CCSF 2-6-21

City College of San Francisco

LGBTQ+ Medical Case Scenarios: An Experiential Learning Perspective

This presentation consisted of reviewing LGBTQ+ medical case scenarios through the lens of City College of San Francisco medical interpreter students. Due to COVID-19, class was held over zoom. Each of the students read and studied three LGBTQ+ themed vignettes and associated discussion points before class. This allowed for a robust, highly interactive class discussion over zoom on how medical interpreters can collaborate with clinicians in providing more culturally competent care to the LGBTQ+ community.

The audience consisted of medical interpreter students.

Audience feedback/impact of this presentation:

Thank you so much Dr. Holt for a wonderful presentation. During my time in school and medical field I have not experienced such a deep, detailed, and informative presentation on LGBTQI. It blows my mind on how much I learned today, words that I was not sure off, and you made everything so clear and easy to understand. Enjoyed how you kept the class active and allowed for group discussion vs sitting down and just listening. You are an amazing teacher/Dr. and full of knowledge on this topic. Thank you for your valuable time! The most important thing I learned today was not just one thing but many. I am more informed on how to approach a person with different gender identity. Also being able to know the definition of all words that relate to a person was so helpful. For years I was confused on these definitions and did not know how to respond but now I am more aware and know what the description of the word is. (For example, sexual orientation, gender nonconformity and gender dysphoria). This allows me to engage more with that person and make them feel comfortable, secured, and important. The impact of todays class was being more open minded of all different ways that a person can relate to. This will allow me to interpret better and refer to the patient the right way to make them feel comfortable and to help that patient out even more vs not knowing how to refer to them or what they might be going through. Not everyone is knowledgeable on how to treat LGBTQI people and feel like they are alone in the world. Being able to have this understanding changes the way we see each other and be able to pass that word on so more people know and understand with out judging. ***

I enjoyed the presentation completely. Dr. Holt was very informative, easy to understand and open. I learned: I obtained clarity on “gender” (biological) and “sexual orientation” (a person’s preference and how they identify themselves). Another important topic covered was gender dysphoria and the possible consequences. The facts presented helped me realize that not only do I need to practice humility between cultures, it is also very important for me to check my biases when it comes to how each person identifies themselves. Everyone deserves the same respect and I also will continue to educate myself in this area. ***

Dr. Holt has a great voice and is a natural presenter. The vignettes he provided were incredibly helpful, without which our understanding wouldn’t have deepened. His work is important for anyone studying to enter the health care industry. I learned: I didn’t think I’d learn much as over a third of my friends are LGBT. But I certainly did. I’ve learnt the challenges LGBTQIA people face in medical settings – it had never quite occurred to me. I’m sure these insensitivities still exist somewhere in SF Bay Area when health care staff are not well-trained. Unimaginable in the conservative parts of the country. Since I’ll be serving primarily the Chinese population and the older LGBTQIA among them are still mostly in the shadow, for instance, one of my close friends is a middle-aged Chinese male who has always had a close relationship with his mother and yet his sexuality has never been revealed or discussed, I shall exercise even more care when assisting these men and women. ***

Vignettes are very detailed and interesting. Felt like they described what LGBTQIA people are going through. I learned: The health disparities that LGBTQIA people encounter everywhere including in health care and how it affects them profoundly when seeking medical advice or treatment. I familiarized myself with terms used and will be able to be respectful when addressing LGBTQIA people. Will be attentive to degradation or privacy violations. Also, inequalities that occur within the medical field, including other parts of the country with less resources, should be reason to propose laws/bills that allow LGBTQIA people to receive quality care and services. This activity encouraged me to advocate and support LGBTQIA human rights. I will be more sensitive when referring to the LGBTQIA community. ***

It was a great learning experience. It highlighted things that as a heterosexual person I would not think twice about like the importance of pronouns, or the difference between gender, sex, and sexual orientation. I learned how at-risk transgender people are and how important it is to create a save and inclusive space for everyone. I will be more mindful of the language I use and try to educate myself not to make people feel excluded or offend anyone out of ignorance. ***

I think it was a very straight forward presentation to clarify/know the basics, but most important aspects of those who are trans. I learned: Respect is the most important. Be open when I do not know what a gender denomination means. Since I’m on the shy side, I’m always shamed to ask for more information if the other person does not disclose it to me, but here I learned that are ways to live a safe open door incase somebody would like to express the real person. ***

All the case studies are really good. We had a lot of good discussions among our group and learned a lot from all the cases. I learned: A person being transgender doesn’t mean they have gone through the surgery and a MTF transgender that is interested in men shouldn’t be identified as gay. ***

Before today’s lecture I only heard LGBT and now I learned LGBTQIA. Very good lecture and Dr. Ron Holt’s passion for teaching us how to treat these groups of people with respect and love.  Dr. Holt taught us how to address and to affirm a transgender during her Pap smear check. To assure that I am affirming of the patient’s gender and explained the procedure is to check the anatomy is present. To make the patient feel safe is priority. Show love and respect to others regardless of their choices for being themselves. ***

Never make assumption on anyone’s gender identity or gender orientation. Confidentiality. Never disclose any information you learn about the person to others without their permission. Understand that they are sharing this with you because they trust YOU, not your friends or family members. Never judge a book by its cover. To learn how to create a safe environment for others to open themselves to you. Stay open-minded and know that our words have impact on others as much as they have on us. ***

It is a really interesting talk and clarify a lot of misconception that I had it before. Dr. Holt has interacting with the class and make it more fun. I really enjoyed it. I learned what it is mean by straight, gay. The meaning of trans-gender. Why it is important to introduce myself to another person by pronouns. ***

They were complex and full of new terminology that I was not 100% familiar with. The questions were also complex and had to read it a couple of times to grasp the meaning. I learned: Do not assume anyone’s pronouns, sexual orientation, and/or gender identity. Is safe to respectfully ask if I do not know. Was a positive impact on me as it amplified the understanding of how someone’s identify his/her/themselves and part of the struggle his/her/they have to go through to be accepted by society. I will be more patient, open, and empathetic when meeting new people. ***

Great management of information and knowledge of the subject. I learned: Knowing the different genders and sexualities, which will help me personally to understand and accept each person as they want to be or appear without judging or offending. On the contrary, it makes me more kind and gentle when understanding what everything is about. Study cases in the breakout room was good because it gave me the opportunity to discuss a situation with others with different views and cultures. ***

This is a very meaningful lesson and learned a lot of LGBTQI topic. I learned: how to address someone’s gender better in a more respectful way. I learned to not make an assumption on someone’s gender based on their appearance and how to handle when someone reveal his/her/they gender to me. ***

It was quite challenging to answer the questions for each vignette because I was not very familiar about this topic and I did not have too many chances with the LGBTQIA population. So, it was difficult to come up with an answer because I was not sure if that’s the right action to do it or not. I learned: Know the differences between gender identity and sexual orientation. Always no assumption. Respect people all the way because we never know what others had gone through. Treat people equally and treat them in the way that they want. ***

CCSF 8-30-20

City College of San Francisco

LGBTQ+ Medical Case Scenarios: An Experiential Learning Perspective

The presentation consisted of reviewing LGBTQ+ medical case scenarios through the lens of City College of San Francisco medical interpreter students. Due to COVID-19, class was held over zoom. Each of the students read and studied three LGBTQ+ themed vignettes and associated discussion points before class. This allowed for a robust, highly interactive class discussion over zoom on how medical interpreters can collaborate with clinicians in providing more culturally competent care to the LGBTQ+ community.

The audience consisted of medical interpreter students and one graduate student.

Audience feedback/impact of this presentation:

I found the vignettes very eye opening and helpful. When you are explaining how an office can be more inclusive, I realized I’ve never seen inclusivity at an office. Putting out a rainbow flag or changing the sign at an office is so fast and simply and yet it hasn’t happened in every office. Really upsetting.

Impact of session: Being able to practice multiple times how to talk to our coworkers, friends, and loved ones if they need to talk while giving them time to express their feelings in their own time! Having *** express how she would talk to her son made me emotional, because I could really feel the love in her words and if that makes me feel good, I can only imagine what it must be for someone who is really going thru that time in their life.

Do not assume people’s gender identity. I learned how to approach people without offending them.

