Social and Structural Barriers Faced by and Sexual Minorities in Obtaining Reproductive Healthcare Montida Fleming Jefferson Medical College, Thomas Jefferson University, , PA

The Problem Gender Literacy • women are less likely to have health Training medical professionals in understanding insurance and less likely to receive routine Pap unique health concerns in the LGBTQ population, tests compared their heterosexual counterparts.1 and how to be sensitive to those concerns, is an • Transgendered males were found to be less likely important tool in reducing and to receive preventative health services such as healthcare disparities. pap tests due to both lack of insurance and Medical students with increased clinical exposure to discrimination by healthcare providers.2 LGBTQ patients3: • Barriers may include: • Perform more comprehensive histories Mazzoni Center – Stigma and discrimination • Hold more positive attitudes toward LGBTQ • Provides quality and comprehensive health and – Lack of compassion, sensitivity, and gender literacy patients wellness services for the LGBTQ community in by healthcare workers • Possess greater knowledge of LGBTQ health care Philadelphia and surrounding regions. – Lack of health insurance concerns • Continuum of services provides a safe space that – Misconceptions about risk in female bodied people respects the dignity of all individuals they serve. who do not have with males An easy way to conceptualize important differences between a person’s , sexual • Focuses on a compassionate model of care to – Language used by public health advocates regarding improve their patients quality of life. preventative care for female reproductive organs orientation, biological sex, and is by using a genderbread person: • Women’s Health Initiative stems from a national Discrimination grant – RHEDI (Reproductive Health Education In 42% of the transgendered males delayed seeking Family Medicine) – seeks to increase training of healthcare when injured or sick, and nearly half family medicine residents in reproductive health (48%) delayed seeking preventative health services procedures. due to discrimination by healthcare providers.2 • Residents are trained to provide compassionate and culturally sensitive care, including pap testing, more advanced GYN care, and medication abortions, to LGBTQ patients.

References 1. Dilley JA, Simmons KW, Boysun MJ, et al. Demonstrating the importance and feasibility of including in public health surveys: Health disparities in the Pacific Northwest. Am J Public Health. 2010;100(3):460-7. 2. Grant, Jaime M., Lisa A. Mottet, Justin Tanis, Jack Harrison, Jody L. Herman, and Mara Keisling. Injustice at Every Turn: A Report of the National Discrimination Trans* (with the asterisk) is used as an umbrella Survey. Washington: National Center for Transgender Equality and National and Lesbian Task Force, 2011. term to indicate a variable and dynamic definition of 3. Sanchez NF, Rabatin J, Sanchez JP, et al. Medical students’ ability to care for lesbian, gay, identity, including anyone that identifies on the bisexual, and transgendered patients. Med Stud Edu. 2006;38(1):21-7. 4. Mazzoni Center. (2013). Trans* Care at Mazzoni Center . Accessed October 27, 2013. http:// transgender spectrum, those who consider mazzonicenter.org/content/trans-care-mazzoni-center 5. Mazzoni Center. (2013). History & Mission. Accessed September 29, 2013. http:// themselves bi- or multi-gendered, and those who do mazzonicenter.org/about/history-and-mission not identify with any labels.4