A recent podcast examined the disparities in healthcare experiences and outcomes for LGBTQ+ individuals with multiple sclerosis, suggesting the need for inclusive care, improved awareness training for healthcare professionals, and further research.
- LGBTQ+ individuals with multiple sclerosis experience less favorable healthcare and poorer overall health compared to heterosexual, cisgender individuals.
- Lack of inclusivity, poor communication, and inadequate healthcare professional knowledge contribute to these disparities.
- Recommendations include improving cultural awareness training of healthcare professionals, promoting inclusive care, and integrating the discussion of sexual orientation and gender identity into routine assessments.
Multiple sclerosis (MS) already poses substantial healthcare challenges. However, for individuals identifying as lesbian, gay, bisexual, transgender, queer, or questioning, plus other identities (LGBTQ+), the challenges are further worsened. According to a podcast transcript published in the journal Neurology and Therapy, these individuals generally face less favorable healthcare experiences and poorer health outcomes than their cisgendered heterosexual counterparts.
The podcast discussion included Dr. Mark Cascione, the Medical Director of the South Tampa MS Center and Vice President of Axiom Clinical Research; Dr. William Conte, an MS specialist at Methodist Hospitals in Merrillville, Indiana, and Assistant Professor of Neurology at Indiana University; and Dr. Amy Sullivan, Associate Professor of Medicine at the Cleveland Clinic Lerner College of Medicine, Director of the section of Behavioral Medicine and Research at the Mellen Center for Multiple Sclerosis, and Director of Engagement and Well-Being as well as Diversity Leadership in the Neurological Institute at Cleveland Clinic.
The Multifaceted Nature of Disparities
The discussion centered on how disparities are not merely related to MS but encompass a wide array of psychological, emotional, and physical health issues. Transgender individuals, for example, face high rates of mental health distress and complications arising from long-term exogenous hormone use and gender affirmation surgery.
Several underlying factors contribute to this healthcare gap, including poor communication between healthcare providers and LGBTQ+ patients, a lack of healthcare professionals’ knowledge about LGBTQ+ health issues, and gaps in research focusing on sexual orientation and gender identity in MS.
Recommendations: The Road to Inclusive Care
To address these disparities, healthcare professionals need to be allies of the LGBTQ+ community. That might mean increasing education of healthcare professionals to help them better understand the unique challenges faced by this community, particularly those with MS. Using sensitive and gender-neutral language, offering LGBTQ+ representation in patient materials, and providing access to LGBTQ+ MS support groups are also advised.
Tailoring Approaches for Transgender Individuals
For transgender patients, healthcare providers need to have cultural awareness training focused specifically on the unique healthcare needs of this subgroup. Healthcare providers may look into providing gender-neutral intake forms, healthcare facilities, and bathrooms. They may also consider taking a comprehensive history of prior surgery and hormone use and collaborating with gender management teams as needed.
Other Considerations for Clinicians
The current research emphasizes that clinicians should adapt their practice to provide inclusive and competent care. Integrating discussions of sexual orientation and gender identity into routine clinical assessments is a starting point. For transgender patients, additional care may be given to address their unique healthcare needs, including the effects of hormone therapy and surgeries. Providing care for transgender patients calls for an interdisciplinary approach, potentially involving gender management teams and mental health professionals.
By addressing these disparities and implementing these recommendations, clinicians have an opportunity to significantly improve the quality of care for LGBTQ+ individuals with MS.
Conte, W. L., Cascione, M., & Sullivan, A. B. (2023). Podcast on the challenges and recommendations to address Unmet Needs in MS for LGBTQ+ populations in the United States. Neurology and Therapy, 12(5), 1399–1407. https://doi.org/10.1007/s40120-023-00506-4