In vulnerable times like illness, feeling supported, understood and seen can be critical to those receiving care. That’s why the definition of patient-centred care is expanding to include much more than a patient’s diagnosis.
For people who identify as LGBTQ2S+ (lesbian, gay, bisexual, transgender, queer and/ or two-spirit), it is important that a health-care space be welcoming and safe, whether they need cancer treatment or anything else, says Amanda Bolderston, a faculty educator in the Radiation Therapy Program at the University of Alberta. A lack of inclusion can make a difference in regards to whether a person feels comfortable accessing care at all.
Bolderston studies approaches to LGBTQ2S+ community health care and is developing a website called Queering Cancer, which includes resources for LGBTQ2S+ people who have cancer.
“Treating everybody the same isn’t really the best care because we’re not the same, we all have unique needs,” says Bolderston.
“If you’re coming into an environment [as an LGBTQ2S+ person] you’re looking for clues that a) it’s friendly and b) they include people like you.”
Practical approaches, like adjusting signage and intake forms and furthering medical professionals’ education about members of the LGBTQ2S+ community can have life-saving effects in the long term, says Bolderston. These resources can help support someone to feel more comfortable expressing their unique needs to a health-care provider and, in turn, get the specific care they require.
For the past four years, Alberta Health Services has taken the initiative to offer more inclusive care to all Albertans, including through its Cancer Control Alberta program.
Get acquainted with some of its services:
Connect Care combines health records into one single electronic file that is accessible across the province within AHS.
What’s important is that, among other things, it provides a sensitive and respectful opportunity for an individual to identify themselves and, when appropriate, disclose their sex at birth, administrative gender and gender identity.
“That way we ensure that we accurately reflect a patient’s identity to help them have a safer, more inclusive health-care experience,” says Dr. Ted Braun, AHS vice president and medical director of central and southern Alberta.
The program also offers the ability to select a third gender – the option of “X” – and a broader range of gender identities like transgender, two-spirit and non-binary.
“A lot of patients who are LGBTQ2S+ don’t come out to health-care professionals because there may be previous experiences that were negative in the health-care system. We don’t often give them a chance to come out,” says the U of A’s Amanda Bolderston. “Forms are really important because they allow the patient an easy way to identify initially.”
The first wave of Connect Care rolled out in Edmonton in November 2019. Eventually, AHS plans to implement it across the province.
Diversity and Inclusion Council
Since its founding in 2016, the Diversity and Inclusion Council has created LGBTQ2S+ inclusive resources for staff and patients. It also plans Pride parties and organizes a presence in the Pride Parade.
The AHS LGBTQ2S+ / Sexual and Gender Diversity webpage offers tool kits for health-care teams. These include safe space posters, educational videos and specific documents on things like how to use preferred pronouns when addressing patients.
On the patient side, there are tips on how to bring up sexuality, sexual orientation or gender identity with a health-care provider, resources on transgender health, and information on services that support diversity for all ages from youth to seniors.
SOGIE PAC (Sexual Orientation, Gender Identity and Expression) is a new Provincial Advisory Council formed by AHS in January of this year that engages with local communities to understand what’s needed to help LGBTQ2S+ patients feel more supported.
It exists, like many councils within AHS, to improve health services by engaging with the community and then incorporating relevant feedback to improve how AHS operates in all levels.
Though new, SOGIE PAC plans on eventually informing and enhancing program planning, development and evaluation with contributions and perspectives from the LGBTQ2S+ communities.
“The top priority in [its] work plan is actually creating educational materials for our staff and physicians,” says Braun.
Not everyone wishes to be referred to as either “he” or “she.” Foster inclusion by identifying the pronouns you prefer first. For example, “I’m Mary Smith, and I use she/her/hers.”
Examples of personal pronouns: