LGBTQ Health Competency Outside Of Boston

rhode island

The harsh realities of LGBTQ health care beyond Boston

By: Nicole Lashomb*/TRT Editor-in-Chief—

What do you do if you are LGBTQ, are in a medical emergency and the only hospitals around you are not competent in LGBTQ healthcare? That is the dilemma the community will face each time medical care is sought throughout most areas of the commonwealth, Boston excluded.

In the latest Human Rights Campaign Health Equality Index (HRC-HEI), only three hospitals outside of Boston received a designation as a leader in LGBTQ Healthcare. Considering the number of hospitals and medical institutions throughout the commonwealth, that exponentially low number is alarming to say that least. An in-depth story on this very topic and its findings are published on page 3 of The Rainbow Times‘ January 2020 issue.

What if you don’t live in Boston? The pickings are slim. However, there are a few facilities outside of Boston who have taken LGBTQ affirming care seriously and vigorously. A few is not nearly enough to ensure the safety—physical and otherwise—for members of the LGBTQ community, specifically the necessary training needed to treat transgender, non-binary (NB) and gender non-conforming (GNC) patients.

Although many people live in liberal Massachusetts for its progressive ideals and messages of inclusion set forth by the legislature, the report within the pages of this publication describes the current situation and it is frightening for our community, particularly for those outside of the Boston area. If practitioners, nurses, registration attendants, and other medical staff do not understand the unique issues presented by the LGBTQ community when seeking out emergent or routine medical care, how can the queer community be treated without bias, with competency, affirmation, and compassion?

For anyone entering a medical facility, it is a vulnerable moment—a moment that at any time can mean the difference between life or death and our healthcare system is failing us overall.


The findings

There are more than 30,000 transgender residents in the commonwealth of Massachusetts alone, according to Project Out, Inc. Of those 30,000, most cannot afford to live in Boston to receive care from the commonwealth’s plethora of institutions that are affirming to the needs of the trans community, at least according to the HEI. Others I’ve known have traveled more than two hours to attend medical appointments at trans-affirming and competent facilities in the region.

I’ve heard countless stories from other trans people, people I consider family and friends, who have sat outside of the emergency room for hours in various parts of the commonwealth, even when they needed urgent care, out of an intense fear that they will be humiliated, “outed” and lose their dignity and respect in the process by medical professionals—some of the very people who are taxed with upholding the Hippocratic Oath who swear “to do no harm.”

Unfortunately, the city that I love and call home does not have one affirming medical facility or institution that is listed in the HEI, not for the LGBTQ community as a whole and not for the trans-specific community either. It’s long past time for people, facilities, and institutions to put their money where their mouth is. It is not enough to say that the practice is LGBTQ affirming or simply march in a pride parade. Policies, treatment protocols, and practice must demonstrate it, every day.

We have a long way to go, all around.

According to the HEI, 73 percent of transgender respondents reported that they believed “they would be treated differently by medical personnel because of their LGBTQ status” and 70 percent of transgender or gender non-conforming patients have “experienced some type of discrimination in healthcare settings.” Those are alarming statistics that must be addressed.

Likewise, the Index noted that 56 percent of “lesbian, gay or bisexual patients surveyed have experienced some type of discrimination in healthcare” and 29 percent reported that they “believed they would be treated differently by medical personnel because of their LGBTQ status.” When the members of the same medical community want feedback about their work with LGBTQ individuals and they can’t find many who’ll disclose if they are or not members of this community, the answer is clear as to why. Likewise, this is why people who seek care do not often mention that they are members of the LGBTQ community, even though there are certain medical considerations when addressing the needs of this marginalized group.

All of these stats are reprehensible. The medical system is failing one of the most vulnerable populations around us, repeatedly. My only question is who will hold them accountable in liberal Massachusetts and beyond?

*Nicole Lashomb is editor-in-chief of The Rainbow Times and co-executive director of Project Out. She holds an MBA from Marylhurst University and is a graduate from the esteemed Crane School of Music, where she obtained her BM. To reach Nicole, e-mail

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