Sex…and Gender
Dr. Brian Hurley
Dr. Brian Hurley, an addiction psychiatrist, became interested in healthcare disparities while in medical school. “I was in Medical School at the University of Southern California, right near Los Angeles General with its enormously diverse patient population. I was very much aware that while we were learning about pharmacology and anatomy, we were learning little about the social determinants of health or about the disparities in healthcare in many diverse communities.”
In 2011, he was both surprised and honored to be chosen among many clinicians and educators to be one of nine members of a committee charged by the AAMC (Association of American Medical Colleges) Advisory Committee on Sexual Orientation, Gender Identity, and Sex Development. In 2013, while a Fellow working at NYU’s Bellevue Hospital and VA New York Harbor Healthcare System, he helped develop the guidelines to teach doctors of the future about treating Lesbian, Gay, Bisexual, Transgender Patients and People Born with Differences of Sex Development in a way that eliminated discrimination and optimized patient care. “I am very grateful to NYU and VA for being so supportive of my work in contributing to this important guide.” The extraordinarily comprehensive document the team created is “truly revolutionary,” says Dr. Hurley. Mostly, he explains LGBT patients have the same health problems as the rest of the population, “but the context and climate” in which they live is different and must be understood by those providing care. A key and almost obvious point is the concern among LGBT patients that they will be received in a hostile environment causes many LGBT patients to avoid seeking care. “This only makes their health problems worse,” says Dr. Hurley.
Looking at just one chapter for specific examples of how the guide proposes to have doctors training go beyond having the topic of LGBT as an optional medical school subject, are proposed changes in the hospital environment that would improve care of LGBT patients. Six of among two dozen recommendations include:
· Employment of LGBT-identified providers
· Designation of diversity officers, student and faculty groups, and individual leaders who identify as LGBT
· Requirement of continuing education in LGBT issues for employees, especially leaders
· Identification of and steps to address instances of discrimination in the health care environment
· Developing an “out list” of students, staff, and faculty who openly identify as LGBT and who are willing to speak publicly on issues and serve as mentors to students and employees
The guide, including the competencies, was published on the AAMC website and released at the 2014 annual meeting in Chicago to a room full of welcoming medical school deans- and is available as a free pdf download at: http://www.aamc.org/lgbtdsd
Video promoting the project: https://www.youtube.com/watch?v=Om0hkKRH38c
