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Sexual Identity and Unconscious Bias in Healthcare_608x320-1090774914

Sexual Identity and Unconscious Bias in Healthcare

June 10, 2021
June 10, 2021

An encounter with the healthcare industry involves personal interactions with a provider. For success in treatment and for encouraging healthy behaviors, a trusting relationship needs to exist between the patient and a healthcare professional. This isn't always easy for members of minority groups whose previous interactions in healthcare may not have been positive. According to the LGBT Health Education Center, "When working with lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients, it is especially important to build rapport as a way to counteract the exclusion, discrimination, and stigma that many have experienced previously in health care."

Unconscious Bias During LGBT Healthcare Experiences

Without intending, healthcare providers may demonstrate bias during a healthcare encounter in what is said and in general behavior. An example from the same resource is that "a clinician or other staff person may say something or use body language that communicates a stereotype or antagonistic message about LGBTQ people. Sometimes called 'microaggressions,' these kinds of actions and statements often determine whether a patient follows medical advice or returns for care." Multiple negative healthcare experiences by someone identifying as LGBTQ have the potential to increase stress and can lead to detrimental behaviors as well as health outcomes.

Avoiding Unconscious Bias in Healthcare Related to Sexual Identity

The LGBT Health Education Center also offers that "no matter how we feel about prejudiced behavior, we are all susceptible to biases based on cultural stereotypes that are embedded in our belief systems from a young age. A 2015 study based on data from the Sexuality Implicit Assessment Test found that heterosexual physicians, nurses, and other health care providers implicitly favored heterosexual people over gay and lesbian people."

An important component of reducing impact of bias in this area is awareness. A BMC Medical Education article describes the use of "Programs designed to increase student or provider knowledge of the LGBTQ community and LGBTQ-relevant health care issues… [through] lectures, readings, videos, interviews or presentations by LGBTQ individuals, and group discussions." These programs should address a wide range of subjects, "including sexual orientation, gender identity, sexual history taking, LGBTQ terminology, disclosure of orientation and gender identity, discrimination and prejudice toward LGBTQ individuals, impact of LGBTQ-related discrimination on health, factors affecting medical access and care for LGBTQ patients, myths and stereotypes about LGBTQ individuals, transgender medical care, and legal concerns relevant to elderly LGBTQ individuals."

The same article suggests three important steps for reducing the impact of sexual orientation bias:

  1. Inspire "change through increasing knowledge among faculty and students for the need for bias awareness. This can be achieved by providing information regarding disparities in health care and the role of health care provider bias, encouraging students to reflect on what they should do in hypothetical encounters with LGBTQ patients."
  2. Employ bias awareness strategies "in a supportive and individualized learning environment such as patient simulation that provides students with opportunities to receive direct feedback about perceived implicit biases while minimizing student defensiveness."
  3. Ensure learners understand "that implicit biases – whether negative or positive – are universal psychological phenomena."

Ultimately, cultivating awareness is key to counteracting the negative impacts of unconscious sexual identity discrimination. The LGBT Health Education Center makes it clear that "An important way to reduce disparities, therefore, is for health care professionals to address their own biases on the individual and interpersonal levels. A first step is acknowledging that we are all vulnerable to biases. Once we are confronted with this awareness, our first impulse may to be deny or avoid it. It is normal to feel uncomfortable, but the only way to change our thoughts and behavior is to acknowledge our biases, become curious about them, and practice ways to transform them."

Diversity & Inclusion Training for Healthcare

In order to provide quality care and positive outcomes for all patients, it is imperative to address and manage diversity and inclusion. There are many implications to this topic and its impact on morale, quality of care, cost of patient attrition, and healthcare disparity. Create a culture with no tolerance for bias by pausing, planning, and practicing positive interactions. A workforce that understands the importance of recognizing unconscious bias, diversity in the workplace, cultural competence, and health literacy not only improves peer-to-peer and caregiver-to-patient relationships, but also has the power to influence your organization's bottom line. Learn more about healthcare training for diversity & inclusion.