"We're Here, We're Queer, Get Used to It": Advancing LGBTQ + -Inclusive Language in Public Health

• Published in: American journal of public health (1971) Vol. 114; no. 2; pp. 170 - 172
• Main Author: Harvey, Tyler D
• Format: Journal Article
• Language: English
• Published: United States American Public Health Association 01-02-2024
• Subjects: Acquired immune deficiency syndrome; AIDS; Anxiety; Bisexuality; Community; Correspondence; Data collection; Discrimination; Gays & lesbians; Gender; Gender aspects; Gender identity; Health care; Health care facilities; Health services; Heterosexuality; HIV; Human immunodeficiency virus; Injustice; Language; Lesbian/Gay/Bisexual/Transgender Persons; LGBTQ people; Opinions, Ideas, & Practice; Physicians; Polls & surveys; Public health; Questions; Social Science; Surveys; Transgender persons; Writing/Reviewing/Publishing; United States > US
• ISSN: 0090-0036; 1541-0048; 1541-0048
• DOI: 10.2105/AJPH.2023.307529

I recently had my annual physical with a new doctor-an experience any queer or transgender person knows to be anxiety-provoking. Before going into it, I asked myself: How much do I share? Should I be honest about certain things, or should I do what needs to be done to get out as quickly as possible? I decided to go with the former this time, writing down "queer" when asked my gender on the intake form. Minutes later, I found myself responding to questions from the doctor about my gender identity-all of which had nothing to do with my visit that day. Leaving, I felt regret, frustrated at the doctor and myself. This experience reminded me that the language used in clinical and public health settings remains limited for me as an individual from the lesbian, gay, bisexual, transgender, and queer (LGBTQ1) community.This was not my first negative experience with a doctor and probably will not be my last. Unfortunately, these experiences are not unique to me. It has been shown that the health system is particularly ill-equipped to deal with the unique needs of LGBTQ1 individuals. 1 A survey of US academic medical institutions found that only 16% reported having comprehensive LGBTQ1-competency training within their faculty practices.2 Given this, LGBTQ1 people often find navigating the health system difficult, and discrimination within health care spaces negatively influences the health-seeking behaviors of LGBTQ1 people.3 In a nationally representative sample of 1828 LGBTQ1 people, one in five reported delaying medical care because of discrimination within the health system.4 There are many needed reforms to improve LGBTQ1 health, and one of those centers on the words we allow people to use to describe themselves.Despite recent increased sociocultural acceptance surrounding LGBTQ1 issues and a greater percentage of Americans identifying as LGBTQ1, the field of public health as a whole still lags behind in adapting and implementing appropriate, inclusive language for the whole range of LGBTQ1 identities.5 Some systems, particularly ones focused on LGBTQ1 health, such as Fenway Health in Boston, are leading the ways in such efforts.6 But, for the most part, public health surveys, national studies, and medical forms overlook us, either not including any questions regarding diverse sexual and gender identity at all or including ones that are flawed.Here, I present two arguments regarding the implications around the lack of LGBTQ1-inclusive language in public health: (1) it is an injustice, and (2) it is bad for science.