I really like the three examples. I learned reactions matter. Reacting with love, compassion, and being judgment free saves lives. Do not assume gender and sexuality of others.

The vignettes of the three different stories were well chosen and the questions at the end of each one were very insightful. I think they really left an impression on our minds. The most important thing I learned is that I am now more competent to identify the terms lesbian, gay, bisexual, transgender, homosexual, and heterosexual. Thanks to this activity, I am now more aware of the importance of treating people ethically, using open-ended questions and gender-neutral language, so that they feel comfortable and safe in case they need to disclose any personal information. 

Great presentation with the case studies! Nice sharings! I learned a lot about LBGT topic. I appreciated this learning. I learned what it means to be an LBGTQIA individual; some terms such as genderqueer, internalized homophobia, and internalized transphobia; some open-ended and gender-neutral language can prevent awkward or offensive social situations.

Be more aware and careful when talking to people especially I realize that SF is a very diverse place. Never make assumptions (think before speaking) about a person’s potential queer identity. Always be careful speaking with the sensitive topics. Be careful with the word choices as sometimes its’s easy to take things for granted.

Today’s topic/activity kinda reminds me of an interaction with a previous coworker who I didn’t realize might be a gay. I made some assumption that he’s straight, which created some embassassing/awkward moment – he asked me if I hate gays which made me feel bad…I think I really need to be more aware and open minded (which is easier said then done) in the future in my interatctions with others.

Great! It was great to learn ways in which clinics and places can be made more inclusive and welcoming towards the LGBTQ+ community. It was also nice to learn speech techniques that might help people we know feel safe and comfortable speaking with us about their sexuality and know they won’t be judged. I now have some knowledge of what words to avoid and which are better choices.

Thank you. Do not harm. I’ll remember to be careful.

The beginning of the class was a wonderful ice-breaking moment. It was great to have Dr. Holt’s owns perspective base on his personal life experience. I am very grateful for that. 

I learned that premature disclosures can lead to suicidal ideation and great distress or harm. An excellent way to open the door for someone I think is struggling with personal sexual orientation or gender identity is to keep a gender-neutral language and understand how the key is to create a safe and open environment. Finally, do not “out” the person. 

As a Spanish medical interpreter, I can make the difference for our LGBTQIA+ community by showing respect to them by the correct use of pronouns and preferred name, not making assumptions about a person’s gender, and creating a safe and open environment.  

Dr. Holt explains very well about LGBT. It helps me better understand as an interpreter how to speak to LGBT patients.

I really enjoyed the way the class was. It was easy to follow and easy to learn.                                                         

I learned the difference between gay and transexual, the difference between sex and gender and what is the risk of suicide among the LGTB community.                                                                                        

I learned different scenarios and new vocabulary about LGBTQI community. I learned trans can be straight, lesbian, or gay. Some people can notice their gender identity at very young age. Keep an open mind and be compassionate.

Very nice lecture. Information is consistent and relevant. I will definitely look for some of the disparities and barriers pertaining to LGBT healthcare environment.

LGBT people are not treated equally in this society. I would treat LGBT groups equal as other humans in health care facility.

I learned a lot from these vignettes. They were really specific and realistic. I learned how to be a LGBTQ ally to support them and show my love to them. Ways to open the door for a friend, family member, or coworker who is struggling with sexual orientation or gender identity to come out to me. Today’s lesson has change my view, as a healthcare interpreter, what I can do to improve their clinic experience. Respecting and treating LGBTQ patients the way they want to be treated.

I enjoyed all the vignettes, they were very informative and educational. They illustrated different scenarios that allowed us to examine the different outcomes in a medical setting and our role as interpreters in them. I enjoyed the questions and discussions that follow them.

I will be always be open, respectful and supportive of other person’s identity, orientation and sexual expression

KCU Feb 24-25, 2020

Creating a Safe and Welcoming Environment for LGBTQ+ Patients

On February 24 and 25, Dr. Holt had the honor of returning to his alma mater, Kansas City University, to discuss LGBTQ+ healthcare with faculty, staff, students, and administration. He had the opportunity to present sessions and moderate a panel of trans patients in front of over 400 attendees across two campuses. 

Many topics were discussed on how to make the healthcare setting a safe and welcoming environment for LGBTQ+ patients, including the impact of the waiting room, intake forms, and patient interactions. 

One of the highlights of the visit was a meet and greet luncheon with KCU’s SAFEE group, which is a student led advocacy group for LGBTQIA+ students. Complimentary copies of Dr. Holt’s “Life and Love” coloring book were available at the SAFEE event.

The following are written comments from attendees of the panel and/or one of the Dr. Holt’s sessions:

This talk was very eye opening and informative in how to approach a transgender patient from a medical perspective. As a collective group we have very little exposure to working with the LGBTQ community and so any exposure we can get is very valuable. The most important thing I learned was how to first respond to a transgender patient in a way so that the patient feels welcomed and accepted. – M

Personally, it was just reaffirming the knowledge that all our patients are humans and deserve respect and our best efforts to their care. For me particularly, it was even more motivating to make sure that as a physician this group of patients know that I “see them” and love them as humans. I am a Christian and I know that there is much that has been done and said erroneously while hiding behind that title. That’s NOT what a true Christian is, so I would love to do my small part to change that experience for the LGBTQ+ population. I learned to not forget/neglect this group of people. – F

As an out gay man I think having LGBT topics in healthcare built directly into our curriculum not only improves our education, but also supports my own thoughts, beliefs, and comforts in my own life. Knowing that my peers are receiving this education and are becoming aware of this population only fortifies my hopes for a better healthcare future. I learned the importance of “setting the stage” and how a few personal and heartfelt comments to a colleague/friend/family can have SUCH a large impact in their lives (decreased risk of substance abuse, decreased risk of suicide…only from a few words)! – M

This talk really opened my eyes and my heart to the realities faced by transgender people in our society. I was really nervous to come here today to deal with my feeling of discomfort about this topics because of my own ignorance. I appreciate the candor and honesty of the panel. I would love to learn more of what I can do to be more educated as a provider. I learned how crucial it is to provide a safe and caring environment for patients that identify this way. I also learned how much I need to learn and about my own prejudice and ignorance. – F

As a gay man these presentations were very enlightening and I was very happy to see my classmates learn about how to treat/care for LGBTQ patients, as well as hear from two trans females about their stories here locally. Dr. Holt’s lone discussion was also very crucial for everyone to listen to since we will all be treating LGBTQ patients in whatever field we choose. I learned how easy it is to make your office/practice a welcoming/accepting place for LGBTQ patients. Many providers who haven’t had exposure to LGBTQ patients/culture may not even consider including our community in their practices, but Dr. Holt made it very easy to do so much. – M

I learned there is a respectful and professional way to help LGBT patients as a medical professional. – M

I thoroughly enjoyed listening to the panelists on their personal experience as well as their expertise in law and healthcare. It really opened my eyes to the human nature of trans experiences and the need for more understanding. I learned LGBTQIA experiences are diverse and different for every person. It is upon physicians to seek to understand. – M

I thoroughly enjoyed the panel today. It was incredibly valuable to speak with and learn from people from the community. The power of human connection and the opportunity to hear other’s stories really facilitates true learning and understanding. I learned how to be an ally as a healthcare professional. It was really exciting to receive concrete ways to support the LGBTQIA+ community in a healthcare setting. Today was the first time the subject was addressed in my medical education. I would like to have more lectures like this. – F

I really appreciate your sharing your personal story. As a straight, cisgender person sometimes it is hard to understand the gravity of the consequences of coming out. The small tips you shared and the larger perspective the panel provided will really help me in advocating for my patients in the future. I learned simple ways to make patients in the LGBTQ community feel comfortable in the healthcare setting. – F

Was very educational and made me more aware of the how to ask, when to ask, and what certain things/topics need to be addressed when caring for the LGBTQ community. I learned to just be accepting and listen to the patient and just treat them like any other patient. – F

It’s eye opening to what I don’t know and how uneducated we are in LGBTQIA healthcare needs. I wish we were given more education on the diverse needs of these patients, because I want to help and be an ally, but I am concerned that I don’t know enough. I learned how to establish an open relationship with a LGBTQIA patient simply by telling them that I accept them; and even if I need to research for them, let them know that I will do the best I can to support them and get them the care they need. Open and honest communication. – F

