1. Adopt and post a nondiscrimination policy that explicitly includes sexual orientation, gender identity, and gender expression. Healthcare settings have historically discriminated against LGBTQ+ people, and many LGBTQ+ people do not seek mental health or health care services due to past negative experiences or a fear of negative experiences. It is important for health care organizations to include sexual orientation, gender identity and gender expression in their nondiscrimination policy. Click here for examples of nondiscrimination policies. The nondiscrimination policy should be visibly and clearly posted at the facility, in print materials, and online. This creates a welcoming environment for LGBTQ+ people by ensuring this policy is communicated to patients and their families. Including the nondiscrimination policy in job listings and the employee handbook can help attract and support a diverse LGBTQ+-identified staff. To further the nondiscrimination policy within inpatient facilities, create an LGBTQ-inclusive visitation policy. Define “families” broadly to include non-married partners, families of choice who may not be biologically related, and parents acting in loco parentis who may not be biologically or legally related to their child. Nondiscrimination policies are more meaningful when there is a well-defined process for reporting and responding to any discrimination complaints. Clear directions for reporting should be posted with the nondiscrimination policy and communicated to staff and patients.

2. Deliver ongoing staff training in LGBTQ+ affirming care. Staff training is vital for the creation and maintenance of a welcoming environment for LGBTQ+ people. Ongoing training allows for staff to build their knowledge of and comfort with LGBTQ+ issues each year while also giving new staff skills to serve LGBTQ+ patients well. Education increases staff knowledge and confidence around LGBTQ+-specific language and communication. Education includes information about LGBTQ+ health disparities and inclusive health practices that goes beyond “equal treatment.” Click here for a listing of New Mexico in-person trainers and online LGBTQ+ training.

3. Provide gender-neutral language on forms that allow for patient self-disclosure about sexuality, gender, pronoun, and preferred name. Health outcomes are better for LGBTQ+ people when they are open with their healthcare providers about their gender and sexual orientation. One way to facilitate that disclosure is to create forms that reflect the reality of LGBTQ+ lives. Making forms gender-neutral allows for a multitude of genders outside the male/female binary and sexuality outside of heterosexual/homosexual binary. Forms that ask (but do not require) a person’s pronoun, preferred name, and sexual orientation allows patients to start the conversation with their provider. Click here for more resources for creating gender-neutral language on forms. Fenway Institute: Ready, Set, Go! Fenway Institute: Focus on Forms and Policies

4. Maintain a physical healthcare environment that is welcoming to LGBTQ+ people by ensuring representation in waiting room art and marketing materials, and having a gender neutral restroom. The physical environment of the mental health or medical clinic is one of the first interactions a patient has with the organization. Artwork and posters in waiting rooms communicate who is valued and served in the space. When images reflect LGBTQ+ lives, people of color, and people living with disabilities, more people will feel welcomed in the space. One member of our Fierce Pride LGBTQ+ focus group said, “If there is even the tiniest rainbow flag in the waiting room, I will find it.” LGBTQ+ people scan environments for symbols that communicate acceptance and safety. A bathroom labeled as unisex or gender-neutral creates a safe space for transgender or gender nonconforming people to use the restroom privately and safely. Many transgender and gender nonconforming people avoid using public restrooms out of fear of awkward questions or retribution. Magazines and informational brochures that feature LGBTQ+ people reinforce the commitment by the organization to be proactively inclusive of all gender and sexualities.

5. Create LGBTQ+ inclusive tobacco cessation resource referral system and educate staff about high rates of tobacco use in LGBTQ+ communities. Understanding the prevalence and root causes of health inequities in LGBTQ+ populations is crucial for effective mental and physical healthcare. Due to factors including history of trauma, discrimination, and target marketing, LGBTQ+ people smoke commercial tobacco at nearly twice the rate of the general population. Commercial tobacco is the number one cause of preventable death in the United States. Tobacco kills more than Americans than complications from AIDS, alcohol, car accidents, murders, suicides, drugs, and fires combined. LGBTQ+ people are shouldering more of the health burden of tobacco and need support in quitting. Agencies can set up a fax or email referral system to enroll interested patients in free cessation services. Technical assistance is available for free. Learn more here. Providers can learn tools for a brief tobacco intervention here.