Primary Care Pearls
Primary Care Pearls
"I don't feel welcome there." - LGBTQ+ Health in the Office (Part I)
In this episode, Delaney, Chloe, and Dr. Canarie help us understand how to provide inclusive care for everyone, including patients from LGBTQ+ community.
=== Outline ===
Chapter 1: Creating a welcoming environment
Chapter 2: Sexual history and organ inventory
Chapter 3: An informed physical exam
=== Learning Points ===
- A simple, basic thing to do to create a safe environment for trans individuals is to commit to using their correct pronouns and name, which may be different from their legal name or the name on their medical records. This extends to before and after the visit, when you may be discussing a patient with other staff members.
- Somebody's gender expression may be vastly different from their gender identity, and the same goes for sexual identity and sexual expression. What this means for us is that we shouldn't make assumptions about the individual sitting in front of us, for instance, that someone is taking hormones or wants to be, or that somebody who identifies as lesbian, bisexual, or gay is practicing a certain type of sex.
- Use trauma-informed care when taking a sexual history and performing the physical exam. And we should be doing this with every patient we see, not just LGBTQ + patients. This can look like asking permission to discuss a topic and offering patients the choice to opt out.
=== Our Expert(s) ===
Dr. Canarie graduated from Arizona State University and the Geisel School of Medicine at Dartmouth. He completed his combined internal medicine and pediatrics residency at the Yale School of Medicine in 2020. During this time, Dr. Canarie studied under Anchor Health’s cofounder, A.C. Demidont, DO, AAHIVS, where he experienced firsthand how lifesaving competent care is for LGBTQ people. After graduating, Dr. Canarie served as a chief resident in pediatrics. In 2021, Dr. Canarie was hired as the medical director of Anchor Health’s HIV Prevention & Treatment Program.
=== Toolkits and Resources ===
- YSM Dean’s Advisory Council guide
- Fenway textbook: Transgender and Gender Diverse Health Care: The Fenway Guide
- Free CME sponsored by Fenway: https://www.lgbtqiahealtheducation.org/
- Neo pronouns: https://neopronounss.carrd.co/
- CDC: Taking a sexual history using the 5 P’s https://www.cdc.gov/sti/hcp/clinical-guidance/taking-a-sexual-history.html#cdc_generic_section_3-the-five-ps
=== Listen to more LGBTQ+ voices ===
- Making Gay History (podcast & book)
- LGBTQ&A (podcast)
- TransLash (podcast & website)
- Gender Reveal (podcast)
=== About Us ===
The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine. The project aims to create accessible and informative podcasts about core primary care topics centered around real patient stories.
Hosts: Delaney Rawson
Producers: Helen Cai, Josh Onyango
Logo and Name: Eva Zimmerman
Theme music and Editing: Helen Cai, Josh Onyango
Other background music: The Mini Vandals, Density & Time, The Tides, Jesse Gallagher, Chillout, Astron
Instagram: @pcpearls
Twitter: @PCarePearls
Listen on your favorite podcast platforms: linktr.ee/pcpearls