Sexuality Education

LGBTQIA+ Affirming Health Care: Tips for Professionals and Patients

Doctors’ appointments aren’t necessarily something that most people actively look forward to but when the patient in question is LGBTQIA+, the prospect can be downright terrifying. Receiving healthcare is often a vulnerable position to be in and when the risk of discrimination is that much higher, many LGBTQIA+ folks hesitate to take the chance even if it means denying themselves critical care. 

According to a report by Lambda Legal, “almost 56% of lesbian, gay, or bisexual respondents had at least one of these [various negative types of interaction with healthcare professionals] experiences; 70% of transgender and gender nonconforming respondents had one or more of these experiences.” Those kinds of numbers make it abundantly clear that LGBTQIA+ individuals are consistently discriminated against in healthcare environments and this discourages them from seeking needed care; not to mention that in some U.S. states, healthcare professionals can legally turn away an individual for being LGBTQIA+. 

These systemic issues need to be addressed but at the same time, LGBTQIA+ people are suffering at the hands of healthcare discrimination which has potentially life threatening consequences. There is room both to critique the system and recognize that it needs to be overhauled, as well as to acknowledge that people need access to compassionate care now. Both healthcare providers and LGBTQIA+ patients can take measures to make healthcare a more accessible and affirming experience. There are strategies to mitigate discrimination and exposure to it despite the fact that it may not be entirely unavoidable. 

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For Healthcare Professionals: Curating an LGBTQIA+ Welcoming Environment   

Change starts on an individual level and all healthcare professionals should strive to address the unique hurdles LGBTQIA+ people face when seeking care. Here are some ways to practice LGBTQIA+ affirming care:

  • Ask patients’ pronouns and default to gender neutral language if their pronouns are unknown. Additionally, make space for patients to disclose both their legal name and the name they identify with as sometimes they are different, especially for transgender people. 

  • Explicitly display support for LGBTQIA+ people and their health

    • Display brochures (multilingual when possible and appropriate) about LGBT health concerns, such as breast cancer, safe sex, hormone therapy, mental health, substance use, and sexually transmitted infections.

    • Hire LGBTQIA+ staff members

    • Attend and support local LGBTQIA+ events and businesses 

    • Publish a non-discrimination statement such as this example

  • Allow for a wide variety of identities and boundaries on intake forms 

    • This may include replacing the strict male/female options with blank spaces for both “gender” and “sex” categories.

    • Add room for patients to specify what name they’d like to be called, in addition to their legal name 

    • Allow people to disclose boundaries for the doctor such as not wanting to be weighed or not wanting a genital exam (unless explicitly necessary to the health concern at hand) 

  • Commit to continually learning and improving, especially in instances when you have made a mistake. 

  • Don’t assume anyone’s gender, anatomy, or sexuality

  • Listen to how patients describe their own sexual orientation, partner(s), gender, and relationship(s), and use their language. Although many LGBT people may use words such as “queer,” “dyke,” and “fag” to describe themselves, these and other words have been derogatory terms used against LGBT individuals. They are not appropriate for use by health care providers unless and until explicit consent is given by the patient. If you are in doubt as to how to refer to a patient, ask what word or phrase they prefer.

  • Ensure there is a gender neutral restroom option for patients

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For LGBTQIA+ Individuals: How to Protect Yourself

  • When searching for doctors, utilize resources such as a local LGBTQ+ clinics and centers for recommendations, or a directory like the one from the Gay and Lesbian Medical Association.

  • Look up reviews of a potential doctor to learn more about their patients’ experiences.

  • Explore the practice’s website to see if they explicitly display support for LGBTQIA+ people.

  • If you have questions for the doctor before you feel comfortable going in for an appointment, try emailing or calling the office and ask them questions about their experience working with LGBTQIA+ patients. Listen to your gut feeling about them after your call.

  • If possible, consider bringing a trusted friend, someone you feel safe and comfortable around, to your appointment. 

  • Your doctor’s job is to take care of you; the best way you can help them do that is by being upfront about your boundaries and any pertinent information about yourself, including your identity. Any good doctor will appreciate the guidance and unless your requests go against medical necessity, they should respect it.   

  • If you have a negative experience with a healthcare professional, make sure to practice self-care and process it with a trusted therapist if you have access to one. If not, talk with a consenting loved one about your experience.  

Hopefully these tips will assist both healthcare professionals and LGBTQIA+ patients to make LGBTQIA+ healthcare affirming, compassionate, and accessible. No one’s health should suffer because of ignorance. Healthcare is a human right for all, not just those who conform to arbitrary societal standards. LGBTQIA+ people deserve equitable access to proper healthcare. 

Sexuality Professionals Series: An Interview with Haley Hasen

Embrace Sexual Wellness is conducting a multipart spotlight series of interviews with sexuality professionals. If you missed the previous installments, check them out on our blog. For the final installment in our interviews, we spoke to Haley Hasen, educator and erotic laborer (Haley/Haley’s).

Haley Hasen is the founder of Haleyhasenuncensored, LLC. Haley is an artist, sex educator, certified crisis interventionist, erotic laborer, and sex toy enthusiast. Haley is involved with a federal work-study with RAINN, and is an art therapy intern at the nonprofit Clean and Sober Street based in DC. Haley is studying to receive a Master’s Degree in Art Therapy at George Washington University through a trauma-informed lens. 