I really enjoyed this talk! I appreciated hearing the personal experiences of the people on the panel and I believe attending this talk made me more aware of how I can be a more empathic physician. I learned to meet and treat people where they are. To remember that everyone simply wants be treated with dignity and respect at the end of the day. – F

The panel was priceless. I think that students being able to talk to and listen to real trans people is essential before they go into clinicals. – NB

Thank you. I learned the resources in the area; the level/more micro aggressions than I was aware of; how simple it really is to be inclusive; and how to address “treating the organs that are present”. – F

This panel has further shown the need for more medical professionals who are competent in treating trans patients. The school curriculum does not offer that much training on this subject, so I will need to be proactive about seeking out the information that I will need to take better care of patients in the future. The importance of being at the very least aware of the legislature that has been enacted/is being debated was also highlighted during this panel. As a physician, I will also have expertise that can potentially be leveraged to help advocate for policies that will benefit patients. I learned the need for more physicians who are educated about current treatment standards for trans patients. If a physician does not know how best to treat a particular patient, they should at least know where to refer that patient so that they can get the care that they need. – F

Thank you so much for talking to us. Your story was very moving and thank you for putting together the panel. I learned the hardships that LGBTQIA members go through and how I can present myself as an advocate and make everyone feel welcome when I am their doctor. – F

Thank you so much. I feel like I don’t get enough education on LGBTQ issues, and I’m so grateful for any opportunity to learn more and be a better physician. More opportunities like this would be very helpful. I learned the importance of respect for patients of all kinds. – M

As a gay male I already had some knowledge in regards to LGBTQIA+ health. However; this talk was helpful for learning how to ensure a standard of care that not only addresses a patient’s anatomical biology and risk factors, but the psychosocial needs as well. I learned how to approach the clinical care for a trans individual seeking medical therapy, specifically how to approach sensitive subjects in a polite and sincere manner. Also, the capacity for us, as medical professionals, to be a greater advocate for a disproportionately underserved and mistreated community. – M

This panel really helped me understand the small things that we as future physicians can do to make people of the LGBTQ+ community feel comfortable and respected. I learned to say, “Thank you for sharing”. – F

I feel like I learned a great deal and appreciated the view points of the trans panel members. They were able to get across their personal experiences and we should treat the whole individual. Treating all patients as a whole human being was reinforced by attending this panel. – M

Very informative. Learned how to approach patients in the LGBTQ community. – M

Learned that any provider can offer care to transitioning individuals – it’s just a matter of seeking the information and training necessary. – F

Great panel – this info is so important for us to learn. These are human beings, so treat them as such. – F

Makes me more aware of how to address my future trans patients. Also teaches me how to make my future trans patients feel comfortable and accepted. I learned how trans people feel being on the patient side of their physicians’ office. – F

I feel better prepared to discuss transgender issues with a patient in the future in a way that makes them feel respected. I was raised in such an open minded family that I didn’t realize some these issues were still such a problem. – F

This helps to be a better physician that can treat all patients with respect and dignity. Trans folks matter. – F

Learned how to be more sensitive and appropriate with transgender patients. Good advice on how to approach a new patient that is trans and how to ask questions. – M

This will make me have a more open mind to the LGBT community. I can strive to put aside stigma and provide open care as I would with any others. I will work to have conversations with an open mind. I learned that trans people go across state lines for care. Trans people just want normal care.

Thanks you so much for being so open on this topic. This has given me the confidence to be open with the conversation to my future patients. Everyone just wants to be heard and seen for who they are, not just what is shown on their charts. – F

It helped me understand more about the community and now of a better approach. – M

This was a very helpful session. I haven’t had a lot of experience interacting with trans people to my knowledge. This session just opened my eyes to the various things that trans patients go through when trying to access care. This panel helped give me the knowledge of what I don’t know, so I can know what questions I need to ask moving forward. I learned how to appropriately respond to someone telling you they are transgender; and what a positive experience looks like for a trans patient. – M

Thank you so much for talking to us today and having a panel of such inspirational, educational, and well-informed women. I hope to be a better informed ally of the LGBTQ+ community. This talk helped me achieve a part of that. I was grossly unaware before today. I learned how to best address a trans patient’s medical care and how to, and how not to, treat them and how to ask medical questions. These people are just people and deserve quality unbiased medical care. – F

I thought this was amazing! I loved the panel members openness and honesty and willingness to be vulnerable. I would look forward to more open discussions from people with personal experiences. It opened my eyes to the personal struggles trans people face every day. I thought it was awesome to have a lawyer on the panel to give her insight as a professional. I also loved the perspective from the older (but so young) woman and why she decided to complete her surgery despite her age. Both of the panel members were amazing and I wish I had more time to get to know them! I learned how to respond as a psysician when a trans person comes out to you; the professional and respectful way to present yourself as their healthcare provider; and how to explain to them how you can best provide care for them as they identify, but also their anatomy. – bisexual F

This talk was wonderful. I am so appreciative of this information because I am a straight female that wants to practice in my home state of California. I know I will have many LGBTQ patients and I want to make sure I give them the best possible care. I want to be respectful and helpful to all my patients. I learned how to help someone feel at ease when they come to see their physician. I think it is also so important for all of us to hear how difficult it is to live in society as LGBTQIA and what we can do to make it slightly better. – F

Much appreciated. I learned the importance of establishing trust and acceptance early in a patient encounter with LGBTQIA patients. – F

Very good information. Thank you! I learned how to discuss these items with patients. -M

It was a nice experience hearing from people who first hand have lived through it. I learned acceptance is not the same as tolerance. – M

This panel showed me the perspective of trans patients in a patient encounter and what has made them uncomfortable in the past. Learned how to respond to a trans patient in the healthcare setting in a way that makes them more comfortable. – F

This helped me to realize some of the things I believed were inclusive were actually exclusive. Treat everyone the same. – M

It is interesting to hear from patients who have gone through different difficulties to get care. This will stay in my mind as we go through rotations and see patients. Learned to be kind and caring and compassionate in all aspects and struggles of their care and life. – F

Info was useful and interesting. Treat the patient regardless of gender identity. – M

I really appreciated the openness of the panelists. This was the first time I had such an open conversation and learned a lot. I was shocked at how one of the panelists had to travel to Michigan for care. – F

I have a greater appreciation for the struggles of the LGBT community in regards to healthcare and daily life. I learned the advances that have been made in recent years are being opposed by various political and legal points despite the efforts of many. – M

It was nice having people share first hand about their experiences. Learned how to initially react when a patient comes out about being LGBTQ. – M

It will influence me in a positive way. Learned the perspective of a transgender person. – M

Very informative/insightful conversation I feel more people should hear. I will take the things I learned here today and try to build on them in the future. One of the most important things I learned today was how to start a dialogue with our patients in the best way to make then feel comfortable. Also to know I am there for them and will give them the best care possible no matter what. – M

I think this talk was very important as it is the first time we’ve been exposed to how to treat LGBTQ+ patients. I thought the panel was great and it has definitely impacted me as a future physician. I learned that how, as a physician, to better treat the LGBTQ+ community and how to address their health needs while making sure they feel they’re in a safe and welcoming environment. – F

I don’t feel adequate enough to help this community, but this talk helped me understand what I can do and treat all patients effectively. I want to continue learning because I never want to turn away a patient who needs help or make a patient feels like they can’t come to me for treatment. We need more healthcare professionals who are educated and trained – I want to be one of those providers. – F

Good talk/panel. Will be more supportive and less judgy – work on empathy and knowledge. Learned to treat the anatomy that’s present, but treating the person is more important. – M

The panel has reminded me of the importance of treating the entire person and not just the anatomy they are born with. I learned how even just a compassionate touch or listening ear can make such a difference in someone’s life. – F

Great talk. I appreciated having several different perspectives of the speakers. It was exceptionally helpful to have a legal perspective. – F

This will make me a better physician who is willing and able to provide proper treatment/aid to everyone and anyone, straight or trans. It will make me lack bias to any gender. I learned to be open, understanding, nonjudgmental and kind to everyone. Be willing to learn from the LGBTQ community. – F

Be more considerate and respectful towards LGBTQ+. Also be honest with them. If I do not have the full knowledge to properly treat them, let them know upfront and help then find physicians that can give them best care. I learned to treat all LGBTQ+ patients with the respect they deserve – just like all other patients. – F

