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Pioneering Policy and Practice for LGBT Care

The University of California, San Francisco (UCSF) Medical Center addresses the unique needs of San Francisco’s significant lesbian, gay, bisexual, and transgender (LGBT) population through its LGBT Resource Center, a division of the UCSF Office of Diversity and Outreach. The Center provides information, education, advocacy, and support to UCSF’s LGBT patients, staff, and supporters.

Founded in 2007 by Shane Snowden, now health and aging director for the Human Rights Campaign (HRC), the center is considered a national leader in increasing awareness of LGBT issues, including equality and inclusion. In 2013, UCSF’s groundbreaking LGBT-inclusive policies, practices, and training made it the only institution in the United States to have received a perfect score on the HRC’s Healthcare Equality Index (HEI) for six consecutive years.

In 2005, UCSF Medical Center implemented a comprehensive set of policies, protocols, and strategies to offer more equitable and culturally competent care to LGBT patients. These policies became the first LGBT-related material featured in the Agency for Healthcare Research and Quality’s (AHRQ’s) Health Care Innovations Exchange.

UCSF’s policies include allowing patients to indicate that they are in a “registered domestic partnership” in the electronic admitting and registration system. The hospital is in the process of updating language since the June 28, 2013, ruling on Proposition 8 made same-sex marriage legal in California. Policies also incorporate an inclusive visitation policy that extends equal visitation rights to same-sex partners and same-sex parents of patients, and new verbal communication protocols.

In addition to other resources made available to patients, the LGBT Resource Center maintains an Out List, which allows patients to look up an LGBT provider and/or a provider knowledgeable about LGBT issues. In addition to acting as a resource for patients, the Out List also serves as an informal networking and mentoring tool for LGBT staff and medical students.

According to AHRQ, more than 100 health organizations nationwide, particularly those participating in the HEI, have contacted the LGBT Resource Center for additional information about the program, and a number of them have adapted it to their institution’s needs.

Providing equitable and culturally competent care to patients starts with educating staff. The medical center incorporates in staff orientation targeted training on the use of welcoming and inclusive behaviors and supports ongoing cultural competency training and education.

According to information provided to AHRQ in 2011, approximately 850 staff and faculty receive inclusive and LGBT-related education and training each year through multiple programs and resources. Key staff, including nurses and admitting, registration, billing, and reception employees, participate in educational opportunities including learning to incorporate LGBT-inclusive systems and protocols into their daily routines to ensure a compassionate environment for all patients.

The medical center also regularly participates in LGBT-friendly activities and events, including LGBT Health Awareness Week, National Coming Out Day, and LGBT History Month. “Patients can walk into the medical center and see flyers for LGBT events and activities,” says Larry D. Lariosa, MA, director of the LGBT Resource Center and diversity manager at the UCSF Office of Diversity and Outreach. “This can be really validating, to see yourself represented in the artwork, in the flyers. Creating a welcoming environment for our diverse patient populations is something we are committed to.”

UCSF’s innovative LGBT work also extends to gender nonconforming/transgender patients. The Child and Adolescent Gender Center at UCSF Benioff Children’s Hospital offers comprehensive medical and psychological care, as well as advocacy and legal support for youth. Additionally, UCSF Women’s Health Primary Care at Mount Zion offers transgender-specific and inclusive primary care services.

For more information about UCSF Medical Center’s LGBT initiatives, please contact:

Larry D. Lariosa, MA
LGBT Resource Center
Diversity Manager
Office of Diversity and Outreach
University of San Francisco, California


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