June 17, 2022

By Lisa Ryan

Two recent events have offered opportunities for current and future providers to learn best practices for delivering informed, respectful health care to LGBTQ+ patients.

The second annual LGBTQ+ Health Symposium on Wednesday, June 15, organized by the College of Medicine and Tower Health, was virtual and open to the public. The all-day event covered a variety of topics, from the basics of sexuality, gender identity and expression, to providing culturally sensitive health care to LGBTQ+ patients who are refugees.

“Society at large has failed the LGBTQ+ population, and it is important that we are deliberate in the correcting of inequalities in our system,” said Zachary Winchell, a PGY-1 psychiatry resident at Tower Health – Phoenixville and a symposium organizer. “It was wonderful to be able to approach this important topic through an educational and interesting event.”

Tower Health residents worked alongside College of Medicine MD program students and staff members from the Office of Diversity, Equity & Inclusion on the Symposium. They planned for the event to kick off with a 9 a.m. presentation by the Mazzoni Center, an LGBTQ-focused Philadelphia health care provider. That presentation introduced attendees to the concepts of gender and sexuality as they applied to health care, and defined common LGBTQ+-friendly language and vocabulary.

Building off attendees’ common understanding following the morning’s first presentation, speakers throughout the day were able to tackle LGBTQ-affirming practices as they applied to particular subjects. Presenters covered such topics as best practices for talking with patients of various ages and life experiences about pre-exposure prophylaxis (PrEP), or providing culturally sensitive care to LGBTQ+ patients who are refugees.

Kathryn A. Brandt, DO, is a board-certified OB/GYN and chief in the Division of Obstetrics at Tower Health – Reading Hospital; she completed one of Hahnemann University Hospital’s first fellowships in gender-affirming surgery. Brandt’s presentation discussed gender-affirming surgery as well as ways providers can help reduce gynecological health disparities between cisgender and transgender, nonbinary, and gender-diverse patients.

Brandt also covered both the potential recovery challenges as well as the joys associated with gender-affirming surgeries, which Brandt said have a 1% regret rate.

Closing out the event after Brandt’s talk, symposium organizer Maryssa Lyons, MD, a PGY-1 psychiatry resident at Tower Health – Brandywine Hospital, encouraged event attendees to leave with the goal of connecting with LGBTQ+ patients and colleagues in their moments of joy, and to use their power as physicians to enhance equity that allows everyone to live their fullest lives.

“I hope this symposium has given you the resources to be the person some of the most vulnerable people need, from the waiting room to the provider’s office,” Lyons said.

The MD program class of 2023 gained resources toward the same goal in a student-driven version of the symposium, which helped prepare the medical students to have more respectful patient interactions during clinical rotations. The day-long event on Wednesday, May 15, also began with an introduction to concepts and terminology related to the LGBTQ+ community and health care, before delving into more specific subjects.

“Medical students have wildly different levels of exposure to the LGBTQ+ population,” Winchell said. “It is important that everyone gets to a minimum level of competency so that they can give the proper care to any person, regardless of their gender identity or sexuality.”

Alexa Profozich, MD program class of 2023, helped organize both symposiums and said format was the main difference, rather than content. Students took part in case study discussions and could choose between two small-group lessons: a presentation on transgender primary care by Elliot Goodenough, MD, PhD, a provider at Drexel Medicine’s Partnership Comprehensive Care Practice, and a presentation on demographics of HIV-positive adolescents and PrEP initiation for young people given by Nellie Lazar, a Philadelphia-based nurse practitioner.

Profozich, who also helped plan the 2021 symposium, said the format change would benefit students.

“It permits more participation and discussion, compared to only didactic lectures,” they said. “The student symposium also featured a patient panel of queer individuals sharing their health care experiences. I think it’s very beneficial for students to hear clinical experiences that may vary from their own.”

They hoped their fellow medical students left the event feeling more comfortable providing competent care and creating inclusive health care environments for LGBTQ+ patients. Profozich said there are simple things physicians can do to make LGBTQ+ patients feel welcome in health care settings.

“First and foremost, I think it is important to never assume someone’s pronouns regardless of their appearance, especially if a patient has previously identified their pronouns in the electronic medical records,” they said. “Additionally, if someone’s queer identity is not pertinent to the chief complaint, it seems unnecessary to draw attention to it if it is not influencing health care management at the present time.”

Zac Nan, MD program class of 2025, agreed, and added that health care providers should remember that when they need to ask health-related questions that involve a patient’s sexuality or gender identity, they must do so in a nonjudgmental way.

Nan hoped current and future physicians left the symposiums with a better understanding of the health disparities LGBTQ+ patients face, as well as greater ability to communicate with those patients respectfully.

“All of us will eventually encounter an LGBTQ+ patient, no matter what specialty we choose to go into,” he said. “Through symposiums like this, we can help to reduce health disparities facing the LGBTQ+ community and build trust between providers and our queer patients.”