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February 23, 2020
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Haidn Foster, a second-year medical student at the University of Cincinnati, recently launched the online publication Pride in Practice to offer more comprehensive LGBT health care education for medical students, residents, physicians and other health care workers.
“I wanted to advance the state of LGBT health care education,” explains Foster. “We know that the LGBT community has disparate and almost uniformly worse health care outcomes compared to the general population. They have unique health care challenges that need to be addressed. I wanted to provide a forum for providers, medical students and community advocates and patients to share their stories, best practices and tips about how to make health care more LGBT-inclusive and competent.”
Foster says mental illness, suicide, substance use, obesity and risk of heart disease, among other health outcomes, affect the LGBT population at higher levels compared to the population broadly. This can partially be attributed to members of the community being more hesitant to go to health care providers to seek treatment as a result of stigma other patients might not face, he says.
“Transgender patients have very obvious and different needs, for example, coming in for treatment and asking for gender-affirming hormones or surgeries,” says Foster. Members of the LGBT community may also need a different conversation with health care providers about family planning and ways to safeguard sexual health, he says.
Foster, a 31-year-old native of Seattle, has a special interest in LGBT health. He graduated with undergraduate and master’s degrees in English from the University of Washington and ran a marketing company for several years before going back to Portland State University for a Bachelor of Science degree in preparation for starting medical school. An experience with a chronic medical condition that caused severe pain, but was ultimately treated successfully, left him curious about his body and how physicians managed to cure him.
“These physicians had such an impact in my life that I couldn’t see myself doing anything other than trying to have that same impact in other people’s lives,” says Foster, explaining his path to medical school. “Throughout medical school, I’ve been deeply involved in advancing LGBT health care policy through the American Medical Association.”
One of Foster’s posts on Pride in Practice looks at the ‘ABCs of LGBT Health’ and focuses on helping health care workers expand their vocabulary of LGBT-inclusive terminology. For example, Foster says, non-binary refers to a gender identity that is not exclusively male or female. Non-binary people can identify as simultaneously male and female, somewhere between those two identities, or not identify as being on the traditional gender spectrum.
Meanwhile, gender expression is defined as the outward manifestations of one’s gender including: behaviors, clothing, hairstyle, makeup, name, pronouns, voice and more. These expressions of gender can be interpreted by others as masculine, feminine, or as belonging to both or neither category, according to Foster’s article.
The publication also includes articles from College of Medicine faculty members, Sarah Pickle, M.D., and Aaron Marshall, Ph.D., and Juliana Madzia, a second-year M.D./Ph.D. student. Gerald Montano, D.O., a columnist for Pediatric News and member of the Pennsylvania Commission on LGBT Affairs is also featured on the site. Pickle, who is an associate professor of family medicine and associate division director, medical education, says the publication aligns with the College of Medicine’s efforts to teach medical students how to properly care for transgender patients. She authored an article for the site titled “I Integrated Transgender Care into My Practice, and You Can Too.”
“It’s inspiring to see students like Haidn who are taking these advocacy and educational efforts to the next level,” says Pickle, who has published a paper on transgender medicine curriculum with the American Association of Medical Colleges. “Pride in Practice helps to inspire the current and future workforce of providers.”
Fellow medical students and UC faculty have offered positive responses to the site, says Madzia, who contributed an article titled “Bisexuals Have Worse Health Outcomes: Here’s How Physicians Can Help.”
“I wanted to write for Pride in Practice because I've talked to so many people in the LGBT community, who have avoided going to the doctor because of discrimination or discomfort that they had experienced in the medical setting,” says Madzia. “Most of the time this is due to a lack of education or awareness on the part of physicians, so our hope is that Pride in Practice will be a resource to physicians at all points in their career who could benefit from learning more about providing optimal care for LGBT patients.
“I've found that so far in medical school, regardless of how busy things get, you can always find the time for the things you care the most about,” says Madzia. “The most important reason for my choosing to go into medicine in the first place was to work to reduce the barriers to health care that people in marginalized communities experience. So, for me, taking the time to do something like write for Pride in Practice is right in line with what I value and therefore something that I'll always prioritize.”
Lead photo taken by Colleen Kelley/AHC.