Caring for the LGBTQIA+ Patient: A Best-Practices Primer on Language, Sexual Function Considerations, and Health...

Despite representing a growing percentage of the global population, queer patients (i.e., lesbian, gay, bisexual, transgender, intersex, and/or asexual; LGBTQIA+) continue to experience significant disparities in gynecologic healthcare. Common barriers to inclusive care include discriminatory healthcare experiences, difficulty finding identity-affirming providers, and systemic lack of competency in addressing queer-specific medical needs. Such barriers arise out of heteronormative assumptions, limited provider training, and insufficient understanding of diverse sexual and gender identities. This narrative review examines gynecologic care considerations for lesbian, gay, bisexual/pansexual, asexual, intersex, and transgender patients. We review research documenting how queer patients delay or avoid healthcare due to fear of judgment, discrimination, and inadequate provider understanding. Our review highlights unique healthcare needs across different queer identities, including inclusive and culturally-sensitive sexual health screening that includes (but is not centered solely on) queer-specific sexual practices; considerations for transgender patients undergoing gender-affirming care; and incorporating intersectionality into assessment, treatment planning, and delivery. Finally, we make direct recommendations for caring for queer patients, including developing inclusive intake processes; training healthcare teams in affirming, non-discriminatory practices; using gender-neutral language; recognizing the diversity of sexual and gender identities; and addressing minority stress and its impacts on health.