It’s just incredibly frustrating to hear about how LGBTQIA+ patients are being treated by healthcare “professionals”. If your religious beliefs prevent you from being a decent person what does that say about your god? If your personal beliefs keep you from meeting patients where they are and being there for them no matter what, why did you even choose to be a physician? Patients, friends, and family: We want to be loved. The continued mistreatment of the “other” is tired. We need to be better than this. Let’s all grow up a little bit. I’ll strive to be more aware in my practice as I strive to provide the best care possible. I learned being different is deadly. – M

I think this talk and panel will definitely help me become more comfortable treating LGBTQ patients and making them feel more comfortable in the healthcare setting. I’ll definitely remember the pointers on how to ask questions, talk to patients, and make my office more welcoming. – F

I loved the panel. It was very educational. I really liked the honesty. I learned how to professionally and appropriately handle patient encounters. – F

I really appreciate the vulnerability and honesty displayed. I can only imagine how hard that must be. I was a little surprised to discover how much I don’t know about the LGBTQ+ community struggles, but this panel helped me realize that it is okay to ask questions. I plan to educate myself further. Showing people respect and kindness can have a significant impact on their lives. This should be a given, but often is not. I hope that in time our world changes for the better. – F

I appreciate the panel and Dr. Holt feeling comfortable enough to share sensitive experiences with us. The most important thing I learned, while there may be specific health concerns for LGBTQ+ community we need to keep in mind, the best thing we can do is to treat all our patients the same and show them the same amount of care. – F

This was very positive The talk put into perspective how medicine and social factors interact in not just the trans community, but the community at large. I learned that trans patients require an individualized medical approach similar to all others. It will require research and effort to make sure I am medically knowledgable such that I can provide these patients the care they need. – M

The panel was really eye opening for me. I’ve never openly heard from a trans individual so this was very informative. The presenters were very inspiring and informative. I learned there is no wrong way to be compassionate to a trans patient as long as the care provider is open to communicating respectfully with the patient. – F

Honestly, I am very ignorant about many of these issues, so I appreciate the opportunity to discuss this in an open forum. Learning how to approach these conversations with a patient population was very useful. I have a lot to learn about being an open and welcoming provider, but I think this was a first good step. – F

I have a better knowledge of all the extra things LGBTQ+ patients have to go through/deal with. I learned how to approach some of the more difficult aspects of caring for an LGBTQ+ patient both medically and as an advocate for them. – M

I was not very knowledgable on trans people, so all of it was very enlightening – I appreciated the personal anecdotes from Dr. Holt and the panel. It made it more personal and helped me understand some of the daily and clinical struggles they all faced and how I can improve myself as a future physician to treat this patient population. I learned how to respond in a clinical situation when someone tells you they are transgender as well as the personal anecdotes that had caused them emotional distress in the clinical setting. – F

I appreciated hearing the frank conversations about trans health. Loved hearing your perspectives. You all are amazing. I learned we can advocate for initiatives to promote LGBTQIA health. – M

The panel was great. It was wonderful to hear from individuals with first hand experience faced by LGBTQ individuals and suggestions they have for future doctors. I really appreciated the information on how to structure an inclusive environment for patients. – M

I knew what I now realize is grossly little about transgender healthcare and being trans in general. Having trans individuals here gave me much more insight than I could have gained from a powerpoint. I learned how I can be an accepting and informed advocate for LGBT+ patients and peers. Also learned that a PCP can provide HRT and other trans care and that there are protocols available. – F

This panel and ensuing lecture will be very important to informing my ability to provide care for LGBTQ individuals. I learned about the deep importance of the transition process and how it is currently under attack. Also looking forward to having resources to turn to for bettering my care. – M

I appreciate the panelists taking time to share their personal stories with the class! – F

I was interested in hearing about the legal aspect of these situations. It wasn’t something I thought would involve me as a future doctor, so I am glad to have learned a bit about what my patients may have to face in order to receive care. It was important for me to hear from real patients about the negative experiences they have had. – F

I think it was helpful to hear from a lawyer and someone in the medical field about trans rights/treatments. The panelists were quite interesting and informative! I learned the great disparity trans people experience in receiving basic care. – F

I always enjoy hearing and learning about patient populations that I have little to no experience interacting with. I want to learn how to be a resource and compassionate healthcare provider. Thank you for sharing your stories! – F

I enjoyed the fact that we had this talk. I feel the best way to help all orientations is by normalizing conversations like this. This talk helped me realize that it isn’t only the way I present myself, but also the entire atmosphere that makes someone more comfortable. I learned the risk factors for various orientations and gender identities. -M

I really appreciate this panel. I grew up in an extremely conservative community in the South where I had little to no exposure to this population. Since leaving that community, I have had to learn how to interact with and learn the struggles of this population. I alway try to listen to how to best accommodate and talk with people because I just have no clue. I know there are others who want to be helpful but just do not know how and having talks like this really help let me know what I am doing is wrong. I learned to try to make an interaction “normal”. I feel like sometimes I can make a person feel uncomfortable because of my questioning. Hearing how to ask the correct questions and when has really helped me. – F

This showed me how to better approach LGBTQ+ patients and their health concerns. It definitely provided more clarification. Advocacy and resources for patients and physicians – I haven’t heard too much about these. – F

I really appreciated having this talk/panel at school today. It brings up an important and very culturally relevant topic that is not often discussed in medical school. I think this makes all of us better future physicians, because it gives us the tools to be able to give our future patients the best care that we can. I learned to be aware, sensitive, and empathic to not only the physical and medical needs of people, but also their emotional and psychological needs as well. People are people, no matter what walk of life, and they deserve to be treated as such. – F

This will help me be more compassionate and know how to respond to trans patients. I learned we cannot just be kind to trans patients, but have to advocate for them. – F

I liked hearing from trans folks. I enjoyed their experiences and expertise. We need more than one required lecture on LGBTQIA patient care. I learned more about law and I would like to be a better advocate. I already knew this, but I liked being reminded that anyone can be a LGBTQIA advocate and that any PCP can treat trans patients and given them the best care available. – M

I was looking forward to this talk mostly because I am very unfamiliar with how to approach treatment for the LGBTQIA community while being a practicing catholic. I believe all the speakers really shed light on issues and barriers trans people face when it comes to healthcare and gave me a lot to think about in my future practice. I learned how best to approach my future care of trans patients – not only how to provide objectively good healthcare, but how best to make them feel comfortable and be an open and accepting physician for all people, regardless of how they identify. – F

I will be more aware. As a cis female with little exposure to the LGBTQIA community, this helped me place myself into another’s shoes. I hope to approach all my patients with equal compassion, regardless of their background/medical history. I learned that communication, while incredibly important in a patient-physician relationship already, is even more important when managing the care of an LGBTQIA patient. There is more emotion and vulnerability involved in their health, so compassion and communication is key. – F

I have always known that members of the LGBTQ community face bias in healthcare. I have never realized how this intersects with race and sex bias as well, leading to extremes levels of bias and causing the trans community to avoid healthcare altogether. It makes me want to make sure that the trans community knows that I will be a practicing physician that will be a source of culturally competent care, particularly to trans men who are pregnant (as I want to go into OBGYN). – F

It was really eye opening to hear from people who have transitioned or are transitioning. I would have liked to hear about other experiences as well from other members of the LGBTQIA community. I learned to listen to everyone/patients more than just to get an HPI. – F

I think the panel will help educate me in how to talk to and treat my patients in terms of not only patients, but as human beings as well. Learned to always ask how they’d like to be addressed and to ensure I fully explain everything to a trans patient to assure they don’t feel judged or blindsided. – F

This will help me to be more aware of the needs of my LGBT patients. I found the US 2015 trans survey to be very eye opening. – F

This allows me to be more inclusive in my treatment of patients in the future and more understanding of all patients. I learned how to best respond when a patient opens up about their identity or sexuality. – F

I learned that it is okay to have an open and honest conversation with patients and it’s normal. Thank you for a great, candid, conversation. – F

This talk exposed me to some of the many challenges the trans community faces, including discrimination, insurance difficulties, and difficulties getting the medical care they need. I learned ways to talk to and make trans patients feel more comfortable, including saying, “Thank you for sharing”. – F

