The mission of the U.S. Department of Health and Human Services (HHS) is to enhance the health and well-being of all Americans, by providing for effective health and human services and by fostering sound, sustained advances in the sciences underlying medicine, public health, and social services. HHS works to ensure that LGBTQ+ people, their families, and communities receive equal access to health services by providing enhanced resources for LGBTQ+ health issues; developing better information regarding LGBTQ+ health needs; and working to close the LGBTQ+ health disparities gap that currently exists.
There's a lot of information about schools issues for lesbian, gay, bisexual, transgender, queer, and questioning youth both on the ACLU's website and elsewhere on the web, but sometimes it can be difficult to find your way to the resources you need online. ACLU has gathered some of the best information plus great stuff from other organizations and websites on this page to help you find things that can help you learn more about your rights and what you can do to make your school a safer, more welcoming place.
The mission of the U.S. Department of Education’s Office for Civil Rights (OCR) is to ensure equal access to education and to promote educational excellence through vigorous enforcement of civil rights in our nation's schools. To serve this mission, OCR enforces civil rights laws to protect all students from unlawful discrimination and harassment based on race, color, national origin, sex, disability, and age. This includes students who are lesbian, gay, bisexual, transgender, queer, questioning, asexual, intersex, nonbinary, and individuals who identify their sexual orientation or gender identity in other ways (LGBTQI+).
Bullying, harassment, exclusion from school activities, and other forms of discrimination can interfere with LGBTQI+ students’ access to a safe and inclusive school environment. Federal law, however, requires schools to ensure that LGBTQI+ students and other students have equal access to all aspects of a school’s programs and activities.
Learn more here and to find resources from the department of education.
Fighting for equality means we can’t afford to let anyone fall through the cracks. Human Rights Campaign (HRC) works locally, nationally and globally on issues that affect the LGBTQ+ community. HRC partners with people across demographics, industries and governments to provide leadership on how to back up pro-equality statements with real action and create a society where none of us is left behind. Here is a link to HRC resources Their goal is to ensure that every LGBTQ+ person is free to live their life openly, with their equal rights ensured. They know that goal requires that we keep educating, supporting and inspiring ourselves and each other.
Many Americans refrain from talking about sexual orientation and gender identity or expression because it feels taboo, or because they’re afraid of saying the wrong thing. This glossary was written to help give people the words and meanings to help make conversations easier and more comfortable. LGBTQ+ people use a variety of terms to identify themselves, not all of which are included in this glossary. Always listen for and respect a person’s self identified terminology.
While the legal issues surrounding gender identity and sexual orientation are frequently talked about as if they fall into a singular category, they involve multiple areas of law, including family law, employment law, immigration law, juvenile law, tax law, and health law, among many others. Thus, it can be difficult to find resources that touch on all or most of these areas. This Beginner’s Guide includes information about how to research legal issues that affect LGBTQ+ people.
This National Education Association (NEA) resource page is designed to provide educators with LGBTQ+ information, tools, and resources they need to support transgender and non-binary students, to be more inclusive of LGBTQ+ history in their classrooms, and to stop LGBTQ+ bias and intolerance in our public schools.
GLMA is a national organization committed to ensuring health equity for lesbian, gay, bisexual, transgender, queer (LGBTQ) and all sexual and gender minority (SGM) individuals, and equality for LGBTQ/SGM health professionals in their work and learning environments. To achieve this mission, GLMA utilizes the scientific expertise of its diverse multidisciplinary membership to inform and drive advocacy, education, and research. Here is a link to their resources for patients, providers, and researchers.
The AAOS respects the lives of every person regardless of race, religion, gender, creed, or sexual orientation, and continues to support its members and the public. Here is a link to their mission and resources.
Orthopaedic Hospital Medical Magnet High School (OHMMHS) engages students in a rigorous curriculum focused on college and career readiness. Here is a link to a list of books with LGBTQ characters and themes.
Pronouns are used in everyday speech and writing to take the place of people's names. We frequently use them without thinking about it. Often, when speaking of someone in the third person, these pronouns have a gender implied. These associations are not always accurate or helpful.Mistaking or assuming peoples' pronouns without asking first, mistakes their gender and sends a harmful message. Using someone's correct gender pronouns is one of the most basic ways to show your respect for their identity.
How do I become better at approaching and treating LGBTQ patients? This is great training from the Center for Medicare and Medicaid.
