During Pride Month, I often ask myself, “Why is Pride important?” And “How do I integrate my identity as an out and proud gay man with my role as a professional development specialist?”
The answer to my first question is simple, yet heartbreaking. Pride is important because somewhere, someone from the LGBTQIA+ community continues to wake up feeling that they are better off not existing than being their authentic selves. The answer to my second question is more complex. Planning and implementing LGBTQIA+ education has become incredibly complex in today’s sociopolitical climate. While the need for this education remains significant, some institutions have reduced support for initiatives aligned with diversity, equity, and inclusion (DEI), in part due to evolving regulatory and funding considerations.
Current State
As nursing professional development (NPD) practitioners, we must acknowledge the complexity of the current environment. Standard 9: Respectful and Equitable Practice, of the Nursing Professional Development: Scope & Standards of Practice (Harper & Maloney, 2022) underscores our responsibility to advocate for and partner with marginalized communities. Discrimination, stigma, shame, and systemic barriers drive the significant health disparity experienced by members of the LGBTQIA+ community.
LGBTQIA+ individuals suffer from higher rates of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) infection, a fact that has long been associated with a level of stigma. This coupled with minority stress (e.g., heterosexism, racism, and classism), higher rates of HPV, and higher rates of tobacco and alcohol use contribute to elevated risk of certain cancers including cervical, breast, prostate, and colorectal (Kratzer et al., 2024).
On top of all that, gender and sexual minority patients are less likely to engage with a primary care provider. Approximately 20 percent of lesbian, gay, and bisexual adults report delaying or avoiding medical care altogether due to discrimination or fear of discrimination. Those numbers increase to more than 30 percent when speaking specifically about transgender, gender non-conforming, and non-binary adults (Liu et al., 2024).
Even when care is accessed, patients may experience discomfort or mistrust. Individuals report challenges discussing sensitive health concerns and often perceive gaps in clinician knowledge regarding LGBTQIA+ care (Miller et al., 2023).
These experiences contribute to emotional burden and may further delay seeking care. Transgender patients, in particular, face unique challenges in accessing care. According to a national survey conducted by Mahowald, Gruberg, & Halpin (2020), 20 percent of white respondents and 38 percent of respondents of color reported their medical providers being physically rough or abusive when treating them.
LGBTQIA+ youth are also especially vulnerable in terms of mental health outcomes. These disparities are associated with higher rates of anxiety, depression, and substance use disorder (Shaikh et al, 2024). According to the Trevor Project, 50 percent of LBTQIA+ youth who desired mental health support were unable to receive it in the past year, and 90 percent reported that recent sociopolitical developments negatively impacted their well-being (The Trevor Project, 2024). Lesbian, gay, and bisexual individuals are approximately four times more likely to attempt suicide compared to their heterosexual counterparts, and rates are more than six times higher among transgender and gender non-conforming individuals (Schreiber & Culpepper 2026; “US Trans Survey”, 2022).
The Case for LGBTQIA+ Education
Beyond gaps in access to care, discrimination, and health disparities, there are critical clinical considerations that directly impact patient outcomes. Laboratory reference, screening tools, and medication dosage ranges often rely on sex-based parameters that may not align with a patient’s gender identity. Clinicians must be knowledgeable about hormone replacement therapy (HRT), perioperative considerations, and clinical and emotional implications of holding or continuing therapy. Furthermore, cancer and pregnancy screening recommendations may not align with gender presentation, requiring thoughtful, individualized care approaches. These complexities underscore the importance of structured, evidenced-based education to ensure safe, equitable, and patient-centered care.
Navigating the Environment
An essential component of creating a welcome environment for LGBTQIA+ patients lies with professional development. Standard 8: Advocacy highlights the need for high-quality care for the populations that we serve. The onus is on us, as healthcare professionals, to create an environment where everyone feels comfortable bringing their whole selves into the medical space. Not doing so can lead to profound clinical consequences. It is here that we can and must act.
When facing the challenges of creating meaningful, much-needed education, we must always bring it back to data and outcomes. The framing of LGBTQIA+ education through the lens of increased morbidity, mortality, and patient experience can often cut through the noise and facilitate operational engagement.
In accordance with Standard 11: Collaboration, engaging key partners is essential. That may include human resources, risk management, patient experience, quality and safety, employee relation groups (ERGs), shared governance councils, chaplaincy services, social work, behavioral health, and medical staff leadership. Collaboration across disciplines strengthens implementation and supports integration into organizational practice.
