Key messages

  • Policies make overt reference to LGBTI people
  • Affirmative action policy promotes staff diversity.
  • LGBTI representatives are consulted about clinical services.
  • LGBTI-specific symbols and health materials are displayed in public areas.
  • Staff are trained to use language that is inclusive of LGBTI people and their relationships and to respectfully document LGBTI identity and health history.
  • There is a referral network of LGBTI-inclusive services and providers.

Case study

A woman in her 50s attended a new general practice to discuss her struggles with coming out in mid-life. She had previously attended another clinic; however, she found the reception staff were abrupt when she attempted to change her marital status to single. The GP did not understand and suggested that she attend couples counselling with her ex-husband to try for reconciliation.

The woman noticed a new clinic advertised in the local LGBTI magazine and decided to give it a try. When she arrived, she was reassured to see a rainbow sticker displayed on the door and a poster in the waiting room stating ‘you don’t have to tell if you are gay, lesbian, bisexual, trans or intersex, but you can’. The new patient intake form had a question about ‘partner’ rather than husband and asked the gender of the partner. Although she didn’t complete the section, the woman hoped this was a good sign. She felt comfortable to tell the GP that she was embarking on a new relationship with a woman, which was exciting and fulfilling, but she was experiencing a great deal of guilt about her adult children, who were both very distressed with the situation. The GP was empathic and understanding, and able to provide her with information about PFLAG, a support group for families with a member who is coming out.

This practice was able to create an environment that was respectful and safe for this woman, and the skills and knowledge of the GP satisfied her need to be understood and referred to appropriate resources.

Inclusive practice principles

Inclusive practice principles were applied in the following ways:

Affirmation

  • The clinic makes overt reference to people who are LGBTI within its policies regarding privacy, marketing, staff training and patient-centred care.
  • The clinic has an affirmative action policy regarding the appointment of a diverse range of staff, including people who are LGBTI.
  • Advice is sought from representatives from LGBTI communities regarding clinical services.

Freedom from discrimination

  • The clinic displays an anti-discrimination policy that includes direct reference to people who are LGBTI. The policy specifies that discrimination on the basis of sexual orientation, gender identity or intersex status is not tolerated from staff, patients or carers.
  • The clinic institutes disciplinary measures for any staff member in breach of this policy.

Access and equity

  • The clinic displayed symbols and LGBTI-specific health materials in the waiting room that indicate an inclusive approach
  • Receptionists were trained to use language that is inclusive of the diverse range of people who are LGBTI and their relationships, while being careful to protect confidentiality
  • Clinical staff were trained in skills of respectful facilitation of disclosure and sensitive sexual history taking, as well as in evidence-based LGBTI specific health information
  • Clinical staff carefully and respectfully documented LGBTI identity in the patient files and referral letters with the permission of each patient
  • A referral network of services and providers known to be LGBTI-inclusive was developed.

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