Lesbian, Gay, Bisexual, and Transgender Inclusion in Physical Therapy: Advocating for Cultural Competency in Physical Therapist Education Across the United States

Background and Purpose. People who are lesbian, gay, bisexual, transgender, or queer (LGBTQ) should be considered in the discussion of improving cultural competency within physical therapy education to improve both culturally competent health care and the classroom learning environment. It is important to recognize the health care disparities affecting the LGBTQ community because people who are LGBTQ have higher risks of certain types of cancer, substance and tobacco use, sexually transmitted infections (such as human immunodeficiency virus and hepatitis B), and mental health issues (such as depression, anxiety, eating disorders, and suicidal ideation). Along with these health risks, patients who are LGBTQ typically face discrimination and bias, insensitivity of providers, a lack of knowledge about LGBTQ health care issues among providers, and decreased access to care; these problems may lead to substandard care. Position and Rationale. Current events in the news about the rights of lesbian, gay, bisexual, and transgender people bring to light the discrimination faced by this community. The topic of LGBTQ health care disparities has not been well researched or discussed in the profession of physical therapy. We assert that the inclusion of LGBTQ content in health care professional education programs will lead to better care for people who are LGBTQ. Although patient care is a primary concern, it is also crucial to create safe learning environments for students who are LGBTQ and enrolled in health care professional education programs because this population has higher rates of mental health disorders, weight-related issues, and suicide as well as higher self-reported levels of perceived emotional stress. Discrimination and disparaging comments directed at students who are LGBTQ are common in health care professional education programs and need to be addressed to provide these students with the same opportunities as their counterparts who are heterosexual and/or cisgender. Discussion and Conclusion. This position paper provides recommendations to health care educators for improving cultural competency and outcomes for patients who are LGBTQ as well as suggestions for creating an inclusive learning environment and climate for students who are LGBTQ. Specifically, curriculum content should highlight the appropriate usage of language and terminology for people who are LGBTQ, evidence of health care disparities and challenges faced by people who are LGBTQ, and active training in understanding the unconscious (implicit) bias of health care providers and how bias can affect both the treatment of patients and students. Furthermore, we recommend adding “sexual orientation” and “gender identity” to the nondiscrimination policies of physical therapist education programs, LGBTQ training for faculty and staff, concerted efforts to hire faculty members who are LGBTQ, orientation events for students who are LGBTQ, and targeted programs for students and staff members who are LGBTQ.