1. Caring for LGBTQ Patients Methods for Improving Residents’ Cultural Competence Chicago, IL, 36 th Forum for Behavioral Science in Family Medicine, September 18 th, 2015 Maliheh Nakhai, MD R3 Providence Oregon Family Medicine Residency Elizabeth Klein, MD Faculty, Providence Oregon Family Medicine Residency

2. Disclosures We (Dr Elizabeth Klein and Dr Maliheh Nakhai) do not have any disclosures to report

3. What you will learn: AAFP recommended curriculum guidelines for FM Residents Communication Health history Primary care counseling Patient-centered treatment http://www.aafp.org Search: LGBT Curriculum Guidelines http://www.aafp.org

4. Self assessment Strongly agree(1), agree(2), neutral(3), disagree(4), strongly disagree(5) A.I understand my LGBTQ patients’ specific needs B.My waiting room environment is LGBTQ-friendly C.I am aware of which of my patients are L, G, B, T, or Q D.I have resources available for the unique needs of LGBTQ patients E.I have experience with LGBTQ patients F.My staff is sensitive to the needs of LGBTQ patients

5. Word Cloud Lesbian Gay Bisexual Transgender

7. Cis/Trans

8. LGBTQ(IQ) What’s the definition of… Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Questioning

9. MSM What’s the definition of… Men who have sex with men

10. WSW What’s the definition of… Women who have sex with women

11. CASE Small Groups: 3-4 participants

12. Coming Out Stars

13. Risk Factors, Preventive Care

15. Physical Health Cancer

16. Physical Health Cancer Fitness

17. Physical Health Cancer Fitness Obesity

18. Physical Health Cancer Fitness Obesity Injury/violence

19. Physical Health Cancer Fitness Obesity Injury/violence Trans Concerns

20. Cardiovascular Health

21. Mental Health

22. Sexual Health Lesbian Gay Bisexual Trans

23. Transgender Terms M2F F2M Transition-related Hormones Surgery

24. Special issues for Youth Violence bullying homophobic victimization Substance abuse Depression Suicide and suicide attempts Homelessness Sex work Legal sanctions Heteronormative language/culture

25. Making your practice LGBT friendly Create a welcoming environment Visual environment non-discrimination statement Inclusive language Forms Interactions Educational handouts

26. Making your practice LGBT friendly Avoid assumptions AND unrelated probing Get the facts Be aware of Health Issues that may impact LGBT patients Show your commitment to providing care to all in our community Treat patients like people too!

27. Organizational assessment How LGBT-Friendly is your organization now? Have your providers been trained in care of LGBT patients? Are diverse LGBT patients represented on fliers? What other ways is it friendly? This year, how will you make your practice more LGBT friendly?

28. Resources-Internet Top Health Issues for LGBT Populations Information & Resource Kit http://store.samhsa.gov/shin/content//SMA12-4684/SMA12-4684.pdf http://store.samhsa.gov/shin/content//SMA12-4684/SMA12-4684.pdf GLMA.org The Fenway Institute: LGBThealtheducation.org Kaiser Family Foundation bulletin on LGBT health and access to care and coverage UCSF Transgender Center for Excellence: transhealth.ucsf.edu TransActive www.WPATH.org Sarabecker.com/t LGBTdata.com lesbianSTD.com OutForHealth.org/for-providers.html

29. Q&A

30. Self assessment Strongly agree(1), agree(2), neutral(3), disagree(4), strongly disagree(5) I understand my LGBTQ patients’ specific needs I have resources available for the unique needs of LGBTQ patients I feel more competent in my care of LGBTQ patients What suggestions do you have for our presentation?