The LGBT Health Workforce Conference is the largest and most well known national LGBT health workforce conference in the United States held annually in New York City. The conference provides an overview of up-to-date practices (climate, educational, research, and clinical) in preparing the health care workforce to address the health concerns and disparities of lesbian, gay, bisexual, and transgender (LGBT) communities. This conference is designed for health professionals (M.D., D.O., P.A.-C., R.N., N.P., D.D., social workers, psychologists, etc.), educators, and students (pre-health professions, professional schools, and graduate), but all interested are invited to attend. CME credit will be available.
For many LGBTIQ+ workers coming out is a never-ending process. A recent study in the UK shows coming out at work is still a problem. Here is an article written by Raymond Trau, Lecturer RMIT University on this subject with a great list of resources at the end of the article.
An LGBTQ+ mentorship program enriched the experience of medical students and physician mentors. Beanlands et al. Can Med Educ J 2020
The Schulich School of Medicine and Dentistry implemented a LGBTQ+ mentorship program led by LGBTQ+ medical students. LGBTQ+ faculty and resident physicians were paired together. From survey responses, mentees and mentors shared that the program created a positive, reassuring, and sense of belonging that had not been experienced prior to participating in the program.
Transgender individuals' workplace experiences: the applicability of sexual minority measures and models. Brewster et al. J Couns Psychol 2012
The purpose of this study was to evaluate the psychometric properties of 3 validated measures of workplace experiences of sexual minority people could be modified to specifically address transgender individuals. A total of 263 transgender individuals completed theWorkplace Heterosexist Experiences Questionnaire, the Lesbian, Gay, Bisexual, and Transgendered Climate Inventory and the Workplace Sexual Identity Management Measure. Psychometric analysis supported the applicability of these modified measures for use in transgender research.
Experiences of Transgender and Gender Nonbinary Medical Students and Physicians. Dimant et al. Transgend Health 2019
An online survey was distributed to transgender and gender nonbinary U.S. physicians and medical students. Approximately 50% of the respondents reported that they had not disclosed their gender identity at work. Additionally, 69% heard derogatory comments about transgender and gender nonbinary people and 33% witnessed discriminatory care of a transgender and gender nonbinary patient. Significant disparities exist regarding gender identity.
LGBTQ bullying: a qualitative investigation of student and school health professional perspectives. Earnshaw et al. J LGBT Youth 2020
Investigators conducted focus group interviews of students and school health professionals' qualitative study to describe perceptions of LGBTQ bullying. Results revealed a disconnect in perceptions of LGBTQ bullying among LGBTQ students versus SHPs. LGBTQ students described experiences of bullying while the SHPs reported minimal LGBTQ bullying. Changes are needed to improve communication between LGBTQ students and SHPs, and education is needed to strengthen SHPs' skills to respond to LGBTQ bullying.
This is an editorial and personal account of navigating medical school as LGBTQ+ by Aliya Feroe. She ponders what her classmates and patients will think of her being a queer provider and the heaviness of being seen as an expert in LGBTQ+ issues.
U.S. medical school admissions and enrollment practices: status of LGBTQ inclusivity. Gamble et al. J Osteopath Med 2021
One hundred and eighty schools were surveyed and 75 responded. Of the 75 respondents, 73% allowed applicants to self-report a gender identity other than male or female and 20% allowed applicants to report sexual orientation. Medical schools need to improve the collection of sexual orientation and gender identity demographics to help address disparities among LGBTQ+ applicants.
Does Medical Students' Sense of Belonging Affect Their Interest in Orthopaedic Surgery Careers? A Qualitative Investigation. Gerull et al. Clin Orthop Relat Res 2021
Medical students from 4 schools were interviewed about their interest in orthopedics and sense of belonging with orthopaedics. Responses reveal that students derive their sense of belonging in orthopaedics based on how closely their identity aligns with stereotypes that orthopedic surgeons are white, male and athletic. Students that lacked a sense of belonging to the stereotypical group decided against orthopaedics.
Experiences of LGBTQ+ Residents in US General Surgery Training Programs. Heiderscheit et al. JAMA Surg 2022
6381 responded to the survey with complete answers. Of the 6381 residents, 5% identified as LGBTQ+. A higher percentage of LGBTQ+ residents reported discrimination, sexual harassment and bullying compared with non-LGBTQ+ residents. LGBTQ+ surgery residents reported suicidality because of this mistreatment. It is critical to develop multifaceted interventions to foster safe and more inclusive learning environments.
Assessment of the Prevalence of Medical Student Mistreatment by Sex, Race/Ethnicity, and Sexual Orientation. Hill et al. JAMA Intern Med 2020
A total of 27,504 students at 104 allopathic medical schools responded to a survey of mistreatment. Female, underrepresented minorities, Asian, multiracial, and LGBTQ+ students reported more mistreatment. Interventions are need to address these disparities to promote diversity, equity and inclusion in medical school.
Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training. Hu et al. N Engle J Med 2019
A total of 7409 residents from all 262 surgical residency programs responded to a survey regarding mistreatment during training. Of the 7409 surgery residents, 31.9% reported gender discrimination, 16.6% reported racial discrimination, 30.3% reported verbal or physical abuse, and 10.3% reported sexual harassment. Rates of all types of mistreatment were higher among women and this mistreatment occurs frequently among general surgery residents, especially women, and is associated with leads to burnout and suicidal thoughts.
Experiences of Transgender and Nonbinary Physicians During Medical Residency Program Application. Kvach et al. J Grad Med Educ 2021
Twenty-six eligible transgender and nonbinary residents from 10 medical specialties completed an online survey. Of the 26 respondents, 69% felt unsafe disclosing their gender identity due to fear of discrimination and negative impacts on match; 27% felt they were ranked lower because of gender identity discrimination; 42% were misnamed or misgendered. Gender-affirming practices, nondiscrimination policies and education are needed to create a safe and inclusive learning and working environment.
Still in the closet: the invisible minority in medical education. Lapinski and Sexton BMC Med Educ 2014
4112 students from 6 osteopathic medical schools were invited to participate in the survey, 1334 (32.4%) completed it. Approximately 15% of respondents self-identified as lesbian, gay, bisexual and no respondents identified as transgender. LGB students reported higher levels of depression, slightly lower levels of perceived social support, discomfort with disclosing sexual orientation and the majority of students described their campus climate as noninclusive. Policies to improve diversity, equity and inclusion are needed to support all students.
Attitude and Perceptions of the Other Underrepresented Minority in Surgery. Lee et al. J Surg Educ 2014
Of the 388 general surgery residents that responded to an online survey, 2.6% identified as lesbian, 6.3% as gay (6.3%), and 2.4% as bisexual. Among all respondents, 54% witnessed homophobic remarks by nurses and residents and 30% witnessed homophobic remarks by attendings. Of LGBT residents, 57% reported actively concealing their sexual orientation from fellow residents due to fear of rejection and 52% concealed identity from attendings fearing poor evaluations. Of the 21% of LGBT residents that experienced targeted homophobic, none reported the event to their supervisors.
The dilemma of disclosure: patient perspectives on gay and lesbian providers. Lee et al. J Gen Intern Med 2008
Using a national marketing database to select a random sample of respondents, a survey was sent to collect self-reported perceptions and chaperone preference based on provider gender and sexual orientation during a genital exam. Approximately one-third of the respondents reported they would change providers or practice if they found out their provider was gay/lesbian.
Sexual and Gender Minority Identity Disclosure During Undergraduate Medical Education: "In the Closet" in Medical School. Mansh et al. Acad Med 2015
A survey was disseminated to all medical students enrolled in U.S and Canada medical schools. Respondents were asked about their sexual and gender identity, whether they were "out" (i.e., had publicly disclosed their identity), and, if they were not, their reasons for concealing their identity. 5,812 medical students from 152 schools responded. Of the 912 students that identified as LGBTQ, 30% reported concealment of sexual identity in medical school. Policies to create an inclusive environment that supports LGBTQ students is needed.
Physicians' attitudes toward homosexuality--survey of a California County Medical Society. Mathews et al. West J Med 1986
A survey that included the Heterosexual Attitudes Towards Homosexuality (HATH) Scale questionnaire was mailed to all members of the San Diego Medical Society. 930 physicians completed the questionnaire. HATH scores indicated that 37% were homophilic, 40% were neutral and 23% were homophobic. Females were more homophilic, psychiatrists were the most homophilic and orthopedic surgeons were the most homophobic.
Barriers to Increasing Diversity in Orthopaedics: The Residency Program Perspective. McDonald et al. JBJS Open Access 2020
Program directors and coordinators from 75 of 155 allopathic orthopaedic surgery residency programs responded to an online survey regarding barriers to increasing diversity. Programs participating in Nth Dimensions and/or Perry Initiative programs had higher percentages of URM faculty and programs with more URM faculty had more URM residents.
LGBTQ+ Inclusivity in Surgery-A Call to Action. McKean et al. JAMA Surg 2022
This editorial by McKean recounts the difficulties during the application process to surgical residency. Additionally, they discuss the need for more LGBTQ+ education, allyship, and provide recommendations to more LGBTQ+ inclusive patient care.
