Andrew Gilliver of the LGBT Foundation discusses supporting LGBTQ+ patients and staff, including how to ask the right questions and potential challenges to be aware of.
Of course, dentists have a duty of care to all their patients, but sometimes there are things that we don’t know about our patients that they might feel could be a barrier to them receiving the care they need. This is something that is particularly prevalent in the LGBTQ+ community where there are already so many barriers to accessing healthcare services.
Many LGBTQ+ patients often delay engaging with healthcare providers due to either current or past concerns or negative experiences they may have had. This means that there is likely to be a reduced access to healthcare for many in this community and an unwillingness (or circumstances that may prevent patients) from being open with their healthcare provider.
The less we know about a patient, the less we are likely to consider their needs and services won’t improve. However, we can make sure that we try to end this negative cycle in our own clinics by simply being more aware of the needs of our patients who are part of the LGBTQ+ community.
As a dental patient it is important that you feel comfortable with the person who is treating you. LGBTQ+ patients need to feel that they are in a safe place where, if they choose, they can disclose information about their trans status, gender history and sexual orientation.
Asking the question
It is up to the practice to ask these questions as part of basic demographic monitoring information – not to rely on patients to volunteer their sexual orientation or gender identity first. A patient needs to know why you are asking and recording this information and that it is confidential.
Dental staff should be aware that these questions are as important as any other information collected and they should be confident to explain why they are asking. If a patient does not want to disclose this information it is entirely their prerogative but it would be a mistake not to ask and simply assume someone’s identity – or even worse think that it is not relevant.
To know that no-one in the practice will make assumptions about you simply because you are LGBTQ+ can sometimes be a deciding factor for some people on whether they even go to the dentist or not. Often previous negative experiences of a service can dissuade many people from having any confidence at all that a service is inclusive, non-judgemental and confidential.
As a dentist your role is to bring up anything you can see that affects a patient’s oral health. You have to give people the option to be honest with you. Your patient has to choose whether or not to be honest with you, but at least you asked.
Challenges to be aware of:
- Many LGBTQ+ people worry about whether a service is accepting of LGBTQ+ people and concerned that that their health needs won’t be met
- Being unable to share their sexual orientation, gender, and trans status on registration forms
- Fear that personal information won’t be kept confidential
- Assumptions about their identity based on how they look/sound
- Being referred to services that don’t accept or meet the needs of LGBTQ+ people.
Supporting LGBTQ+ staff
It is just as important to support LGBTQ+ colleagues. Being part of a supportive culture and thinking about how your workplace demonstrates its LGBTQ+ awareness and inclusion internally and externally really can work wonders in making sure that people are able to perform better when they feel able to be themselves.
However, just because a member of the team may be part of the LGBTQ+ community, it is not appropriate to ask them to be a LGBTQ+ champion for the practice, unless they have expressed an interest in this. It’s therefore important to empower all of the team to be allies to the LGBTQ+ community.
An LGBTQ+ ally is someone who is not LGBTQ+ but supports LGBTQ+ people by:
- Being aware of LGBTQ+ people’s experiences
- Avoiding assumptions and using open and inclusive language
- Listening to trans and non-binary people
- Creating welcoming spaces with visible inclusivity
- Giving people opportunities to tell you about their identities through effective sexual orientation and trans status monitoring.
- Signposting to LGBTQ+ specific services and mainstream services.
A checklist for LGBTQ+ inclusion
- Are your online and physical practice environments visibly inclusive?
- Can you confidently use open and inclusive language?
- Can patients share their sexual orientation, gender identity and trans status during registration?
- Is this data being used to improve patient experiences and outcomes?
- Are you confident to signpost to LGBTQ+ support services?
Pride in Practice
If you feel you would like some help with any of the above, please do get in touch with us. As part of the Pride in Practice primary care training programme, the LGBT Foundation are available to support dental services and have become increasingly aware of the importance of sharing support for LGBTQ+ people around their oral health. In addition, it has become increasingly important for us to be able to develop our support for health care professionals who provide comprehensive dental care.
We have been delighted to work with various dental practices throughout Greater Manchester and a selected number of services throughout North West England already to develop our own learning and tailor our training and support to include areas of healthcare that may often be overlooked, and until very recently may not have paid due regard to the needs of LGBTQ+ communities.
For anyone working in the area of dental health who is interested in developing support for LGBTQ+ patients we would be delighted to hear from you. You can contact us via email at [email protected].
Useful resources
- ABC of LGBTQ+ communication for health and social care professionals
- Hidden figures: LGBT health inequalities in the UK
- Monitoring sexual orientation and trans status
- More on pride in practice.
