender (LGBTQ+) minorities experience intimate partner violence (IPV) at higher rates than heterosexual and/or cisgender people. Providers often are less prepared to work with LGBTQ+ survivors, which can be the result of a reliance on stereotypes on what constitutes an IPV victim. This article provides recommendations for working with LGBTQ+ survivors, including screening for IPV regardless of sexual orientation or gender identity, participating in LGBTQ+-affirming trainings regarding IPV, and creating a welcoming and inclusive space that promotes LGBTQ+ survivors' comfort in disclosing IPV.
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Gender and sexual minority individuals face considerable physical and mental health disparities, health risk factors, and barriers to care. These disparities are rooted in systemic and interpersonal prejudice, discrimination, and violence toward lesbian, gay, bisexual, transgender, queer, and other (LGBTQ+) individuals and communities that place LGBTQ+ individuals at increased risk for negative social determinants of health. While also advocating for systemic change, individual providers and clinics have an ethical duty to promote an openly affirming, culturally competent health care environment that can help to address these disparities on an individual patient level.
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Transgender and gender-diverse youth represent approximately 2% of all youth in the United States. Given that gender diversity usually develops during childhood and adolescence, primary care providers must be equipped to recognize and support youth exploring gender identity or experiencing gender dysphoria. This article provides an overview of gender diversity and reviews strategies for creating a welcoming clinical space, discussing gender during the office visit, providing affirming primary care, and supporting youth and their families during gender identity exploration and gender transition.