Why primary care needs to become more gay affirmative

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Rainbow Center. (File Photo/The Daily Campus)

Dr. Marianne Snyder realized several years ago that many APRNs (Advanced Practice Nurses) haven’t been trained to care for lesbian and gay patients. In order to see if this was true and to understand how widespread the issue is, she conducted a study entitled “A Mixed Methods Study of Beliefs, Behaviors, and Experiences of APRNs with Lesbian and Gay Patients.” She came to the Rainbow Center Thursday to explain the findings of her study to a room of students.

Snyder began her lecture by giving a little background on herself: She is an assistant professor at the UConn School of Nursing, has been a registered nurse for the past 35 years and identifies as a cis-gendered lesbian. She then went on to give a little background on why her study is important. In recent years, less physicians have gone into primary care. Instead, an influx of APRNs and physician assistants have filled such positions. In fact, of the 267,000 APRNs out there, 86.5 percent of them are in primary care. On the other end, 3.8 to 10 percent of the population of the U.S. identify as LGBT. So, if the majority of people who provide primary care are uneducated in how to care for LGBT patients, then up to a tenth of people in the U.S. aren’t being properly cared for.

“I basically learned how not a lot of people in the healthcare field, including nurses and doctors, are very educated in treating the LGBT community,” Becky Moody, an eighth-semester economics major, said. “And they had never really received any education, or classes during their education, about it.”

Snyder created Gay Affirmative Practice (GAP) surveys to determine if the APRNs in her study treat being LGBT as an equally positive human experience and expression as being heterosexual. This survey was only the first part of her study, which also included testimonies of the experiences the APRNs had with LGBT patients. The survey results and testimonies were then merged together to create statistics on how well-educated APRNs are.

The information from this was then broken down into themes that were prevalent in many of the responses, including positive ones such as “affirming beliefs and behaviors” and negative ones such as “sexual orientation only asked if relevant.” Those with higher GAP scores tended to fall more into the positive themes. Snyder also broke down the demographics of people who got higher versus lower scores. For instance, Democrats got higher scores, but hospital workers got lower scores. T scores weren’t very good overall, with only 220 of the 678 surveyed reaching the affirming category. Those that did well were also the ones that have either gone through classes or have taken care of numerous LGBT patients.

Snyder had the students attending her lecture brainstorm potential changes that need to be made in policy, research, education and practice. For policy, students said nondiscrimination laws need to be created to prevent things like surgery on intersex children and conversion therapy. For research, students called for a reform of the culture within primary care facilities and for a larger focus on health and medicine for the LGBTQIA+ community. For education, students wanted LGBT focused classes added to the curriculum, education for patients on what quality care looks like and chances to work with LGBT patients while still in school. For practice, students wanted to add structure to care, have a better supply of primary caregivers and provide research to give to patients in need.

“I just learned about the need for more education in terms of health care for the LGBT community,” Naydrine Straper, a fourth-semester communications major, said. “And also how I didn’t know that in some health care providers, in terms of policy, if some provide more affirmation for the community and also how it affects the care that they receive. So it was just interesting to know that stuff like that exists and how you go about solving a problem like that.”

In any case, Snyder emphasized that steps need to be taken to improve the GAP scores of primary caregivers. Everyone deserves high-quality, individualized care.


Rebecca Maher is a campus correspondent for The Daily Campus. She can be reached via email at rebecca.maher@uconn.edu.

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