Healthcare For All: An Expert’s View on Equity and Inclusion in the LGBTQ+ Health
Dr. Carl Streed shares his experiences creating inclusivity in the health and medicine landscape for all patients, highlighting the importance of considering all unique elements when caring for patients of marginalized communities.
By Lydia Lu
Pride Month is a time for society to celebrate LGBTQ+ communities, acknowledging the diversity and vibrancy of lesbian, gay, bisexual, transgender, and queer individuals. The month also highlights the ongoing challenges these communities face, and honors the advocates paving the way for a more equitable future. In the realm of healthcare, equity and inclusion are crucial for LGBTQ+ patients, who often encounter unique barriers and disparities in accessing medical services. Training healthcare professionals to recognize and support patients of all backgrounds and identities is essential to maintaining welcoming environments and improving the health outcomes of LGBTQ+ patients.
Dr. Carl Streed, Jr. is a nationally recognized clinician-investigator, educator, and advocate specializing in the health and well-being of transgender and gender-diverse individuals. Dr. Streed currently serves as an Associate Professor of Medicine at Boston University Chobanian and Avedisian School of Medicine and the Research Lead for the GenderCare Center at Boston Medical Center. In his work, Dr. Streed collaborates with researchers, clinicians, and communities to assess and address the health needs of transgender and gender-diverse populations. His clinical practice, training programs, and research initiatives aim to improve the health outcomes of marginalized communities, particularly LGBTQ patients. In the following Q&A, Dr. Streed shares insights into his advocacy journey and how the healthcare field can become more equitable and welcoming for LGBTQ+ individuals.
What does Pride Month signify for you in the context of your work and advocacy for LGBTQ+ health equity?
Pride Month represents an opportunity to bring attention to the issues facing LGBTQ+ people and communities. As a gay clinician-investigator whose work is focused on the health and well-being of LGBTQ+ communities, Pride is also a month when I am asked to share everything about my work. Consequently, Pride can feel like the only time people pay attention to the issues facing our communities.
Can you explain why equity in healthcare is particularly crucial for LGBTQ+ individuals?
Everyone has a sexual orientation and a gender identity, so equity is not just an LGBTQ+ issue. Equity in healthcare is incorporating all the unique components of a person into the healthcare system and the clinical encounter to ensure we are getting a complete and holistic view of the person presenting for care. Only by doing this are we able to provide tailored care that incorporates the uniqueness of the person in front of us.
How do you integrate the principles of diversity, equity, inclusion, and accessibility into your clinical and research work?
My work focuses on the experiences of people marginalized by society. This means working with communities to identify what research needs to be done and working with them to gather the resources to perform the research appropriately. This means creating teams that reflect the communities and issues we’re trying to understand.
As the Research Lead for the GenderCare Center at Boston Medical Center, what are some of the most impactful projects or studies you’ve been involved in?
Some key projects include improving collection and documentation of sexual orientation and gender identity data as well as patient names and pronouns in our electronic health record. This work isn’t published but it is critical to providing competent care and generating accurate population-level data.
How has your involvement with organizations like the American Medical Association (AMA) and GLMA: Health Professionals Advancing LGBTQ Equality (GLMA) influenced your work and the broader healthcare landscape?
Through other organizations, like the AMA, GLMA, USPATH, I am able to collaborate with experts across the US and the globe. Through such a broad community of health care professionals, I am able to learn more about best-practices in clinical care and research and generate more thoughtful projects with both a local as well as global impact.
How have your research and advocacy efforts influenced institutional, state, and federal policies regarding LGBTQ+ healthcare?
My work has led to the inclusion of sexual orientation and gender identity data being collected in several workforce surveys within large organizations and across healthcare systems in the US. I have advocated for the initiation of sexual orientation and gender identity data collection in other national data sources (e.g., in several countries in Europe). And my publications have been cited by UN reports regarding the need to ban conversion therapy, a major threat to the well-being of LGBTQ+ people.
What policy changes do you believe are still necessary to achieve true equity in healthcare for LGBTQ+ individuals?
One of the most significant changes that I believe will lead to a more equitable health landscape for LGBTQ+ communities is REQUIRED education on LGBTQ+ health in professional schools and training programs. This means requiring LGBTQ+ health content in undergraduate medical education, graduate medical education, and continuing medical education.
How have you seen healthcare access for LGBTQ+ individuals evolve over the past decade?
Absolutely. I have seen us take two-steps forward and one to two-steps back in some places in the country, especially with regards to medically-necessary care for transgender people. I have seen advances in education of future clinicians, but I have also seen some places become more entrenched and unwilling to prepare the next generation of clinicians to care for LGBTQ+ persons. We have evolved, but in fits and starts.
What advice would you give healthcare professionals who want to advocate for LGBTQ health and inclusivity?
Go out and learn what it means to care for people who are not exactly like you. This means being uncomfortable not immediately understanding someone’s identity and then recognizing you DO NOT have to understand in order to be a compassionate and competent clinician. You then have to live up to your own expectations as a lifelong learner and gather the knowledge and skills to meet the unique needs of LGBTQ+ communities.
What future initiatives or projects are you excited about that aim to further equity in healthcare for LGBTQ+ individuals?
I have some specific projects focused on improving health care tools to better incorporate the experiences of transgender patients. I also have a few general projects focused on educating the next generation of clinicians. It’s all exciting and all never-ending. So I hope more people will join in this work.
For additional commentary by Boston University experts, follow us on X at @BUexperts. Find more from Dr. Carl Streed by following @cjstreed. Stay in tune with the GenderCare Center via their website or @BmcTrans. For research news and updates from Boston University’s Chobanian and Avedisian School of Medicine, follow @BUMedicine.
