Community Competency Training Program Analysis

Health disparities in the Lesbian, Gay, Bi-sexual and Transgender community that lack fair treatment. This population deals with many adversities due to their sexual orientation and gender identity. LGBT’s community consists of a diverse population of people who come from all walks of life ((Howard, 2016). Many LBGT’s will delay or not seek health care due to stigma and lack of fair treatment. In other words, they believe that they are discriminated against.

Perhaps the most significant contributing cause of the poor quality of healthcare afforded to transgender patients is the fact that the majority of healthcare providers do not know how to treat trans patients. According to a study done by the Royal College of Nursing, it was discovered that “78% [of surveyed nursing staff] had not had training on how to care for transgender people, and only 13% of those surveyed said they had felt prepared to meet the needs of trans patients they had cared for” (Duffy, 2016). Additionally, around four out of five staff had “no training

Relocating into a senior care facilities can be a frightening experience for the aging population. Getting familiar with new surroundings, new organization structure, and new people that can cause anxiety to rise. For a Lesbian, Gay, Bisexual, Transgender and Queer individual, this experience can be traumatic. The fear of harassment, hostility, and neglect by healthcare providers and caretakers can keep LGBTQ people from seeking care until their health begins to critically decline. LGBTQ cultural competency training is highly recommended for healthcare professionals and social service organizations. The greatest barrier that prevents quality health care for LGBTQ people is the lack of competence among the healthcare professionals.

For us to develop cultural competence we need to have a level expertise, knowledge and attributes. When I mention Expertise I am referring to professional skills such as, being able to communicate correct information for culturally different people and their communities, the skill to candidly discuss racial and ethnic issues and to react to culturally based signs, the skill to understand the meaning that traditions/culture has for each person, Interviewing skills that help to understand and accommodate the role of language in a person’s culture and the skill to use the idea of empowerment on behalf of culturally different people and communities.

The transgender population often have complicated medical needs and encounter numerous health disparities including discrimination, lack of access to quality health care and social stigma. Some health disparities include various chronic diseases, cancers, as well as mental health issues (Vanderbilt University, 2017). Transgender individuals are at increased risk of HIV infection with their rates being reported “over four times the national average of HIV infection, with higher rates among transgender people of color (Grant, Mottet, Tanis, 2011).” In addition, they usually do not have health insurance (Makadon, 2017) and have a lower probability of preventative cancer screenings in transgender men (AMSA, 2017).

In the field of human services, “cultural competency” has become a common buzz meant to address in part the . The intention being, that workers are able to achieve some level of knowledge and training that prepares them to work with

This decision has affected people’s behavior as individuals and public institutions such as family, young, elderly, disabled, LGTB and those with pre-existing conditions. For example, Kates & Ranji (2014) report that health care access and coverage for the lesbian, gay, bisexual, and transgender (LGTB) community in the U.S. face opportunities and challenges when getting access to care. The authors report that LGBT individuals experience some discrimination because of their sexual orientation or gender identity, due to ongoing discrimination, access to health care have been limited to these people (Kaiser Family Foundation, 2014). LGBT individuals not only face discrimination when trying to receive care, but also face difficulties that limit them such as “barriers in obtaining insurance coverage, gaps in coverage, cost-related hurdles, and poor treatment by health care providers” (Kates & Ranji, 2014).

"Cultural competence is defined as a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals and enables that system, agency, or those professionals to work effectively in cross cultural situations (Cross et al., 1989; Issacs & Benjamin, 1991). Operationally defined, cultural competence is the integration and transformation of knowledge about individuals and groups of people into specific standard, policies, practices, and attitudes, used in appropriate cultural settings to increase the

Evidence-informed practice is a critical part of nursing care. To be able to have evidence-informed practice, nurses need to be able to conduct research to find the most up-to-date and relevant information related to patient- and family centered care. When caring for patients, it is paramount to recognize the importance of family and the role they play in care. When one comes out as transgender, it is something that is not only going to affect the said person, but also their friends and family. Family members are key support systems so when you are caring for one person, you are in turn caring for the family as well. This is known as patient- and family-centered care. As there has been an increase in literature pertaining to family-centered care, the question of interest is “What is the impact on a spouse when a partner is transgendered?” To find the answer to this clinical question, the database Medline was utilized. The keywords LGBTQ, transgender, family-centered, spouse, nurse, sexuality and health care were used and combined with Boolean operators. Through this research, knowledge can be gained on how to properly care for the spouse of a transgendered person. This paper will discuss the key impacts of having a transgender spouse, nursing approaches that we can integrate into our care, and resources available for the non-transgender spouse.