As you delve into the development of your content, I encourage you to look for opportunities to strengthen policy, bring in multiple disciplines to hardwire best practice, and fortify community outreach. The broader policy environment continues to complicate and negatively influence access to care and health outcomes for LGBTQIA+ populations (Cahill, 2025; Nuruzzaman & Hsiang, 2025). So using terminology such as gender and/or sexual minority instead of verbiage that invites scrutiny, such as lesbian, gay, bisexual, trans, transgender, or even diversity, may be helpful in garnering support for your offering from operations. As NPD specialists, we have the unique opportunity and great responsibility to equip healthcare teams with the knowledge, skills, and confidence in caring for this vulnerable populace. Advancing this work is essential to improving both patient outcomes and care experiences.
References
Cahill, S. R. (2025). A severe dismantling of LGBTQI+ health equity and equality: Impact of new U.S. policies on the global response to HIV. Journal of the International AIDS Society, 28(5). https://doi.org/10.1002/jia2.26485
Harper, M. G., & Maloney, P. (Eds.). (2022). Nursing professional development: Scope and standards of practice (4th ed.). Association for Nursing Professional Development.
Health & Wellbeing findings from the 2022 U.S. trans survey. (2022). https://transequality.org/sites/default/files/2025-06/USTS_2022Health&WellbeingReport_WEB.pdf
Kratzer, T. B., Star, J., Minihan, A. K., Bandi, P., Scout, N. F., Gary, M., Riddle‐Jones, L., Giaquinto, A. N., Islami, F., Jemal, A., & Siegel, R. L. (2024). Cancer in people who identify as lesbian, gay, bisexual, transgender, queer, or gender‐nonconforming. Cancer, 130(17), 2948–2967. https://doi.org/10.1002/cncr.35355
Liu, M., Patel, V. R., Sandhu, S., Reisner, S., & Keuroghlian, A. S. (2024). Health Care Discrimination and care avoidance due to patient-clinician identity discordance among sexual and gender minority adults. The Annals of Family Medicine, 22(4), 329–332. https://doi.org/10.1370/afm.3130
Mahowald, L., Gruberg, S., & Halpin, J. (2020, October). The state of the LGBTQ community in 2020 - center for American progress. The State of the LGBTQ Community in 2020. https://www.americanprogress.org/article/state-lgbtq-community-2020/
Miller, G. H., Marquez-Velarde, G., Mills, A. R., Hernandez, S. M., Brown, L. E., Mustafa, M., & Shircliff, J. E. (2023). Patients’ perceived level of clinician knowledge of transgender health care, self-rated health, and psychological distress among transgender adults. JAMA Network Open, 6(5). https://doi.org/10.1001/jamanetworkopen.2023.15083
Nuruzzaman, N., & Hsiang, E. (2025). Contextualizing President Trump’s executive orders targeting transgender health and gender-affirming care. American Journal of Public Health. https://doi.org/10.2105/ajph.2025.308265
Shreiber, J., & Culpepper, L. (2023, May). Suicidal ideation and behavior in adults: Risk factors, clinical features, and assessment - uptodate. UpToDate. https://www.uptodate.com/contents/suicidal-ideation-and-behavior-in-adults
Shaikh, A., Kamble, P., Daulatabad, V., Singhal, A., Madhusudhan, U., & John, N. A. (2024). Mental health challenges within the LGBTQ community: A Societal Imperative. Journal of Family Medicine and Primary Care, 13(9), 3529–3535. https://doi.org/10.4103/jfmpc.jfmpc_321_24
The Trevor Project. (2024). The Trevor Project 2024 U.S. national survey on the mental health of LGBTQ+ young people. 2024 U.S. National Survey on the Mental Health of LGBTQ+ Young People. https://www.thetrevorproject.org/survey-2024/
Disclaimer: The views and opinions expressed in this article are solely those of the contributor and do not necessarily reflect the official policy or position of ANPD.
Jake White, MSN, RN, CNE, NPD-BC
Clinical Education Specialist, Hospital for Special Surgery
Jake White is a clinical education specialist at Hospital for Special Surgery in New York City. He serves on the LGBTQIA+ committee and the Pride Employee Relations Group (ERG). White has been offering his "Care of the Sexual and Gender Minority Patient" workshop to nurse residents to great response over the past couple of years. He has received the National Association of Orthopedic Nurses (NAON) Past Presidents QI grant to extend this important work to nursing staff beyond the nurse residency program. White has presented at national conference on DEI training and burnout mitigation strategies for newly prepared registered nurses. He also serves as a clinical instructor for St. John's University in New York City.