I loved it – Thank you! Be kind. – M

Talk was very enlightening. Treat all people equal. – M

Panels like this help me learn a different perspective of other people’s POV. This will help me help my patients get the care/treatment they deserve. I learned to treat each patient encounter with the same demeanor and professionalism. – M

This influenced me to find more resources for trans patient populations. I learned a very illuminating look into the life of a trans woman living as a male for a good part of her/their adult life. Thank you Ms Carmen! – M

I liked how the talk addressed several areas where I had questions about patient care. I learned a lot about how to approach patients in the future. – M

As a future physician, my transgender patients would be more comfortable if I know how to interact with them in an understanding and respectful manner. I learned that transgender people, when revealing their gender identity, would prefer to just receive acknowledgment, instead of further questions. This would help them feel more comfortable. – F

I really enjoyed this panel and the participants. I learned specific ways to take care of the LGBTQ+ community. I learned how to be respectful and handle the care of those that are different than me. – F

I will be more aware of nonverbal communication with LGBTQ individuals. I’ve always thought of trans individuals as being of younger age. Today I learned that even senior citizens go through this. – M

This gave me ideas on how to approach trans patients without offending or upsetting them with my questions. I learned the proper way to interview and refer trans patients in my future practice. – M

This talk was very informative and allowed me gain insight into the patient’s perspective. I believe this seminar/panel will help me be more courteous and respectful to the LGBTQIA population. It was very heartbreaking to hear how transgender patients were being discriminated against as patients and how difficult it was to find the care they need and deserve. – F

I have learned a lot from this talk since I listened directly from trans patients. I haven’t had any personal interaction with that population, so this is a precious experience. I learned how to approach a LGBTQIA patient. – M

This talk was very informative. I learned a lot about how to move forward with pediatric patients. Also learned how to address a transgender patient and interact with them in a healthcare setting. – F

It gave me a better insight on how to act towards my trans patients. Learned how to speak with a patient that is trans. – M

Keep an open and honest line of communication with future patients. I learned how important it is to respect and love everyone, and stick up for those that may not be in a position to do it for themselves. – F

I think just hearing about how I should react when someone says they are trans was helpful. I learned suicide attempt rate was 40% for trans patients. – M

I will definitely be able to use my clinical reasoning to help my patients more effectively. Learned don’t judge anyone. – M

Will try to treat trans patients with the same grace and compassion as all of my patients. – F

As someone who wishes to be an advocate for all of my patients, I hope to learn more about how I can better support my trans patients through their transition as well as how to ensure I minimize any further damage I can cause as a healthcare provider who needs to treat the anatomy they have. I wish to be better educated and know more about resources I can refer my patients to so they can receive the best possible care that is gender affirming. Learned how to provide support to my parents during their transition and what I can say to help them understand my role during this process. – F

This will influence my approach. I learned mental health is a big issue among trans individuals. – M

This was knowledgable and helpful for someone who doesn’t have much experience with the trans community. I learned to always to be caring and welcoming to others. – M

I am inspired to learn more about HRT so I can be prepared to help me patients. Learned that patients can begin the gender dysphoria process at age 2. – M

WSC October 2-3, 2019

On October 2 and 3, Dr. Holt shared his inspiring personal story from hiding to thriving, which allowed him to become the LGBTQ+ advocate he is today. His story included the theme of following your heart and passion in life.

Attendees among both sessions included Wayne State faculty, staff, and students.

Written audience feedback/impact of this presentation:

Wow. This was an amazing talk. I am impressed by how open you were willing to be. You have really opened my eyes to the LGBTQ community. I now have a much more open mind to the struggles that people face with being gay. I will be much more open to people around me and their struggles. I will be much more supportive to those who may be different from myself.

You are such an incredible and inspiring person. Your speech really opened my views on the world. I appreciate that you take the time to come speak with us students at Wayne State College. I learned we all have our own story as well as our own things that make us unique. It is more than okay to be different from everyone else. I have never been one to judge others, but after today’s speech, I will never think of myself as being superior to anyone…no matter what their circumstances are. It breaks my heart to find out that individuals suffer such severe consequences for being attracted to the same gender.

Thank you for your strength. Thank you for not giving up. Thank you for sharing your story and helping me see it’s okay to be your true self. I learned to never hide yourself, never give up, and life is too short to be scared. I want to follow my dreams! I think I’ll switch my major to musical performance. When I am on Broadway, I’ll invite you with front row seats. Thank you.

Thank you for sharing your story! It has changed my life of the better! I learned a life without authenticity is not a life worth living. Every word you spoke today resonated with me, because I am currently going through the exact same things you did – especially in regard to the way your dad treated you.

Very informative and inspiring! It is great how one person can touch so many different people with different lives! I love your presentation. Very moving! I learned it is more thank ok to be who you are and never back down to others. Find your purpose and be who you want to be…always look for where you are supposed to be.

Very powerful as well as heartbreaking knowing what you went through and seeing the person you have become gives me hope. I learned that not everyone is going to love you for who you are, but that doesn’t mean pretend to be someone they will love. It’s different hearing the perspective of someone part of the community with years of experience prior to the age of technology. Hearing your story gave me a new view of how the world is and to see the beauty in it.

You are so strong for sharing your story. You have a big heart. I think that a lot of LGBTQ stories get jumbled together and people become desensitized to the trauma and hurt they really go through. You sharing your story helps this. You gave me a new perspective.

This is the second time I have listened to this presentation. It is so eye opening to hear about the struggles of others based off of their sexuality. I learned how much impact one person can make. I realized that everyone is dealing with something personal that most people have no idea about. Be kind to everyone, because you don’t know what they are going through.

I am very sorry you had to go through what you went through. What you are doing now is very inspiring and you’re very inspiring to others. This is just a constant reminder to treat everyone kindly because you never know what people are going through. This also inspires me to follow my passion. I learned to treat others how you want to be treated; follow your passion; always be kind to others; and be grateful for what you have.

Even though some people that listened to your talk today may not be part of the LGBTQ family, I feel that you made a good point of just being yourself. I loved this…just being more comfy with who you are.

Thank you so much for sharing! I learned I’m not alone and that LGBTQ+ struggles are real and so many people go through it. This just gave me a huge sense of hope and faith. Even though things may be extremely difficult right now, they can get better as long as you have hope within yourself.

This talk is very inspiring for young people who are struggling with situations like this. I love every bit of your message. I learned to accept everyone for who they are. That everyone is loved for who they are. This impacted me to learn more about people who are struggling with this. I love that your spreading this message to young adults.

Thank you! Just amazing to hear your story and have you on campus for our students. I learned there are still people out there whose parents hate them because they are gay. This just reminds me to pay attention to other’s needs and hope I can be there for anyone who needs me.

Very inspirational and based on the questions the audience agrees. I learned we always have family of origin issues to work out no matter how old we get. This is a reminder to set the foundation to know they are safe with you.

I don’t have children but I do have a handful of kids (other people’s kids). Thanks to what I have learned from you, Karen, and the many LGBTQ students that I’ve worked with, I’ve become very aware (and careful) of how I talk about gender roles, gender identity, and sexual orientation around kids. I never assume little boys will grow up and marry a women. I never tease about them liking a girl or having a girlfriend. THANK YOU for helping change the way I talk to children and helping me become a safe person to talk to.

Thank you for all you have done. You seem great and help people all over, so thank you! I learned telling your story has helped a lot of people. You are ok with being in this community and it’s helpful to people all over.

You are a great person and speaker. I know that this doesn’t go with the comments, but this a little story I have. My parents never really supported PRIDE because that’s how they grew up. When I got to my teens I figured out that I liked girls. Over time I started talking to mom about LGBTQ because she knew nothing about it. I told her that I support people and just want people to be happy. I have done this for a while now and she now supports everyone now because of me explaining everything. She will even watch shows with LGBTQ members in them and talk to my father about this. I haven’t even come out yet, but I know my mom will try and understand. I learned to be yourself and don’t always worry about money when you need to follow your dreams. I will now be better at telling people how I feel.

CCSF 9-14-19

LGBTQ Medical Case Scenarios: An Experiential Learning Perspective

The presentation consisted of reviewing LGBTQ medical case scenarios through the lens of City College of San Francisco medical interpreter students. The class divided into small breakout groups, which allowed an experiential learning perspective. After discussing a particular case as a smaller group, the group would present the case to the whole audience with Dr. Holt as the facilitator.

