Jun 29, 2016

Taking Pride in Care for LGBTQ+ Community

Dean Trevor Young at #DisplayYourPride installation at MSB

Dean Trevor Young at #DisplayYourPride installation at MSBWith all the celebrations and rainbow flags marking Toronto’s Pride Month — including our own #DisplayYourPride installation at MSB — it’s easy to believe that the prejudice and stigma that once surrounded the LGBTQ+ community is just a historical footnote. But the tragic massacre in Orlando starkly reminds us that while huge advances have been made, many challenges remain. And among them is delivering effective medical care to the LGBTQ+ community.

Take mental health as an example. I recently spoke about it to our students at Out in Medicine (see the great pieces about MD students Luke Swenson and Alex Coutin). Rainbow Health Ontario notes the LGBTQ+ community is more likely to report unmet mental health needs from anxiety and depression to substance dependence, than the general public. Of tremendous concern is the finding of a 2011 study that the risk of suicide among LGBTQ+ youth was found to be 14 times higher than other youths in Canada. A 2010 study in the United States found 10 per cent of LGBTQ+ youth met the criteria for post traumatic stress disorder and 15 per cent met the criteria for major depression. Especially impacted by these trends are members of the transgender community, which is compounded by the finding that half of trans people in Ontario are living on less than $15,000 a year.

In the face of these challenges, how are we as health professionals responding?

To begin with, we’re acknowledging the issues. The lack of attention or discussion that I saw when I was an MD student has given way to open and thoughtful conversations that are leading to action. For instance, clinics have started using inclusive intake forms. And just by asking trans patients about their preferred gender and pronoun (his/he or her/she or their/they), health professionals help them feel more welcome. This shift in thinking and broadening of acceptance is an extension of how we reframed questions about marital status decades ago when I was a student, to avoid taking for granted that everyone was straight.   

Now, there is a “spectrum” of resources available to physicians and health care workers for LGBTQ+ patients from organizations like Rainbow Health Ontario, Re:searching for LGBTQ Health, CAMH and others. And this month The Lancet published a great Series on Transgender Health, providing a framework to improve the health of this population worldwide. Our health centres are better attuned to the needs of queer patients, while Sherbourne Health Centre offers specialized services and support programs. Meanwhile we are making strides to improve LGBTQ Health Education in our MD Program thanks to work by Drs. Amy Bourns and Ed Kucharski, and being pushed to go even further by leaders like Dr. Kevin Imrie, President of the Royal College of Physicians and Surgeons and Professor of Medicine. We are definitely up to the challenge.

Like the overall struggle for LGBTQ+ equality, we can take pride in some of the advances we have made, while acknowledging that more is still needed. Our mission is to prepare healthcare professionals who are ready to care for the diverse communities in which they will work, which will include treating LGBTQ+ patients. Doing that well is something we can all take pride in.

Trevor Young
Dean, Faculty of Medicine
Vice-Provost, Relations with Health Care Institutions