Nurse’s Guide to Caring for LGBTQ+ Youth

Overcoming LGBTQ+ youths’ mistrust of the healthcare system is vital. Ironclad assurances and actual protection of strict confidentiality are essential.

Privacy from parents and guardians, school personnel, and other authority figures is key. It is also important to help youths understand the implications of disclosing information to healthcare staff, especially when state laws on suicidal or homicidal ideation, sexual assault, abuse and neglect, and other circumstances mandate that a parent or guardian be informed.

At the beginning of one-on-one interactions, care providers should verify that confidentiality is sufficiently explained in a way that is consistent with pediatric guidelines and ethics. Confidentiality may also be established in patients’ medical records by indicating specific information that may or may not be shared with certain parties.

Nurses can better inform youths of their available care options by adopting a forthcoming position on these requirements. This can help you to build trust through transparency. It is only when confidentiality can be assured and protected at all points of interaction that youths can truly feel empowered to share sensitive information that may be vital to their care.

Gaining the trust of the LGBTQ+ youth patient population means that nurses and healthcare providers must understand, and remain aware of, changes in LGBTQ+ concepts, terms, and definitions that such patients and their peers commonly use.

If a healthcare provider displays ignorance regarding the appropriate use of common terms (like genderqueer, gender fluid, nonbinary, transgender man, transgender woman, etc.), or if the provider fails to display humility when offered feedback about their lack of knowledge, those behaviors can lead to an avoidance of care by the patient.

Worse, it could lead to mis-, over-, or underdiagnosis by the provider, which can have lasting effects on patients.

When a provider is uncertain of a term used by a patient or how to address a specific issue in a competent manner, honesty, humility, and authentic curiosity go a long way toward furthering trust and a positive rapport.

The National LGBT Health Education Center recommends the establishment of an environment where colleagues are comfortable correcting one another when incorrect language is used in caring for patients. Working together, colleagues can create a supportive culture of accountability that raises the bar for quality of care.

An inclusive and welcoming environment comprises various aspects of a healthcare facility’s approach to populations such as LGBTQ+ youth.

When a transgender individual makes use of a healthcare institution, an act as simple as using the restroom can be filled with anxiety. Gender-neutral restrooms allow individuals to take care of their personal needs without unnecessary worry. Intake forms and other paperwork should allow for the expression of patients’ chosen gender identity, sexual orientation, and self-definition. The National LGBT Health Education Center’s guide to creating inclusive forms and policies is a valuable resource in this regard.

For example, paperwork related to patients’ gender identity should not be limited to checkboxes for “man” or “woman.” It should instead offer an option to write in a patient’s own gender or genders. It can also have a list of many gender options where the patient can choose more than one.

Gender should never be conflated with sex, which should offer “male,” “female,” and “intersex.” Inclusive signs, pamphlets, and literature geared toward the LGBTQ+ patient population can also foster a sense of safety and acceptance. Recognition of World AIDS Day, Pride events, and National Transgender Day of Remembrance are examples of ways in which healthcare institutions can help LGBTQ+ patients feel recognized as valid members of the wider community.

According to an article published by the Pediatrics Clinic of North America on inclusive and affirming environments for LGBTQ+ youth, a focus on equity of access is crucial. The authors outline several key factors:

• Care must be provided to “all groups of lesbian, gay, bisexual, transgender, queer, and questioning youth.”
• It must be ensured that “services are inclusive of and sensitive to the needs of diverse racial/ethnic groups of LGBTQ youth, including those of color and who are non-native English speaking patients.”
• Services must be provided “to all LGBTQ youth regardless of ability to pay.”

The LGBTQ+ landscape in the 21st-century United States is not unchanging or static. The development of language and identity is fluid and will continue to evolve over time.

Ongoing and up-to-date training is crucial for the healthcare system and its providers to remain aware of best practices and clinical approaches for LGBTQ+ youth.

Nursing care for LGBTQ+ youth is central to the fulfillment of equitable care by all providers and organizations, and robust culturally competent training is paramount.