The audience consisted of medical interpretor students. Signed copies of the book PRIDE were distributed compliments of Dr. Holt.

Audience feedback/impact of this presentation:

Great presentation. A lot of information that gets you thinking and understanding the LGBTQ community. Everything was important to me – especially in the last case about the person who didn’t want a pap because identified as male and had unwanted sex organ. Learned how to handle that and that this can happen.

Very informative, interactive activity. Thank you! Learned how to treat each other when encountering different sexual orientation or gender – Role playing helped a lot.

This is a great opportunity to learn and be in touch with the LGBTQ community. I learned the comfortable way to talk to the person when they confess that they are gay/lesbian. Thank you very much for sharing your stories and giving us valuable information. It was my first time of hearing it and gained a lot.

It was a great session and helped me to have a better understanding. LGBT – deserve to be treated with respect. I cannot imagine all the struggles LGBT people have to face in society in order to be accepted.

Dr. Holt – you have done a thorough job at explaining and breaking down LGBTQ. Thank you. This country is lucky to have you share, spread, and help everyone who struggles with gender identity. I learned the differences between the following: sexual orientation (who we’re attracted to), gender (how society constructs what is M or F), gender dysphoria (gender distress), genderqueer, and pansexual (attraction to soul). I have more clarification on the terms associated with LGBTQ and hope to bring awareness to the youth that I work with in my efforts to specialize in mental health.

It was a great case. It really made my group talk about it and think about the benefit/consequences. I learned that it is important to always explain how much you care for the person who is coming out to you as gay, lesbian, bisexual, or transgender. And say that if they need to talk about anything, you are going to be there for them and your relationship won’t change. It’s important to say the right words for someone who just said something confidential.

Great talk! Very informative. Never assume someone’s sexual orientation regardless what their sexual behavior is. I will be mindful and supportive. Never assume. Make everyone feel safe and welcome.

Jose on the DL – for me I’m still learning about the continuation in sexual orientations – especially how people identify and talk about fluidity. I learned that people can consider themselves as straight and still have sex with men and women. That coming out is a process, not a singular event, and it depends on the readiness of the person. Compassion is key. I will ask open ended questions and be compassionate as people are vulnerable in the process of coming out due to the mental and emotional distress it may cause.

Great scenarios. Lots of information – much of it new. I learned sexual orientation is combo of genes, male birth order, hormone and epigenetics; and how to help support someone who is struggling with their orientation – even if I don’t agree or understand it. I can make an impact on that person’s life (perhaps saving them from trauma, suffering, or saving their life).

Thank you so much for sharing your history with us. I really appreciated. As a mom I learned how important it is to be open minded and respectful with others sexuality.

Blue Cross and Blue Shield of Nebraska 4-26-19

On April 26, Dr. Holt had the honor of presenting and moderating an interactive session on the importance of workplace safety and bolstering a welcoming environment for LGBTQIA+ employees.

This interactive session dove into how to make the workplace setting a more safe and welcoming environment for LGBTQ+ employees, including the impact of the physical environment, employee interactions, inclusive messaging, and how to make closeted employees feel comfortable coming out. Attendees engaged in a robust discussion and Q & A session, which included roleplaying.

The audience consisted of BCBSNE employees as well as invited guests from Omaha area ERGs who were interested in learning more about LGBTQ+ diversity and inclusion. All attendees received a signed copies of PRIDE: You Can’t Heal if You’re Hiding From Yourself.

The following comments were written by attendees on how the session influenced them or what they learned:

Dr. Holt you are amazing. I feel your passion. The power in your story makes me speechless. I learned today to always be sensitive and to be kind. Always be open and love everyone. I learned so much in this session. I could talk for hours! Thank you!

I appreciate the openness of the session. It’s actually very refreshing to have such frank conversations about gender and sexual identity within my workplace. We can actually start making change now and I’m not the only one who wants to!

Excellent presentation. Balance between presentation and Q & A. It was illuminating to hear how a LGBTQ identified person perceives even walking into a workplace. Particularly as a straight man, (I feel) that my employer does not have easily accessible resources for someone struggling with LGBTQ related issues.

I really enjoyed this. I want to increase the diversity and inclusion in Blue Cross Blue Shield. I feel that the organization would be very receptive to change to increase acceptance and inclusion for our LGBTQ community. Thank you for doing this and opening the door for this opportunity to grow! I learned valuable input on how our company can increase resources and inclusion for our LGBTQ community. And there are many others within the work place that are supportive of this movement.

Very enlightening! People are struggling in ways that I had not thought of and I can do more to be visibly affirmative.

I think this was an amazing first discussion and was much needed. I got some great ideas about how to make LGBT issues more visible and how to work with concerned employees.

I learned don’t force someone to come out. Let them come out when the person is comfortable. (Want to) start an ally and LGBTQ+ committee.

(Influenced me into) being my true authentic self. Helping get education/visibility out in our workplace.

Breakthrough thinking! Learned trust and direction on how to begin/manage change. How simple the path is to making change for the better.

I learned it is important to continue to understand the struggles and solutions our coworkers and friends deal with and how we can help. BCBSNE is taking steps to be more accepting and inclusive.

Learned awareness of how the workplace is perceived. I appreciate the tip of asking a person who is either trans or gender neutral what pronoun should be used…I love that. It’s so respectful.

I will be more open about being an ally. Have more signs/visibility for people who are looking for an ally. One in five people need an ally just to be who they are.

I have always said we need to be more visible, but it’s nice for people to agree. We just need action!

This helps me understand that being an ally is ever so important and possible.

This will help conversations with family and friends along with coworkers. I learned don’t force them out and drop hints.

Learned to be more openly supportive and how to introduce yourself in a way to make someone feel safe.

This was very enlightening as I ‘assumed’ BCBS was just as inclusive at Mutual of Omaha. Always keep open channel of communication.

Midwestern University – AZCOM 3-11-19

Creating a Safe and Welcoming Environment for LGBTQ+ Patients

On March 11, Dr. Holt had the honor of presenting two workshops on the Midwestern University – Arizona College of Osteopathic Medicine campus.

These interactive workshops dove into how to make the healthcare setting a safe and welcoming environment for LGBTQ+ patients, including the impact of the waiting room, intake forms, and patient interactions. In addition to discussing what LGBTQ+ patients are at higher risk for, we discussed how to start conversations on sensitive topics, such as sexual health, trans health, coming out, and LGBTQ+ suicide risks. These workshops included a robust Q & A session as well as roleplaying.

The audience consisted of students who were interested in learning more about LGBTQ+ health. All attendees received signed copies of Coloring Book for Healers.

The following comments are from students who attended one of Dr. Holt’s workshops:

Excellent advice on how to open the discussion of LGBT issues with patients. I learned how to welcome LGBT patients and make them feel at ease and deliver the best care possible.

Great session. The verbiage was very useful. It was helpful to learn nonjudgmental phrases to use to get the info I need and build a rapport. I learned how to address and make LGBTQ people feel welcoming in my future practice.

Very inspiring. It gave me a lot of hope for practicing LGBTQ+ friendly medicine in the future. The information was presented in such an open and accepting fashion and answered a lot of questions I had about how to go about it. I will make a point to introduce myself using my pronouns and live genuinely, so that I can inspire others as you have with me.

This was very informative and gave me a lot to think about in terms of how I want to conduct my future practice. It’s easy to forget the privilege of walking into a healthcare setting and feeling comfortable automatically. There are small but significant things I can put in place to help create a more welcoming and comfortable environment for my future LGBTQ+ patients. I learned to open dialogue with a future patient in a way that will be affirming and create a sense of safety, but will also allow me to provide the highest quality of care possible.

As a gay man, I felt even more welcome and comfortable during the presentation since the speaker was openly gay. I liked how he composed himself while talking about topics of sexual orientation. I am debating whether to become more open about my sexual orientation socially and in my career and hope to use this presentation as motivation in the process. The most important thing I learned is how important the “waiting room” reception is to make the person feel at ease from the get go. This is what I realized from the start during Dr Holt’s presentation and felt very at ease.

Great talk. I enjoyed the role playing exercises and learned a lot about conversing from a physician’s standpoint. I learned communication techniques and how to normalize conversations. These techniques will be important in establishing great patient trust.