Sexual Orientation Diversity and Specialty Choice Among Graduating Allopathic Medical Students in the United States. Mori et al. JAMA Netw Open 2021
58,572 graduating allopathic medical students completed an online survey. 5.7% of the females and 6.9% of male respondents identified as LGBTQ+. In the general population, it is estimated that 9.4% of females and 5.3% of males aged 25 to 34 years identify LGBTQ+. Of the specialties, psychiatry had the most LGBTQ+ students (11.6%) and orthopedic surgery had the lowest (1.8%). Compared to heterosexual students, SM medical students experience higher levels of mistreatment and are less likely to pursue specialties perceived to be noninclusive.
Strategies to Bring Transgender and Non-binary Health Care into Pharmacy Education. Newsom and Gilmer Am J Pharm Educ 2021
US pharmacists’ have reported having low self-confidence in communicating with and caring for transgender and nonbinary patients. Simultaneously, transgender and nonbinary patients report a lack of trust in pharmacists’ ability to adequately and respectfully care for them. It is important to improve and increase education pharmacy school to provide adequate and respectful care for the transgender and nonbinary patient.
Development, Implementation, and Effectiveness of a Self-sustaining, Web-Based LGBTQ+ National Platform: A Framework for Centralizing Local Health Care Resources and Culturally Competent Providers. Nowaskie JMIR Form Res 2021
OutCare Health is a nonprofit 501(c)(3) that created an online framework of resources to improve healthcare for LGBTQ+ patients. OutCare Health created an OutList, which is nationwide directory of healthcare providers who identify as culturally competent in the care of the LGBTQ+ community. Additionally, OutCare Health provides public health resources, mentors, and competency educational materials and education across the country.
Medical School Factors Associated with Changes in Implicit and Explicit Bias Against Gay and Lesbian People among 3492 Graduating Medical Students. Phelan et al. J Gen Intern Med 2017
4732 first-year medical students from 49 US medical schools completed an online survey. Of the respondents, 5.5% identified as LGBTQ+. Lower explicit bias against gay men and lesbian women was associated with more favorable contact with LGBT faculty, residents, students, and patients, and perceived skill and preparedness for providing care to LGBT patients. Medical schools may reduce bias against sexual minority patients by reducing negative role modeling, improving the diversity climate, and improving student preparedness to care for the LGBTQ+ population.
How Do Medical Students Perceive Diversity in Orthopaedic Surgery, and How Do Their Perceptions Change After an Orthopaedic Clinical Rotation? Rahman et al. Clin Orthop Relat Res 2021
Students from 27 US medical schools who had completed orthopaedic rotations were surveyed. Prerotation and postrotation perceptions of diversity and inclusion between majority and nonmajority students were compared. Overall, underrepresented minority medical students perceive that orthopaedic surgery is less diverse and inclusive than do their counterparts in majority groups. However, after completing an orthopedic surgery rotation, these negative views often change.
Orthopaedic Care of the Transgender Patient. Ramsey et al. J Bone Joint Surg Am 2021
Gender-affirming hormone therapy (GAHT) has physiologic effects of the patient's health relevant to orthopaedics, including bone health, fracture risk, and perioperative risks such as venous thromboembolism and infection. In caring for the transgender patient, accurate pronoun usage as well as other affirming language is critical for objective and subjective outcomes. Cultural competency in caring for transgender patients can reduce outcome disparities, improve care access across multiple subspecialties, and establish appropriate perioperative management guidelines.
World in transition: sport and transgender athletes. Rizzone Br J Sports Med 2022
Rizzone highlights in this editorial the controversial and under studied subject of sports and transgender athletes. A staggering high percentage of transgender youth experience suicidal ideation and attempt suicide and the mental health and well-being benefits of sports cannot be understated. There is much more research that needs to be done to make sports inclusive and fair for all athletes, including those who are transgender.
Association Between Sexual Orientation, Mistreatment, and Burnout Among US Medical Students. Samuels et al. JAMA Netw Open 2021
26,123 of 30,651 US medical students graduating from Association of American Medical Colleges (AAMC)-accredited US allopathic medical schools completed a survey that included The Oldenburg Burnout Inventory for Medical Students. 5.4% of respondents identified as lesbian, gay, or bisexual. Lesbian, gay, or bisexual students reported higher mistreatment specific to sexual orientation and had an 8-fold higher predicted probability of burnout compared with heterosexual students. Further work is needed to ensure that medical schools offer safe and inclusive learning environments for LGB medical students.
The Future LGBT Health Professional: Perspectives on Career and Personal Mentorship. Sanchez et al. LGBT Health 2018
Seventy-five lesbian, gay, bisexual and transgender medical trainees completed surveys and a subset of 23 respondents participated in three focus groups. Eighty-eight percent of trainees reported working with a mentor and 48.5% reported having a mentor identifying as LGBT. Trainees valued LGBT mentors for positive role modeling, shared understanding of experiences and career development. Creating mentorship programs uniquely focused on LGBTQ+ trainees and mentees is important for positive experiences, networking and career development.
