Q: What preventative care should LGBTQ+ patients discuss with their provider?
A: As a primary care physician who does queer health care, there is a common problem I run into often with my patients. Many queer patients don’t seem to get the same level of preventative health care as other patients do. There are probably many reasons for this, with patient’s past experiences with the health care system being a major factor, as well as the physician’s self-perceived level of knowledge of queer health care and what that entails.
One way that I’ve found to make sure that I’m taking care of patients’ preventative needs, such as cancer screenings, is to do what I call organ-specific care, meaning that I am sure to discuss all appropriate screenings based on the organs that are present. For example, all patients that have a uterus should have routine pap smear screenings. Even for patients who are transgender, if you have a uterus, we should be making sure we are at least discussing the need for pap smears to screen for cervical cancer. Similar screenings that we do all the time for patients also apply in LGBTQ+ cases, including mammograms, prostate cancer screenings, lung cancer screenings and more.
Other important aspects I try to make sure I address as part of normal preventative health care are counseling services, such as tobacco use counseling, substance use counseling and safe sex counseling. While I have these discussions with nearly every patient at some point during the year, LGBTQ+ patients are statistically at higher risk for some of those problems, so I make sure to emphasize those things during an annual physical.
In a nutshell, preventative health care for LGBTQ+ patients is the same as for non-LGBTQ+ patients. Everyone needs the appropriate age and risk factor-based screenings, though I do place more emphasis on some things than others based on discussions that happen in the exam room. Everyone deserves equal health care, and I encourage patients to discuss preventative health care with their doctors.