KCU November 8, 2023

Ethical Care for LGBTQAI Patients

On November 8, Dr. Holt had the honor of returning to his alma mater, Kansas City University, to discuss LGBTQ+ healthcare with over 400 students 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. Dr. Holt also had the opportunity to present his original research findings from his MA thesis entitled, “The Impact of Rural Geography on Sexual Identity.”

A robust Q & A session concluded the 90 minute session.

Written audience comments when asked “Impact on my future practice/other comments:”

I just wanted to say that this was one of the most impactful and important lectures I have had during my time at KCU. Gender affirming care is something that I did not know much about prior to this lecture, but now I feel like I will be a better advocate for this population. Thank you!!

I think this was an incredible talk. I think there is so much about this topic that is unknown and I think it is imperative that everyone regardless of belief and misconceptions here this talk especially those that are going to be future physicians and provide care to this community.

I think it is really important the talk emphasized the risk of suicide for LGBTQIA+ patients, and that by taking every step mentioned in the talk, we are actively fighting to save patients lives. I also really enjoyed the advice given by Dr. Holt on how to address patients and loved ones by repeatedly telling them “Hey if there is anything you would like to tell me, I’m here to listen and nothing you say will change our relationship and i will always love you”. This is helpful advice I will continue to use with patients and loved ones in the future.

I am continually more inspired to serve as an ally, and encouraged by the engagement from various members of our class. I really appreciated the practical scenarios and sample discussions to serve as a bit of a template. I love the idea that Dr. Holt realized he was needed in this mission and is out there bravely trying to make things easier for others. It could be helpful to hear suggestions for allies on ways to use our various privileges (as physicians at minimum) to bring about change and offer support.

I will absolutely remember all the stories told, including your own. They were incredibly moving and opened my eyes to a reality that I had not experienced. I will ensure to create a safe space. In fact, I am already looking at pins to buy for my friends and I.

What I listened to and learned was powerful and I believe it will add to the foundation of how I will practice medicine. I want to be an advocate for my future patients.

I really like how he talked about how to talk about more challenging topics and made them like basic conversation. I also love the responses he gave us as a physician, parent, or friend in response to someone letting you in. This talk was inspiring. I’m grateful to have heard Dr. Holt’s story, and his mission for LGBTQ+ community.

I will endeavor to include LBGTQAI welcoming features in my waiting room and on my person. I will endeavor to use the right pronouns and names, and apologize if I fail to do so. Thank you very much, Dr. Holt! Your work truly makes a difference.

This is a topic I have always been interested but attending the talk last night on gender affirming care and today about your personal experience and the statistics really solidified the type of physician I hope to be. It also reinvigorated me on the ongoing learning that is required to be a welcoming physician and human being.

This lecture didn’t directly impact how I’m going to practice in the future because everything that was discussed was already on my radar and part of my plan. However, for those who believe that they will never see or treat a queer person, I believe having this lecture, and having it be required for our class, is extremely important for those individuals especially. Just because someone isn’t going to specialize in prescribing gender affirming hormones or do gender affirming surgeries, doesn’t mean that everyone shouldn’t be competent in interacting with any member of the queer community.

Very important topic we got to hear about. It was extra special because Dr. Holt shared his personal coming out story and the challenges he had with that. This motivated me as a SD to be more of an ally for my patients and create a space so that all people feel welcome at my practice.

I think this lecture was so important for medical students to hear because we don’t always think of the way subtle things like inclusive bathrooms make a difference in peoples lives.

I want to always make sure anyone around me, especially my kids, know that I will always love them no matter what!

This was instrumental in helping establish an affirming and safe practice as well as practice equality in all situations.

I think with topics like this, the little things go a long way. Dr Holt continuously mentioned how important it is to use the same words someone uses to describe themself (ie if they refer to themselves as queer, don’t refer to them as gay). So I think getting into that habit early will make it easier to do that in future practice, and I think it helps create a much more accepting and comfortable environment for members of the LGBTQ+ community.

