In the United States, June is a time to celebrate the vibrance of the lesbian, gay, bisexual, trans, intersex, queer and questioning (LGBTQIA+) community and its contributions to society. It is also a time to reflect on the progress that has been made in terms of LGBTQIA+ rights – as well as the urgent work that still needs to be done.
An area with still significant room for improvement is in healthcare. LGBTQIA+ people are more likely to experience discrimination in the healthcare ecosystem and more likely to have unmet healthcare needs.
“As a primary care physician, I see the challenges every day in my practice,” says Khristina Booth (she/her), D.O., M.S., family physician, Union Health Center. “From making appointments to getting yearly screenings to medication management, LGBTQ+ patients may face microaggressions and ignorance in their care.”
Adds Janae Sharp (she/her), founder and president, Sharp Index: “There are many barriers, from indoctrinated hatred to lack of community support. Access to care is daunting in some areas. Some may not feel comfortable sharing their identity with healthcare professionals.” One way to address this disparity is to ensure that health tech and services are inclusive of all, regardless of their sexual orientation or gender identity. This means that products and services should be designed to meet the needs of all users – not just a select few.
In recent years, the healthcare industry has seen a significant shift towards technology-driven solutions. Digital health has the potential to revolutionize healthcare delivery and improve patient outcomes.
“Digital health transformation is thinking about human centered care and how humans interact with technology,” says Gabriel Garcia-Lopez (he/him), CPHIMS, director, health information systems, Los Angeles LGBT Center. “Capturing patient data on sexual orientation and gender identity in your EHR and health IT systems can help identify and address inequities experienced by the community.” The development of digital health, however, is not immune to the challenges of diversity and inclusion that exist in many industries. Across the U.S., 46% of LGBT workers have experienced unfair treatment at work because of their sexual orientation or gender identity at some point in their lives and according to the HRC Foundation, earn about 89 cents for every dollar then their straight and cisgender counterparts. The gap widens for LGBTQ+ women (87 cents), transgender men (70 cents) and transgender women (60 cents).
“Initially, my greatest hurdle was concealing my true identity in the workplace. When casual conversations arose, such as discussing weekend activities, I found myself deflecting and avoiding mentioning my long-term partner who was a woman,” said Xand Griffin (she/her), owner, Xand Griffin Consulting. “However, my perspective on success has shifted. I now define my success as uplifting others who have been marginalized and ensuring their voices are heard.”
Adds Ted Eytan (he/him), M.D., M.P.H., family physician, program manager, contract trace force, DC Department of Health: “We understand what it’s like for a person to be denied control of their health/life destiny. We work to change everything as healers, leaders, partners in a health care system that’s uniquely disempowering. We see the potential in every human as we become seen ourselves.”
Digital solutions built on a foundation of diversity and representation, which serves all patients, must be informed by the perspectives and experiences of diverse users to truly improve clinical and operational outcomes.
“Ask them what's important to them and what issues they are facing,” says Tarah Neujahr Bryan (she/her), chief marketing and communications officer at Health Catalyst. “While it's good to create focus on the LGBTQIA+ community, each letter needs to be considered individually alongside more expansive inclusive best practices.” The community uses a variety of terms to identify themselves and vary across communities. Because the community within itself is multifaceted, it’s best to defer to the language the individual prefers.
Says Garcia-Lopez: “As the community evolves, we must do the same. We must ensure our systems can scale to the needs of our everchanging community.”
Adds Dr. Booth: “If I make a mistake, I humbly learn from it and adjust my practice.”
For digital health to truly achieve its full potential, companies and health systems must prioritize the recruitment and retention of diverse talent. This starts with the creation of inclusive workplace cultures, providing equitable opportunities for professional development, and knocking down the systemic hurdles that prevent marginalized communities from entering the industry and accessing care.
“We can get this right,” Sharp says. “We can create tools that help. Digital health tools are important for creating safe communities.”
Explains Dr. Booth: “My hope for the future is those providing care recognize their own bias and work harder to educate themselves and uphold their oath to provide medical care to all, regardless of race, sexual orientation, gender, or disability.”