Erotic labor refers to any kind of sex work. This could be stripping, full service sex work, selling erotic photographs and videos, or any other kind of work that involves sex or eroticism in some capacity. The word “prostitution” is an outdated and generally disparaging term which should be avoided unless someone explicitly identifies themself as such. Erotic labor is highly stigmatized which can make these careers risky because of the lack of safeguards and regulation. At the end of the day, everyone under capitalism has to sell some part of themselves and erotic laborers are no different. Erotic labor is an entirely legitimate and valid career that does not deserve the flack it receives.

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What inspired you to pursue your career path? 
I feel I came about this career path while working on healing and unlearning my sexual trauma. I really appreciate Carl Jung's idea of being a "wounded healer." I hope to create a safer space for individuals to be able to process, heal and unlearn aspects of themselves. I decided to do erotic labor as a way to reclaim my autonomy and sensuality after my sexual trauma. I wanted to have full control over that identity and I feel empowered by this aspect.   


How does your field differ from that of other sexuality professionals?
My field is different due to what I choose to disclose, educate, and advocate for. I am working within the here and now framework. I am also transparent in certain spaces about my identity as an erotic laborer; however, in most spaces I keep this identity hidden due to societal views and protection of myself. I feel I overlap in all aspects of myself and I try to formulate a truer self with one identity instead of being a multi-hat person. 


What is the most rewarding part of your career?
Empowering and creating a safer and healing space for sex workers and individuals who have and are experiencing sexual trauma. I enjoy learning from others and how they present themselves in these spaces. 


What's the most misunderstood thing about what you do?
I am not always turned on and I do not only think about sex. Furthermore, while I have gone through trauma that is not the reason I entered this space. I entered it to empower and reclaim aspects of me that were taken away without my consent. 


What's the most common question you receive from others about your career?
Can you teach me how to have sex?” is usually peoples’ go-to question on various dating apps and it always makes me roll my eyes


What advice would you want to share with aspiring sexuality professionals?
You cannot educate everyone! I learned this from a dear colleague, Lindsay Wynn. 


If you had to describe your work in one sentence, what would you say?
Relevant.


Is there anything you’d like to add? 
Pay, support and uplift Black and Brown Trans Sex Workers; they are the foundation of the sexuality field and are rarely credited. 


Thank you to Haley for sharing their knowledge and expertise with us! We encourage you to visit Haley’s social media and websites, linked below. 

Sexuality Professionals Series: An Interview with Erica Smith

Embrace Sexual Wellness is conducting a multipart spotlight series of interviews with sexuality professionals. If you missed the previous ones, check them out on our blog. For the fourth installment in our interviews, we spoke with Erica Smith (she/her) of Erica Smith Education and Consulting.

Erica Smith spent 17 years working as a sex educator, advocate, and HIV prevention counselor for justice involved youth in Philadelphia, specifically young women and LGBTQ+ youth. Now she offers sexuality education that is tailored specifically to people raised in Purity Culture. Her clients were raised in incredibly restrictive and conservative religious environments that pathologize normal and healthy sexual behavior. Two years ago she started the Purity Culture Dropout Program, where she gives folks all of the medically accurate, queer inclusive, trauma informed, and shame free sex ed that they were denied.

Sex education is a profession that has a wide variety of forms. Some work in a more formal capacity like a school or non-profit, others work freelance. Some choose to become certified, others do not. Some utilize digital media as their main platform, some do mostly in-person work. Some work with youth, others work with adults. Most sex educators have a niche, a few topic areas that they specialize in. For Erica, her focus is battling purity culture. 

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What inspired you to pursue your career path? 
I majored in Women's Studies in college and especially loved the classes on women's health and sexuality. I was very active in feminist politics in school, and my friends and I put on a few sexuality related events that drew a lot of controversy (this was the late 90s at Penn State). I loved doing these events and talking and learning about sexuality. There's nothing else I've ever wanted to do, honestly. 


How does your field differ from that of other sexuality professionals?
As far as I know, I'm the only sex educator who focuses specifically on people raised in purity culture; at least this is what I've been told by many prominent ex-Evangelical mental health professionals who also do purity culture work! 


What is the most rewarding part of your career?
The most rewarding part of my career is witnessing people's lives be truly transformed by the power of sexuality education. Sex education is transformative. It's a social justice issue. Good sex education is power. 


What's the most misunderstood thing about what you do?
That it's all… sexy. That I'm just teaching people the best oral sex techniques and talking about the mechanical aspects of sexual intercourse all day. I am happy to do that stuff and it absolutely comes up, but I'm doing so much more work around things like sexual values, shame, cultural messaging, gender roles and expectations, and things that are quite far from sexually arousing to be honest! Sexuality is such a large topic that touches on so many different aspects of our lives, and the actual act of sex is a rather small part of it.  


What's the most common question you receive from others about your career?
People most often ask how I got started in this field or why I focus on purity culture when I wasn't raised in it.


What advice would you want to share with aspiring sexuality professionals?
That we need more sex educators and that there isn't only one path to becoming one! We need sex educators with a whole variety of experiences and backgrounds and identities.


If you had to describe your work in one sentence, what would you say?
I help people understand themselves and their place in the world better through educating them about sexuality. 


Is there anything you’d like to add? 
Yes! I find social media's role in sex education to be so fascinating. It's a gift. There is great sex ed being put out there by so many people and organizations. This access changes peoples’ lives. 


Thank you to Erica for taking the time to share her perspective. We encourage you to find Erica on social media and her websites, linked below.

Instagram: @ericasmith.sex.ed
Website: purityculturedropout.com