The Impact of Sexual Orientation and Gender Identity on People’s Health

The importance of factoring sexual orientation and gender identity into a person's overall health was the topic of a recent podcast discussion with Matt Bryan, MD, internist at Avenues Specialty Clinic, Anne Pendo, MD, senior medical director for experience of caring, and Mark Briesacher, MD, senior vice president and chief physician executive.

Dr. Bryan joined Intermountain four years ago after relocating to Utah for his husband's job. A large portion of his patients identify as LGBTQ+. He was recently named Intermountain's first LGBTQ+ associate medical director.

"I often get asked, 'Why do you spend so much time thinking about these patients or caring about them? Aren't they the same as us? Aren't they just as equal? Aren't we all equal?'" Dr. Bryan says. "I tend to agree wholeheartedly — of course we're all created equal. But one of the main issues is, especially when looking at health, there are disparities within the LGBTQ+ community. It's really important that we start to address them."

Here are three health-related areas where Dr. Bryan says LGBTQ+ people face higher risk:

  • LGBTQ+ identified youth are at least two to three times more likely to attempt suicide.
  • The LGBTQ+ community has higher rates of smoking-related cancers.
  • LGBTQ+ people have higher rates of all kinds of cancers.

Health disparities are a result in part of LGBTQ+ people avoiding care or getting incomplete screenings. "If you look at lesbians, for example, they're less likely to access care; therefore, they're less likely to get mammograms and pap smears," Dr. Bryan says. "Imagine a trans man, someone who was assigned female at birth but at some point transitioned to male, who would outwardly be very masculine-appearing. If a provider's not asking, 'Do you still have a cervix? Do you still have your uterus?' You're probably not offering to do a pap smear on that guy. And the risk of cervical cancer obviously goes up."

Dr. Bryan says it's important to create a safe environment for LGBTQ+ patients at our facilities. "These are very intimate details about your life," he says. "It's who you love or who you are. If you don't feel comfortable with your provider, you're obviously not going to tell your provider anything. I think it's really important to make it clear to your patients that, 'This is a safe space where you can tell me anything.'"

"Maybe a year after Matt joined our practice, we had a conversation about the importance of knowing your patient," says Dr. Pendo. "If someone looks like a John but has insurance that says Jane and you call them Jane, that doesn't feel good. If our goal is to be a safe, welcoming, trusted space to share intimate details, what can we do as a clinic, as an office, as a team, to make it feel safe?"

What will Dr. Matt Bryan do as Intermountain's LGBTQ+ associate medical director?

"The creation of this official role represents a significant step forward for Intermountain," says Dr. Bryan. "As a large healthcare organization, it's our responsibility to make sure all patients and community members receive the highest quality care. When we invest in our ability to provide the best possible care to LGBTQ+ individuals, we're committing to improving the health of the LGBTQ population. The impact will be felt well beyond the Intermountain West."

Dr. Bryan also plans help caregivers learn how to better care for LGBTQ+ patients.

"Most providers and caregivers haven't had formal training around the care of LGBTQ+ individuals," he says. "This community is a very diverse group that has many distinct health needs. Our goal is to make sure providers feel competent and supported when caring for this population. One way we'll do this is to provide educational opportunities to caregivers."