Takeaway
Amid increasing anti-LGBTQ+ legislation, clinicians have an ethical duty to provide inclusive care. Read on for how to create welcoming environments in clinic and connect LGBTQ+ patients with appropriate resources.
Lifelong Learning in Clinical Excellence | September 15, 2025 | 6 min read
By Calvin Schuster, medical student, Helene Hedian, MD & Alia Bodnar, MD, Johns Hopkins Medicine
Across the United States, legislative efforts targeting gender-affirming care, LGBTQ+ education, and basic civil rights are rapidly advancing, contributing to a climate of fear, stigma, and medical mistrust. In 2020, just over 100 proposed bills targeted the rights of LGBTQ+ people. This number has increased annually, setting an unprecedented record this year: over 950 bills since the start of 2025, most targeting transgender Americans and many targeting healthcare.
LGBTQ+ people are facing mounting threats to their health, dignity, and access to care. This compounds existing health disparities and barriers to care that LGBTQ+ patients already experience, making effective support from healthcare professionals more urgent than ever. To help combat this, clinicians must offer clinically competent care and ensure that their practices are equipped to support LGBTQ+ patients. Supporting LGBTQ+ patients, more than ever, is a professional imperative in medicine.
What you can do:
Before care: barriers you can control
LGBTQ+ patients face major barriers to care, including geographic barriers, financial disparities, limited providers with necessary expertise, and more. As clinicians, one way to combat this is to obtain the training necessary to offer LGBTQ+ competent care. Then, make sure LGBTQ+ people can find your practice, for example by joining the GLMA LGBTQ+ Inclusive Provider directory, a searchable database of providers who practice LGBTQ+ affirming care.
Clinicians should also be prepared to encounter insurance denials, a common barrier for LGBTQ+ patients, for example when attempting to access gender-affirming care, reproductive care, or preventive services like PrEP. Providers can combat denials and advocate for their patients by writing a strong and specific letter of medical necessity, citing clinical guidelines such as those provided by the World Professional Association for Transgender Health (WPATH) and CDC. National advocacy organizations such as Advocates for Trans Equality and Lambda Legal can help with appeals or legal challenges.
During care: your team and your space
LGBTQ+ patients may not return to your care if they enter the clinic space and feel unwelcomed or overlooked. To preempt this, check your space. Try seeing the world through your patients’ eyes: do a walk through of your clinic, checking signs, posters, intake forms, informational handouts, and any other patient-facing material.
Is your space gendered (for example labeled “Women’s Health” or “Men’s Health”) and does it need to be? For example, how might a transgender man feel if he needed a pap smear found that the ob/gyn clinic had a “Women’s Health” sign when he arrived? Do intake forms make assumptions about a patient’s gender or sexuality? About the gender of parents or partners?
After ensuring that the messaging within your clinical space is inclusive of LGBTQ+ identities, consider adding symbols of LGBTQ+ support—such as signs, posters, lanyards, etc.—that express you care about and will advocate for LGBTQ+ patients.
It’s also important to recognize that clinicians are not the first team members that LGBTQ+ patients will encounter. Consider LGBTQ+ sensitivity and cultural competency training for your whole team, including all patient-facing staff. Does your care team feel prepared to effectively and respectfully communicate with LGBTQ+ patients? If a patient approaches you or another member of your team with a concern related to your practice, express gratitude for the feedback and offer to follow up with how it has been addressed, if the patient is interested.
Following care: resource referral
Because of ongoing discrimination interpersonally and nationally, LGBTQ+ patients face challenges and health disparities that may need to be addressed outside of the immediate care space. Therefore, be ready to offer local and national resources, as relevant:
1. Become familiar with local LGBTQ+ social and support groups, so you can refer patients experiencing isolation.
2. Learn about legal nonprofits that address LGBTQ+ discrimination pro bono or aid with updating legal documents to reflect correct name and gender marker.
3. Find local organizations working to address housing, food insecurity, and harm reduction for LGBTQ+ community members in need. Once you learn about local organizations, reach out and introduce yourself as an advocate. This will both facilitate future resource referrals and is another way for community members to find you and your practice.
4. Cultivate an interdisciplinary network of colleagues to refer patients to when needed. This network should include other LGBTQ+ informed providers, and providers that offer LGBTQ+ specific care. If you haven’t yet developed a network of clinicians you trust and find yourself needing to refer a patient, consider reaching out to providers with a personalized message to see if they feel equipped and able to effectively support and care for LGBTQ+ patients.
The future of care: training the next generation
Supporting LGBTQ+ patients also means contributing to the future quality and accessibly of care through education and advocacy. If you’re practicing at an academic institution, contributing to the creation and facilitation of LGBTQ+ health electives and workshops is one way to equip the next generation of healthcare professionals with the skills necessary to offer competent and effective care to LGBTQ+ patients.
You could also focus more immediately on your area of expertise: How do LGBTQ+ patients experience care within your specialty? What unique challenges or considerations are they facing? A literature review can help you understand current challenges and research happening at that specific intersection. You can then inform peers and learners about current issues effecting LGBTQ+ patients in your field, either through teaching on rounds or with a presentation during other student education activities. This will both ensure optimal care of LGBTQ+ patients in your current practice and will also improve future access to LGBTQ+ care by increasing the number of providers who are informed.
There are many readily available resources you can access today to both improve your own understanding of LGBTQ+ care and inform your educational materials.
Legislative advocacy
Ensuring the future of LGBTQ+ care, particularly when access to care is actively under legal attack, also means participating in legislative advocacy. Spend time learning about legal changes happening nationally and locally. This will not only help you learn more about how you can help but will also help you better understand the stressors and barriers patients are experiencing.
Reach out to local nonprofits and advocacy groups who are conducting LGBTQ+ legislative work and offer to help. These organizations are often working on bills that will improve access to care and organizing to counteract proposed bill that will limit access to care. Therefore, having an informed clinician on their team to help testify, either in-person or via written testimony, can make a profound difference.
As LGBTQ+ people face mounting threats to health, dignity, and access to care, inaction is action. As healthcare professionals, we must work toward creating more supportive practices for LGBTQ+ patients to combat so much of the harm that has already been done. The good news: it can be done, and you can be part of the change that makes it happen.
Here are some resources we’ve found helpful:
Mental health resources:
1. Trevor Project: Suicide Prevention for LGBTQ+ Young People
3. Therapy for the Trans Community: Therapy Den
3. GALAP: Gender Affirmative Letter Access Project
Support for LGBTQ+ people and their families:
1. PFLAG
3. Patchwork: Transgender Peer Support
Legal resources:
1. Advocates for Trans Equality (A4TE), including the National Center for Transgender Equality (NCTE) and Transgender Legal Defense and Education Fund (TLDEF) https://transequality.org/
4. Lambda Legal
Healthcare access:
2. Human Rights Campaign, Resources for LGBTQ+ Patients
3. GLMA Resources for LGBTQ+ Health Equity
Educational resources for LGBTQ+ care:
1. National LGBTQIA+ Health Education Center: a Program of the Fenway Institute
2. “Ten Strategies for Creating Inclusive Health Care Environments for LGBTQIA+ People”
2. The National LGBT Cancer Network, LGBT cultural competence curriculum
3. “Vanessa Goes to the Doctor”
5. “Transforming Healthcare: A Guide to Best Practices in LGBTQIA+ Cultural Competency Training”
6. LGBTQIA+ Health Education Center: LGBTQIA+ Care Organizational Change Videos
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.