“Baby, you were born this way”: LGBTQI+ discrimination in healthcare communication between healthcare provider and patient

Summary In multiple healthcare situations, LGBTQI+ people still receive inadequate care due to their sexual orientation and/or gender identity. This inadequate care is a result of the gap in knowledge and skills concerning inclusive communication with LGBTQI+ patients. In addition, most patients still feel discriminated by their healthcare provider. Discrimination can occur both direct due to heterosexism or indirect and unintended due to heteronormative microaggressions. These microaggressions mostly take form in communication between the LGBTQI+ patient and their healthcare provider. Relevance The problem is that most healthcare providers are not aware they display certain heteronormative microaggressions, making it hard to improve this habit. This is a problem, because LGBTQI+ patients can be discouraged from disclosing their sexual orientation and/or gender identity to their healthcare provider or chose to withdraw information about their sexual orientation and/or gender identity that might affect their health. Nonetheless, communication training and increasing awareness for the use of these microaggressions can help to improve the communication between patient and healthcare provider. This can reduce the withdrawing of important information, resulting in a more fulfilling provider-patient relationship and more adequate care overall. However, this individual approach of communication training and increasing awareness will not suffice to tackle this problem once and for all: as most of these microaggressions are supported by a heteronormative society, the problem is rooted in our healthcare system as well as education and institutions. Therefore, a holistic and institutional approach of this problem is also needed. Take home messages To improve communication with LGBTQI+ patients in healthcare situations, it is important that healthcare providers receive adequate communication training considering this topic in their curriculum. Nonetheless, changes at environmental and institutional level are required also to solve the problem of microaggressions and heterosexism in healthcare communication