I have never been more committed to treating every individual that I meet with nothing but love, respect, and kindness – because they were made in the image and likeness of God.

Thank you so much for sharing your personal story and being the best role model and mentor. I’m so lucky to have your support and guidance.

Definitely will impact how I try to address my patients and just make it more natural in setting the tone of myself as a provider and ally.

I will implement the tips we learned today into my future practice because I want every patient to feel safe and comfortable under my care.

Approaching all people with compassion and understanding. I hope to work with children in the pediatric realm, possibly into adulthood through a MED/PEDS specialty and my hope would be to see kids thrive as they develop into adults and beyond. I recognize that I will likely encounter youth that identify differently and for me to help them, I must be open and knowledgeable regarding their experience, their goals, and their hopes for the future while maintaining their privacy and respecting their identity. I believe that my role as a physician is to improve the wellbeing of the patients I serve so that they are able to live fulfilled lives, if and when gender affirming care is part of that, I am open and willing to perform my due diligence in pursuing that knowledge while partnering with experts in the field to provide quality healthcare.

As a Christian, I absolutely want to treat every patient equally and with the utmost respect, but I’m not sure if I am able to give up my own convictions in the process of doing so. This is certainly something I will continue to wrestle with, but I firmly believe that I have the capability of providing high quality care to all patients, including members of the LGBTQ community.

I definitely want to find ways for patients to feel safe to be themselves in the clinic, and most importantly recieve any necessary mental or emotional support they need. I want them to be able to recieve the care they need and not feel stigma or judgement associated with their identity, especially since so many in the LGBTQIA community suffer from serious but preventable health issues due to that fact that they are unable to get the care they need or are too afraid to do so.

Creating an inclusive, welcoming space for my patients even by designing my waiting room to be more inclusive

How I’ll have my intake forms structured and the new phrases I’ll add in while speaking to patients.

I definitely will be getting a pin.

I always try to be conscientious about not misgendering individuals but I have in the past and likely in the future will do the same, hopefully not as frequently and ideally not at all, but knowing that simply acknowledging my mistake and moving on is at times enough to relay my sense of allyship does loads to ease my anxiety when being present and creating space as a future physician for those who might be feeling alone.

The advice on how to make a practice more welcoming to LGBT individuals is definitely something I will implement in the future.

I will absolutely show that I am an ally to those in need in my future clinic.

Definitely gonna consider how best to make my future clinic an affirming place.

Will make certain that my clinic feels like a safe and welcoming place to all.

I used to be a camp counselor and I had numerous kids come out to me in my time as a counselor. I didn’t get to speak to you after lecture but I was wondering if you ever thought about giving a training to YMCA camp counselors. I was in college when this happened and I think having some form of training on how to approach these situations to make sure they’re positive would be so beneficial. Each conversation I had was very positive and emotional but I could see where someone in my position wouldn’t know what to say or how to help provide resources.

Written audience comments when asked “most important thing I learned:

The most impactful parts were storytelling- whether that was Dr. Holt’s or the examples he shared from his email or the optional responses.

The idea of the power of story telling was very insightful. I have been hearing about the idea as far as advocacy and talking with elected officials, and the presentation drove home the point nicely. The rank order and challenges faced by bisexuals was a new and helpful piece of information.

I thought your research on rural LGBTQ health and suicide rates was fascinating, and something that will stick with me as I hope to practice in rural communities.

Hearing Dr. Holt’s story about his father’s reaction to Dr. Holt coming out. The fear and the trauma associated with that experience were apparent in his voice and it helped me relate better with the experience that those in the LGBTQ+ community encounter when trying to seek medical care and even in daily living. It is a startling reality. People deserve compassion. As a physician, in a position of trust and responsibility, I must be present and serve in a manner that allows patients to feel safe, know that their concerns are valid, that they are heard, and that I will do my best to help them.