This talk will greatly influence how I practice medicine and take care of my patients in the future. I feel 100x more confident welcoming an individual into my office and how to address them and risk factors they have. I will be more open-ended in questions I ask and how to address their concerns at different times.

Thank you for this presentation! I’ve learned a lot and think the med school curriculum could benefit greatly with more sessions like this. I learned how to be more welcoming/accepting to LGBTQ patients in practice; and how to present myself to patients to address issues LGBTQ patients may have.

This was very helpful. This is the talk I wish our school had given us on LGBTQ issues. It is very helpful having a rundown of what issues to be aware of. I learned we have some very concrete ways to talk to our patients and open up conversations.

Very helpful in how to make LGBTQ patients feel welcome, so they can get the best overall care. I learned to make my patients feel comfortable to share whatever they need to in an environment that welcomes all.

Great. More confident in my history taking. The stories are the best. I learned how to make a comfortable environment besides just being open and honest and available to patients.

Very good start to learning more; like the ideas of things to say with the specific examples; and gives me an idea to start going forward before habits are formed. I learned how to open the door for a conversation to begin.

Very educational and eye opening. I learned a lot. I learned to tell a patient that they are safe here and with me.

I learned direct tools in my future practice for creating an open environment; the ability to start a conversation to make any type of person feel comfortable; and there are simple ways to provide inclusive care.

This is so needed as part of the regular medical education. I learned setting the stage in your waiting room is hugely important. I will get a rainbow pin.

I knew members of the LGBTQ+ community were at greater risk for mental health and other health related concerns, but I was not aware of just how much. It makes me want to put a greater effort towards treating that community to help them achieve greater health and wellness. I learned how to have a conversation about difficult topics and being honest; how to give options; and make sure they are comfortable to talk.

I’ll be more more aware of this community. I’ll also feel more comfortable in treating them should they be my patient and in how to address them and their concerns. I learned to admit when you don’t know something and to give options to the patient.

This talk brought a lot of awareness and insight to special concerns in the LGBTQ+ community and gave me a better understanding of how I can better care for them. Being direct with LGBTQ+ patients is a good way to build trust, and it’s okay to work together with trans patients to learn how you can be a better physician for them.

This will help me know how to better navigate situations involving any of my patients in the LGBTQ community. One of the best things you can do for your patients is to be open with them and to make them feel comfortable opening up with you.

This educated me on how to approach LGBTQ patients in clinical scenarios. I learned nonverbal inclusivity in a major aspect of care.

I learned a lot about how to approach these important conversations. Really appreciated the information. Will strategize to incorporate info for my future practice.

I will be open and welcoming with my patients. Made are realize how important subtle details can be to my patients. I learned to show that I am accepting all my patients regardless of how they identify.

I learned making sure patients know that you appreciate their identity; keeping your questions open ended; not even asking question just making open ended talking points; how I can make patients more comfortable and how easy it is for me to make a patient feel respected and welcomed.

I didn’t consider the little details like a waiting room and how they influence a patient experience. The little details in intake form, waiting room, a pin, etc, are really all it takes to open a door into LGBTQIA+ sexual history.

I learned how to be a better future physician for all my patients; the use of gay vs queer; learning how to invite an LGBTQ+ patient to discuss their experiences; and how to be welcoming verbally and physically to LGBTQ patients.

This talk made me more aware of how I can approach and talk to patients rather than rely on the patient to do all the hard work. I learned how to open up conversations, subtle ways to make patients more comfortable, and new way to approach/think about LGBTQ patients!

I’ll be more open, welcoming, and normalize things more. I learned the importance of verbal and non-verbal cues in providing a welcoming environment for frank discussions.

Helps me understand how to better serve LGBTQ community and shows that I am welcome to them. Ask open ended questions! Very different from what we are traditionally taught, but very important to get the real info.

I learned setting up waiting room and intake forms; and how to bring up LGBTQ health issues in way that won’t make the patient feel uncomfortable or are awkwardly direct/ inadvertently offensive.

Will pay more attention to clinic/hospital setting and waiting room and make it more inclusive and friendly to all. I’ll introduce myself with pronouns and ask how they’d like to be addressed – this creates a safe space and the patient will be more inclined to open up.

Establishing rapport early (as early as giving options on an intake form) can create a welcoming experience that opens the door for a strong physician/patient relationship. Whether LGBTQ+ or not, every patient wants and desires to feel safe and comfortable trusting their doctors.

I learned how to open the door, improve intake process, set stage for comfortable waiting space, and encourage use of pronouns.

This talk will help me understand the language/pronouns/issues to use/address when serving the LGBTQ community.

Be aware from beginning as soon as visit starts; acknowledge their gender and what they want to identify as. I learned to assess their level of wanting to discuss it and to refer out if uncomfortable/not equipped to treat.

I will be more conscious with conventional proceedings/terms. I learned different methods to approaching sensitive topics in and outside the medical setting.

I will use this info to help create a safer and more comfortable environment for all my patients. I learned how to create a more inviting environment for LGBTQ people.


KCU February 4-5, 2019

Creating a Safe and Welcoming Environment for LGBTQ+ Patients

On February 4 and 5, Dr. Holt had the honor of returning to his alma mater, Kansas City University, to discuss LGBTQ+ healthcare with faculty, staff, students, and administration. His visit included meetings with administration, committees, and student groups on how to incorporate LGBTQ+ health into the curriculum. In addition, he had the opportunity to present workshops, presentations, sessions, and moderate a panel of LGBTQ+ patients in front of over 400 attendees.

Many topics were discussed on how to make the healthcare setting a safe and welcoming environment for LGBTQ+ patients, including the impact of the waiting room, intake forms, and patient interactions.

One of the highlights of the visit was a meet and greet with KCU’s SAFEE group, which is a student led advocacy group for LGBTQIA students. A book signing was held with SAFEE members.

The following are written comments from students who attended one or more of the Dr. Holt’s presentations:

This presentation was very informative and made me feel much more comfortable in my ability to professionally navigate a patient situation with LGBTQ+ issues. -22 y/o m

Very positive. Thank you for taking the time to come talk with us. I learned examples of how to best set the scene to make patients comfortable. – 27 y/o f

Dr. Holt is a wonderful presenter. My favorite part of the lecture was his ability to talk about all aspects of care. He discussed everything from the appearance of the waiting room to how to have an open discussion with LGBTQ+ patients. If the patient is comfortable talking with the physician, then it becomes easier for the physician to identify risk factors that may affect the patient’s health. – 23 y/o f

This talk has opened my mind on how to interact and fulfill the needs/concerns of the LGBTQ community to improve the quality of life for these individuals mentally, physically, and emotionally based on their personal struggles and life complications. – 23 y/o f

I hadn’t thought about small things/subtleties that can make my practice more accepting off the bat. The lecture and panel are integral to med school education and needs to be a mandatory part of curriculum. – 25 y/o f

I learned a completely new perspective of healthcare that I have never thought about before. – 24 y/o m

Today’s panel positively influenced the way I will approach patients that identify themselves as LGBTQ – especially trans patients. I am very glad that this training was provided to me and my classmates. I believe it makes the difference. – 25 y/o f

I will take this newfound knowledge about treating the LGBTQ community and apply it to my own clinical practice. I want to treat patients respectfully and be a resource. – 25 y/o f

This 100% needs to be a part of our curriculum. I feel empowered – am thankful for everything I learned because I feel better equipped to care for my patients. – 26 y/o f

This talk will help how I practice medicine and treat my LGBTQIA patients. – 23 y/o f

What a great experience to be able to hear from individuals in the LGBT community first hand about their healthcare experiences. This is a unique opportunity to hear about these experiences in a safe environment where students can ask questions. – 29 y/o f

I will be more open about addressing certain topics and showing/verbalizing acceptance. I learned strategies to open my conversations about gender and how the patient wants to be addressed. – 26 y/o f

Thank you very much! This will definitely help me care for future patients! I learned the risk of suicide attempts amongst the LGBTQ+ community – especially who is at the highest risk. – 25 y/o f

Amazing! This will prevent me from being assumptive and intrusive into my patient’s life without earning their trust. I learned how to open myself up and visibly be an ally well before I even meet a patient. – 28 y/o m

