We are committed to improving the health and well-being of all members. Our Affirming Blue Partnerships program is designed to support your practice with additional knowledge, skills, and practices to advance the care and equity of our lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) members.
The goals of the program are to:
- Support your understanding of effective communication
- Foster affirming environments, empathy, and sensitivity
- Help identify needs and resources for your patients, our members.
LGBTQ+ patients want health care environments where they feel welcomed and respected. This community has historically faced barriers to accessing inclusive and affirming care. Proactive efforts to build inclusive environments are essential to building relationships with your LGBTQ+ patients.
Many patients look for signs and clues of openness to their gender identity. Assess the physical environment of your office or waiting room to support inclusive care.
Best practices to include in your offices include having:
- A non-discrimination policy
- Gender neutral restrooms
- Health education or reading materials
- Inclusive, non-gendered forms and documentation
- Resource materials from local LGBTQ+ organizations
Train staff (administrative and clinical) on gender identities, terminology, health disparities, and how to avoid stereotypes and assumptions.
Ask questions:
- What gender do you identify with?
- What sexual orientation do you identify with?
- What name or nickname do you go by or prefer?
- What gender pronouns do you use?
Understanding and using the correct terminology with your patients is crucial to providing comprehensive and culturally responsive care.
A best practice is to use neutral language, don’t assume gender or sexual orientation, and don’t assume sexual practices or relationship status.
| Term | Definition |
| Cisgender | Gender identity consistent with assigned sex. |
| Genderfluid | Switching between two or more genders over time or having a gender that changes. |
| Gender identity | Spectrum of personal gender identification. |
| Gender neutral | Not associated with any particular gender. |
| Genderqueer | Gender identity neither exclusively man or woman. |
| Nonbinary | Any gender that is not strictly man or woman all the time. |
| Queer | Umbrella term to describe anyone who is not cisgender, heterosexual, and heteroromantic, or anyone who engages with societally nonconforming relationships, sexualities and sexual expressions, and gender identities and gender expressions. |
| Transgender | Gender identity not consistent with assigned sex. |
| Term | Definition |
| Birth sex | Determined by genitalia and chromosomes. |
| FTM | Female to male (transgender male). |
| Intersex | Differing from exclusively male or female sex. |
| MTF | Male to female (transgender female). |
| Term | Definition |
| Asexual | Not experiencing sexual attraction. |
| Bisexual | Experiencing attraction to two or more genders. |
| Gay | Experiencing attraction to people of one’s own gender. An umbrella term to talk about anyone who is attracted to people of their same gender. |
| Lesbian | A woman who is attracted to other women. |
| MSM | Men who have sex with men. |
| Pansexual | Experiencing attraction to people of one’s own gender. An umbrella term to talk about anyone who is attracted to people of their same gender |
| WSW | Women who have sex with women. |
For an individual whose gender identity differs from their assigned sex at birth, they may be considering or seeking gender-affirming surgery or just exploring options. Understanding common procedures increases confidence and comfort levels for a patient.
We encourage our providers to review our medical policy 189: Gender-Affirming Services (Transgender and Gender Diverse Services) with their patients to better understand and navigate medical options.
Gender-affirming care often includes:
- Egg, sperm, and embryo cryopreservation prior to undergoing genital gender-affirming surgery (limited to one cycle only)
- Genital reconstruction
- Breast augmentation
- Mastectomy
- Electrolysis and/or laser hair removal performed by a licensed provider for the removal of hair on skin being used for genital gender affirmation surgery
- Feminizing or masculinizing speech therapy and/or voice training services
- Facial Feminization (typical components of facial feminization) or Masculinization including:
- Forehead contouring
- Rhinoplasty
- Mandible reconstruction
- Trachea shave
- Blepharoplasty
- Brow lift
- Cheek augmentation
- Face lift or liposuction (as needed in conjunction with one of the above procedures)
- Puberty Blockers and Gender-Affirming hormone therapy is covered at the discretion of the treating provider.
Gender-affirming hormone therapy or GAHT/GHT is often an important step in an individual’s gender journey. Understanding the different treatment options can be overwhelming. Below is an overview of the GAHT therapies.
Patients seeking masculine body features may consider taking testosterone. Testosterone helps to increase masculine characteristics, such as increased body and facial hair, muscle mass, and a deeper voice. There are several different ways to administer testosterone such as injections, gels, or implants.
Please speak to your patient about their medical history, as side effects can range for individuals seeking testosterone hormone therapy. Side effects may include, but are not limited to high blood pressure, high cholesterol, pelvic pain, male pattern baldness, and blood clots.
Patients seeking feminine body features may consider taking estrogen and/or anti-androgens. Estrogen helps to lower testosterone and develop more feminine characteristics, such as slow growth of facial and body hair, and breasts. There are several different ways to administer estrogen such as oral, injections, or patch.
Please speak to your patient about their medical history, as side effects can range for individuals seeking estrogen hormone therapy. Side effects may include but are not limited to increased risk of heart attacks, strokes, and weight gain.