Thank you for being here. I am so sorry you had to experience so many of the things you experienced, especially with your dad. You’re amazing though for using all of your experience to help make the world a better place.

I’ve been fortunate to have been previously educated on most of the topics discussed in the lecture, so for me I thought it was really valuable to have someone come and share their personal experience, especially one so heartbreaking at times. I think it’s always very helpful to have these conversations because, as a straight person, it can be hard to understand why it’s so difficult for some people to be out, or why LGBTQ+ people are so hesitant to access healthcare. It shows us how far we’ve come as a society and as a healthcare system, but also the flaws that still remain and how we can further create an inclusive environment for all.

The rates of suicide and other mental health concerns for trans and gender diverse patients are so so concerning. We can do better by simply being better human begins. All we need to do is be kind to each other and treat everyone like they’d want to be treated. I wish more people understood this as plain and simple as it is.

This lecture helped me to understand that gender affirming care is more than just puberty blockers and discussion of surgery, it helped me to understand that it was also creating a welcoming environment. Making everyone feel heard and seen and called by the correct names. And more on how to approach certain difficult situations and questions.

That gender affirming care is SO much more than the actual medical interventions. It begins the second a patient walks into your office or for someone like me (emergency medicine interested) the second you begin an interaction with a patient. It begins with wearing a rainbow pin on my badge or white-coat to signify I’m a safe place for a patient and that I will respect each patient and treat them with equality.

I have 2 things… the first being the importance as a physician of being accepting of all patients regardless of sexual orientation or gender identity. Not just being outwardly accepting with non gendered restrooms and rainbow signage, but also truly being accepting and a safe space for your patients to be whoever they want and to show up however they please. Also I learned that gender affirming care expands far beyond just prescribing medicine or performing surgery. I think this is a very common misconception in society so I think it was very important to make sure this is understood amongst medical students.

The small things I can do that’ll make a big impact on someone who is struggling.

I learned how there are small things I can do as a physician to make everybody feel comfortable. A flag, a pin, a sign, those things matter to patients to let them know they are safe.

What seems like small and insignificant things to one person, can be the most significant things to another which is why we need to be conscientious of how our words and actions affect those around us.

One way to create a safe space for your pts is by making sure your waiting room area has things that show support for LGBTQ community.

Staggering rates of suicide affecting the community.

The barest minimum to affirm a person is to simply respect them as a human being.

How vital gender affirming and welcoming patient care is to individuals and ways to be proactive not just reactive when a patient or loved one decides they feel comfortable enough to speak to you about their experience.

How to be welcoming to LBGTQAI patients especially how to reduce risk of suicide.

It is better to ask up front than to have to apologize later. I think this is so important because while it might feel awkward to ask someone their pronouns, etc. it is better to do so initially than inadvertently offend someone later.

How to best care for and support the LGBTQ+ community, and provide a safe space for those individuals when they are my patients.

The importance of setting the tone for my patients so they feel safer, and verbal and non-verbal ways I can do that. New vocabulary.

The statistics behind the disparities of transgender youth and the general population. I also found how to make the clinical environment safe for patients who are in the LGBTQ+ community very helpful.

The Trans community tends to be at the highest risk for suicide and mental health issues out of all the individual groups in LGBTQIA.

How high suicide rates are among trans patients.

I gained a better view of the trauma that LGBTQIA people are suffering and have suffered.

Make allyship visible in the office to create a safe space for everyone, but especially for people who undergo so much more than the typical person.

The importance of being a safe space and welcoming and affirming physician to the LGBTQIA community.

The unsettling statistics of the LGBTQ+ community and their mental health. Rainbow railroad.

How to make space for an individual who you suspect might be hesitant about being open about their identity and the importance of saying sorry after misgendering or deadnaming.

I knew the statistics on LGBT abuse and suicide were much worse than the general population, but it was eye opening to learn exactly how much worse they are.

How to care for marginalized members of our community

To be caring and to show that I’m on their side.