Handbook details GLBT patient care

Handbook details GLBT patient care

SUMMARY: A year after it was published, requests are still coming in for copies of a major healthcare company’s groundbreaking handbook on treating the gay community.

A year after it was published, requests are still coming in for copies of a major healthcare company’s groundbreaking handbook on treating the gay community.

Kaiser Permanente has printed more than 14,000 copies of its 72-page guide, which attempts to explain and demystify the non-heterosexual world.

« If people read it, it’s going to make a huge difference in the way medical care is delivered to gays, lesbians, bisexuals and transgendered people, » said Maureen O’Leary, executive director of the 2,000-member Gay & Lesbian Medical Association.

With more than eight million members, mostly in California but also in eight other states, Kaiser Permanente is the country’s largest not-for-profit HMO. It previously published guides on the special needs of African Americans, Latinos and Asians/Pacific Islanders.

The new handbook describes the lives of gays and sensitively explains the prejudices and challenges facing them. It points out that studies have shown medical professionals are as prejudiced toward gays as the rest of the population is.

In regard to medical treatment, the handbook is explicit in its descriptions of sexual practices and the risks they pose. It warns medical providers to be aware of the special needs of transgendered people and not make assumptions about a patient’s gender.

« We want to give providers an overview of things they should think about, » said Dr. Lemuel Arnold, an Atlanta pediatrician who helped develop the guide. « We realize that there is a significant knowledge gap. There’s very little education around this in medical school, not just in issues of care, but issues of interaction and communication. »

Among other things, the guide urges doctors and nurses to use forms that give patients an opportunity to describe their sex and love lives. « I talked to a young lesbian who went to her doctor, and the first thing he said was, ‘You’re not on birth control, so let’s talk about that,' » Arnold said. « There are other ways to approach that besides assuming that they’re involved in heterosexual activity. »

Learning to ask new questions isn’t easy for medical professionals, Arnold said. « For many people, that takes some work. It actually takes practice. » The guide also insists that medical providers remain neutral about their opinions. « Personal biases do not belong in the medical encounter, » it says.

« Lecturing patients about what is right, moral, sinful or a societal standard alienates patients, causes them to further delay medical care, edit what they may say to providers or go to a different provider in the hopes of finding someone whom they can talk to freely. »

Arnold has traveled across the country to give presentations about the guide. « Our goal was not to mail them to providers and have them sit on a shelf, » he said. « The idea is to introduce them to stimulate interest so providers would end up looking at them and using them. »

Kaiser Permanente has sent copies of the guide to every medical school in the United States, and Arnold said he hopes many will adopt it as part of their programs. « This is a great opportunity for education, » he said.