I will be more equipped to properly acknowledge not only my future LGBTQ patients, but also family. I learned NOT to encourage some one to prematurely come out. – 27 y/o f

Grateful that I and my fellow students can hear personalized experiences from people of the LGBTQ+ community. This is the kind of dialogue our school and ALL medical students need to have. – 26 y/o m

I will now better serve my future LGBTQ patients. I learned how to make the waiting room more welcoming. – 26 y/o f

Excellent lecture. Appreciated info on how I can incorporate open ended questions on my intake forms as well as in interviews. This will help me approach the topic without being too invasive. I also really appreciated you addressing how to address the anatomy that these patients may not identify with. – 30 y/o f

The most helpful new thing I learned was how to set the stage for talking about those issues without directly asking the questions. – 29 y/o m

This was the lecture I’ve been waiting for all year! Appreciated the real-life examples of how to interact with and gain the trust of our patients. This session reinforced the importance of pronouns and sensitivity when being a physician and advocate for my patients. – 27 y/o f

I really enjoyed listening to the panelists and learning how little things like a sign in your waiting room can make a huge difference. I also learned ways to phrase things to make my patients more comfortable. Lean into the uncomfort. – 24 y/o f

Provided good background info and good foundation on treating/managing the LGBTQ community. Gave insight into important things to pay attention to with this group. – 29 y/o f

Using the vocabs of LGBTQ people is very important. I will be more aware of the words I use in the future. Dr. Holt gave a lot of good examples of conversations and actions we can take to help LGBTQ population/patients feel more comfortable seeking appropriate healthcare and trusting their doctors. – 25 y/o f

I appreciated the advice from Dr. Holt on how to approach a discussion about doing sensitive exams on people who identity may not align with their anatomy. – 31 y/o m

Felt the first hour was useful in establishing current stats and severity of the issues that are being faced by the LGBTQ community. LGBTQ awareness and sensitivity are critical to providing quality care. – 24 y/o f

This reinforced pretty much everything I always believed. Also, gave me skills and abilities to be able to communicate with people within the LGBTQ community. – 27 y/o f

Thank your for your honesty in sharing your stories and opinions. This was super helpful to try to understand where trans patients are coming from. – 34 y/o f

I thought the panel was great. The statistic that 40% of adult trans individuals have attempted suicide is tragic. – 24 y/o m

I learned to be more cognizant of my use of pronouns. Especially, because the initial introductions can go a long way towards building long term trust. The panel was exceptionally helpful to understand how fluid each person’s experience and preferences are. – 39 y/o m

Inspired me to be more aggressive about advocacy wherever I end up working. Even though I am LGBTQ, I still have a long way to go in order to learn how to advocate/support. Many people’s intentions are good, yet their delivery can be wrong/hurtful. I learned even more the importance of empathy. – 30 y/o f

This helps provide me a scaffolding to make my future practice welcoming and identified as an ally. I learned helpful tips for how to normalize conversations. – 34 y/o f

I think the talk helped me to understand another perspective. I did not have the knowledge to understand the healthcare and social challenges of the LGBTQ community. This talked helped to open my eyes and acknowledge my own need to actively create a welcoming environment for all my patients.- 22 y/o f

I thought this was a beneficial seminar because it educated me how to provide the best care, but also be sensitive to how patients identify themselves. The personal stories were invaluable and have helped me with how I want to approach healthcare for the LGBTQ community. – 27 y/o f

This talk and panel will help me be more aware of the LGBTQ patients I encounter and how I can help them and feel comfortable coming to me with health issues. – 27 /yo f

I learned lots of small things I can do to be more inclusive. LGBTQIA people are a unique population who deserve healthcare that is tailored to their specific needs. – 23 yo f

When I’m a practicing physician, I will make sure pt intake forms represent all my patients. I will create a safe environment for open discussions. – 27 y/o f

I think today’s panel is something everyone needs. Today gave me insight on how to make my future LGBTQ patients more comfortable in the clinic and how a positive experience can change their life. – 24 y/o f

I thought it was very thoughtful and it was great to hear about first hand experiences of the individuals here today. I hope this is something we can definitely continue. – 28 y/o f

This panel opens the door for me (and other students) to explore how our behaviors can be examined in both personal and professional settings regarding being the best provider we can be. – 27 y/o f


CCSF 2-9-19

LGBTQ Medical Case Scenarios: An Experiential Learning Perspective

The presentation consisted of reviewing LGBTQ medical case scenarios through the lens of City College of San Francisco medical interpreter students. The class divided into small breakout groups, which allowed an experiential learning perspective. After discussing a particular case as a smaller group, the group would present the case to the whole audience with Dr. Holt as the facilitator.

The audience consisted of medical interpretor students. Afterwards we had a book signing for the book PRIDE, which were donated to the students compliments of Dr. Holt.

Audience feedback/impact of this presentation:

It is a great learning experience. I learned how to approach a friend, a family member, or someone in the medical field in regards to gender and sexual orientation.

Thank you so much for such an inspirational/powerful speech. I’ve never had any ideas about how to differentiate the LGBT identities until I heard what you shared. I learned the difference between sexual orientation vs. gender identity; ways to open the door for anyone who is struggling with their sexual orientation or gender identity; and that trans person can come out at any age.

The vignettes are very interesting and they support learning. Thank you very much. I learned about individual struggles. Let us continue to find solutions and continue to love one another regardless of differences.

Thank you for coming today! I really learned a lot. I will make sure to always be aware of how I use my words when I interpret for people of different identities and sexual orientation.

Thank you for sharing all of the information. I learned the psychological impact/affect of ‘coming out’ in terms of timing and making decision.

Generally, I learned a lot of new things about LGBTQIA. The most important thing I learned is how to approach and address patients/clients who are LGBTQIA.

Vignettes definitely stimulate thoughts on the community and promote understanding of the various aspects and characteristics of the community. I learned the social issues the community faces and the resulting potential health disparities they may suffer. I am more sensitive to how I can interact with this community in order to better help them in my interpreter role.

Thank you so much for coming and teach us about LGBTQIA community. I learned things I didn’t know before and now I can apply this knowledge when I start working as an interpreter and in my social life as well. This talk reinforced that it doesn’t matter how we identify ourselves, we are still human beings and differences don’t make us worse or better people.

I really appreciate you coming to our class to speak. It was very helpful. I learned to be more sensitive to all because we don’t want patients to be uncomfortable. We want them to feel safe to talk about anything.

I learned to say ‘we are all on a spectrum’, to use the word ‘trans’, and how to introduce myself buy using ‘I am _____ and I go by she/her. And you are?’

Thank you so much for sharing your story. It is truly inspiring – especially because there are people struggling even with all the resources. I loved this talk and all the cases because I feel more prepared about the approach towards LGBTQIA patients. Also, I will use a rainbow pin to open the door to conversations.

Great presentation. I learned how to communicate with someone who is uncomfortable or may not want to disclose sex, gender, or self identification; to ask open ended questions; and use non-gendered language.

I really enjoyed listening to you speak. I learned how to open the door for LGBTQIA. Also, I learned more information about LGBTQIA such as no assumptions and to be more understanding.

It was great to finally know what LGBTQIA really stands for. I learned how to react or how to talk to people who are struggling. Also, the way to welcome them: rainbow flag, intake form, pronoun, bathroom… mindblower. I never thought of these ways.

I have a deeper understanding of LGBT; more open minded and accepting; and probably can save a life.

Awesome. This presentation should be available in every college, high school, middle school, etc. I know more about how to interact with LGBTQ people more appropriately and respectfully. Thank you so much for doing this.

I learned the difference between gender and sex. Better understanding of client population.

Good opportunity to reflect on gender issues. I will be more conscious of using terms to help patients feel safe.

Thank you very, very much for sharing your story. I wish my country is more open-minded regarding LGBTQIA. I am sure there are many people who want to know about you and need help from you!

It’s a very beautiful and inspiring talk. I learned how to treat others with respect as a peer and a human. ‘Follow your heart and passion and doors will open’.

Inspiring, powerful story! Thank you for sharing. Always great to hear different ways of how to navigate difficult situations and the exact phrases.

Great scenarios to practice. I learned the hardships that trans have to deal with in health related things.

It was an amazing opportunity for me to understand LGBTQIA more and better. Thank you so much. Everything was so important for me to learn.