In case you somehow missed a dozen businesses rolling out the rainbow flags, June is the month when LGBTQ+ individuals celebrate their identity and the respect and freedoms they’ve slowly—too slowly—gained while they continue to fight for more. You can be a part of the progress made by ensuring you practice nursing that includes people from all sexual and gender identities. Here are five ways to start.

Understand the diversity of LGBTQ+ community

We’ve used the term LGBTQ+ here for simplicity’s sake, but there are a dozen variations on how the community of gender and sexual minorities is called a group. One of the longer ones is LGBTQIA2S+, which stands for Lesbian, Gay, Bisexual, Transgender, Queer and/or Questioning, Intersex, Asexual, Two-Spirit. The plus sign, here and in all similar acronyms, refers to the countless other ways people may identify themselves. Of course, you aren’t expected to know every possible combination or every type of identity that exists. Still, you need to recognize just how diverse this patient population is so that you’re less likely to make assumptions or broad generalizations. ‍

Understand the barriers to care for LGBTQ+ people

Research has shown a range of poorer health outcomes within the LGBTQ+ community, and the two significant reasons for those poorer outcomes are discrimination and difficulty with access to care. Those two reasons aren’t unrelated either. One of the most significant barriers to care is past negative experiences of discrimination, prejudice, or stigma from healthcare personnel that make a person feel less comfortable seeking care. Other reasons for limited access include lacking insurance, providers’ lack of knowledge about their needs, and fear of being misunderstood or mistreated. The more you know about barriers to quality care for LGBTQ+ people, the better you’ll understand this patient population. 

Use inclusive language

There are two parts to this one. The first is knowing basic terminology. One of the most comprehensive glossaries for this comes from the National LGBTQIA+ Health Education Center, a fantastic resource. Their Glossary of Terms for Health Care Teams is available in English or Spanish. 

Knowing the correct terms to use is only half the battle when communicating effectively with members of the LGBTQ+ community. It’s also essential to understand and use respectful and inclusive language, even if it’s different from what you’ve been taught in school or used to. For example, many men who have sex with men do not relate to the terms “gay” or “bisexual.” So if you’re asking a question about their sexual partners, you may need to ask whether they are gay, bisexual, or have sex with men—even if some of that seems redundant. 

Another example is how you ask about a person’s marital status. They may be single, married, divorced, widowed, partnered, in a polyamorous relationship, or some other form of relationship. Be specific in your questions while remaining respectful. The following guides can help:

• Focus on Forms and Policy: Creating an Inclusive Environment for LGBT Patients
• Providing Inclusive Services and Care for LGBT People
• How to Use Inclusive Language in Healthcare
• Inclusive Language for Medical & Health Education: An Evolving Guide
• Dell Medical School Inclusive Language Guidelines

Do your part to make the environment LGBTQ+ welcoming. 

You may or may not have much control over the clinical environment. Still, you do have some control over how you present yourself, and you may be able to make recommendations to improve the LGBTQ+ inclusivity of the clinical environment. Here are some suggestions for both:

• Include your pronouns on your name tag. 
• Include a rainbow flag, pink triangle, trans flag, or similar stickers, buttons, or pins on your name tag, lanyard, scrubs, or whatever your dress code allows.
• Be sure the organization’s nondiscrimination policy is prominently in view.
• Have rainbow, trans, or similar flags or decor visible in the clinical area. This can be subtle, such as a small rainbow by the nurse’s station that conveys “you’re welcome here.” 
• Have unisex restrooms available.
• Have posters that mention special days related to LGBTQ+ communities, such as World AIDS Day (December 1), Pride (month of June), and National Transgender Day of Remembrance (November 20). 
• Be sure any health education literature, such as trifold brochures, has diverse images and inclusive language and that some specifically pertain to LGBTQ+ health. 
• If books or magazines are in a waiting area, include some that specifically relate to LGBTQ+ themes. This could be as simple as a couple of children’s books that feature two moms, or two dads or magazines whose cover stories feature LGBTQ+ related articles or individuals. 

Be aware of the biases, misconceptions, stereotypes, and other assumptions you or others might make. 

This is a tough one because you may not realize you have a bias or believe a misconception until it’s pointed out to you, inadvertently offend a patient, or later discover something you said that you shouldn’t have. First, avoid making assumptions based on someone’s appearance or other personal characteristics that they fall into a particular sexual or gender category. Allow them to tell you who they are. 

Second, be compassionate if you make an inaccurate assumption or another mistake. What’s important is that you commit to learning to be more aware and apologize—simply and directly, without going overboard—if you make a mistake or cause an offense.

Third, take the time to read regularly about what LGBTQ+ inclusive care looks like and read writings by LGBTQ+ people. The more you hear their voices, the more you understand them and their needs. 

These are just a few tips above, but we’ll provide more this month. So watch for other ways to improve your LGBTQ+ IQ!