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LGBT Health. 2018 Nov 7. doi: 10.1089/lgbt.2018.0118. [Epub ahead of print]

National Findings from an LGBT Healthcare Organizational Needs Assessment.

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1 National LGBT Health Education Center at The Fenway Institute , Fenway Health, Boston, Massachusetts.
2 Division of Infectious Diseases, Department of Medicine, University of California San Francisco School of Medicine, San Francisco, California.
3 Department of Psychiatry, Massachusetts General Hospital , Boston, Massachusetts.
4 Harvard Medical School , Boston, Massachusetts.



LGBT populations require expanded access to healthcare that meets their unique needs. This article presents the primary findings of a training and technical assistance needs assessment conducted with healthcare organizations in geographically diverse areas of the United States to help determine gaps in LGBT health familiarity, preparedness, comfort, and practices.


A total of 5980 staff members and 638 leaders from 18 healthcare organizations participated in online needs assessment surveys. Cross-sectional findings and significance were evaluated using descriptive statistics and two-sample t-tests.


Significantly more clinicians agreed that they were familiar with lesbian, gay, and bisexual health needs compared with being familiar with transgender health needs (81.7% vs. 68.3%, pā€‰=ā€‰0.005). The majority of clinicians rarely or never talked to their patients about sexual orientation (55.4%) or gender identity (71.9%), mostly due to believing that the topics were not relevant to care, concerns with making the patient uncomfortable or offending the patient, lack of experience, and not knowing the appropriate language for talking about the subjects. Nearly one-third of staff respondents did not know if sexual orientation or gender identity/expression was included in organizational nondiscrimination patient policies.


Although clinicians may self-report that they are familiar with LGBT health issues, gaps in practice and knowledge indicate the need for more training, especially in transgender health and in talking to patients about sexual orientation and gender identity. Healthcare organizations also need support in ensuring that their organizations create inclusive environments by educating staff and leadership on nondiscrimination policies.


LGBT; cultural sensitivity training; healthcare; needs assessment; sexual and gender minorities; survey


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