Many LGBTQI Latinx lack appropriate mental health care due to the many external factors that include structural competency and the social determinants of health and clinical intervention. Structural competency is the medical education of understanding the stigma and inequities among marginalized diverse communities in order to reduce poor health outcomes of the specific community (Metzl, 2014). Specifically, structural competency focuses on the whole population, rather than, the

Travers et al. (2010) conducted a qualitative study of service providers in Canada and found that even in a country that has been proactive with regard to LGBT rights there still remains significant barriers to service provision for LGBT homeless youth. Providers cited concerns about resources being clustered in one area that is not accessible to the majority of LGBTQ youth, as well as the types of services being provided focusing specifically on HIV prevention and decreasing the focus on other important issues. The providers indicated this singular focus often discourages LGBTQ youth from utilizing services. Additionally, concerns were raised about the lack of evidence based information on transgender youth, as well as a lack of training on LGBTQ youth issues. Providers denounced the use of specialists in LGBTQ issues, but instead insisted that all providers should be trained to provide services to LGBTQ youth. A common theme in the focus groups was recognizing a mutual responsibility. The providers expressed frustration that there appears to be a general denial within the community that LGBT youth present, and this seems to be significant when considering service provision that comes from religious organizations. The study indicates that across the board, agency attitudes have not caught up to social attitudes or rights. Additionally, they highlighted that the current focus of mitigating risks does not account for promoting appropriate well rounded services in light of systematic issues. According to a study by Durso and Gates (2012), the most significant barrier to service provision is funding, followed by population identification, lack of training, and lack of support. A qualitative study of professionals serving homeless youth; including youth that identify as LGBTQ voiced several concerning issues in serving LGBTQ youth. Discrimination

Sexual and social stigmas largely affect the health of the lesbian, gay, bisexual and transgender (LGBT) population. While many reports from the Institute of Medicine, Healthy People 2020 and the Agency for Healthcare Research and Quality recognize a need to improve the quality of health care, barriers still remain. LGBT patients face legal discrimination, especially with insurance, a lack of social programs, and limited access to providers competent in LGBT health care. Although the Affordable Care Act increased access to care for LGBT patients, unless these patients feel understood by providers and develop trust in the system, they are not likely to utilize care. Healthcare providers need to recognize how these vulnerabilities, as well as persistent racism and stigma linked to sexual orientation and gender identity, make the healthcare needs of LGBT patients more challenging than the general population. Healthcare providers also need to promote cultural competence within this population and broaden their clinical lens to include health promotion, in addition to addressing concerns mentioned above within the population. Additionally, medical and nursing schools need to ensure that future providers are adequately educated by including information about this population in the curriculum.

Since I started my internship in the fall of 2016, I noticed that transgender clients seeking services are underserved, because

Bringing the issues to the forefront, creates awareness of the injustice, discrimination and socioeconomic inequities that exist. Studies show that fifty percent of employees who are either gay or transgender, have stated that they have faced discrimination at their place of employment (SHRM , 2016). Regrettably, twenty-six percent were fired, twenty percent were removed from any interaction with their customers and seventeen percent were overlooked in regards to a position they qualified for (Burns & Krehely, 2016); (SHRM , 2016). Not to mention, twenty-eight percent received poor employee evaluations due to their sexual orientation or because they were transgender (Burns & Krehely, 2016). Unfortunately, forty-one percent reported being verbally

Integrating Knowledge into Clinical Settings: Knowledge is power. It is essential as clinicians to stay open minded and be willing to expand our knowledge that many times will be challenge by our clients, especially when they are very different from us such as in race, religion, gender, sex orientation, etc. Therefore, it is very important to stay humble and to be aware that we do not know it all and we cannot do it all. Then, we will be able to create a welcoming and safe environment, where we can provide an efficient therapy for anyone who seek our help. In this case, staying updated with current information about the different and most significant issues in the transgender community and being aware of the proper etiquette to interact with