National Survey of Oncologists at National Cancer Institute-Designated Comprehensive Cancer Centers: Attitudes, Knowledge, and Practice Behaviors About LGBTQ Patients With Cancer. Schabath et al. J Clin Oncol 2019
149 of 450 oncologists from 45 cancer centers completed a survey measuring attitudes and knowledge about LGBTQ health and institutional practices. Of the respondents, 65.8% reported that knowing patients’ gender identity was important and 39.6% that knowing sexual orientation of patients was important. 70.% of respondents were interested in receiving education of the unique health needs of LGBTQ patients.
Oncology healthcare providers' knowledge, attitudes, and practice behaviors regarding LGBT health. Shetty et al. Patient Educ Couns 2016
108 of 388 oncology providers from a single institution completed a survey. While 94% stated they were comfortable treating this population, <50% answered knowledge questions correctly. Furthermore, 26% actively inquired about a patient's sexual orientation during exam and 36% believed mandatory education on LGBT cultural competency was needed at the institution. Providers who routinely inquire about the gender identity and sexual orientation of their patients may improve care by offering tailored education and referrals.
Specialty Choice Among Sexual and Gender Minorities in Medicine: The Role of Specialty Prestige, Perceived Inclusion, and Medical School Climate. Sitkin and Pachankis LGBT Health 2016
Medical trainees and practitioners (358 sexual gender minorities, 1528 non- sexual gender minorities) were surveyed regarding specialty choice. Specialty prestige and perceived inclusivity predict sexual gender minority specialty choice. Sexual gender minority diversity initiatives in prestigious specialties may be effective in improving diversity among providers across specialties and ultimately improved care of sexual gender minority patients.
Meeting the Patient Care, Education, and Research Missions: Academic Medical Centers Must Comprehensively Address Sexual and Gender Minority Health. Streed et al. Acad Med 2021
The authors outline discrimination experienced by LGBTQ+ persons and highlight the unique disparities they experience across access and outcomes. The authors posit that by systematically improving clinical care of, incorporating education and training about, and research with LGBTQ+ people into their core missions, academic medical centers can dramatically change the health care landscape. Academic medical centers can eliminate health disparities, expand necessary research endeavors about sexual and gender minorities, and prepare the health care workforce to address the unique needs of these overlooked populations.
Assessment of Internal Medicine Resident Preparedness to Care for Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning Patients. Streed et al. J Gen Intern Med 2019
1018 PGY1-3 residents at 120 U.S. internal medicine residency programs completed a pretest followed by a 1-h online training module addressing sexual and gender minority health. Students were test following the training module. Regardless of year in training, residents exhibited improvement in SGM health knowledge following the didactic module. It may be possible to reduce health disparities among LGBTQ patients with improved physician training on clinical care of LGBTQ patients and families.
Do Ask, Tell, and Show: Contextual Factors Affecting Sexual Orientation and Gender Identity Disclosure for Sexual and Gender Minority People. Suen et al. LGBT Health 2022
74 sexual and gender minority participants were enrolled. 55 of the 74 participants were organized into nine focus groups and the remaining 19 participants participated in cognitive interviews regarding the disclosure of sexual orientation and gender identity in a healthcare setting. Two main themes emerged: (1) need to understand the relevance sexual orientation and gender identity questions and (2) the importance of communicating physical safety and freedom from discrimination. Contextualizing the relevance of SOGI data sought and safety from discrimination could help improve the accuracy and sensitivity of data collection efforts.
Medical Training in the Closet. Turban N Engl J Med 2019
This article describes the struggles and also the positive experience from the perspective of a gay male during medical training and practice. The author calls for change in policy but also empowers individuals to make small changes to promote inclusion and equity.
What's Important: Applying to Orthopaedic Surgery as a Member of the LGBTQ Community. Weaver J Bone Joint Surg Am 2022
This editorial by Weaver recounts the difficulties during the application process to orthopaedic residency. He talks about the signals that students use when applying to residency that we affectionately call a “6thsense.” This was the article that posted on Twitter by JBJS and received a bigoted message from an orthopaedic surgeon and in response received an outpouring of love and support from the LGBTQ+ and allies of our community.
Coming Out at Work is Not a One-Off Event by Raymond Trau. This editorial discusses one of the biggest challenges members of the LGBTQ+ community face, coming out at work. The best solution is for allies to "create an inclusive culture so people feel safe to be themselves at work and able to have a real choice about coming out, which increases commitment and career satisfaction."