Nurses critical in assuring health needs of LGBTIQ youth

Five American teenagers, all bullied because they were gay, have committed suicide over the past few weeks. The deaths have caused a media storm and raised a critical question: Did the social or healthcare system fail these adolescents? "Absolutely," says Concordia University Professor Deborah Dysart-Gale. "Bullying and such resulting suicides are avoidable. Healthcare workers have tools that can help queer teens – no one needs to die because of their sexual orientation."

As Chair of the General Studies Unit of the Faculty of Engineering and Computer Science, Dysart-Gale's research normally addresses different research areas. But for a special issue of the Journal of Child and Adolescent Psychiatric Nursing, she produced a review article that's a call to action for nurses to leverage their position in society and clinical milieus.

The study argues that nurses can advocate for better healthcare and services for teenagers who are LGBTIQ: lesbian, gay, bisexual, transgendered, intersexed (people who are in the process of gender reassignment surgery) and queer. "My goal in writing this paper was to raise practitioners' awareness, since queer and intersexed teens are in the blind spot of the healthcare system," she says.

Despite progress in social acceptance and civil rights, LGBTIQ adolescents can be reluctant to consult a physician because they may experience misunderstanding, bias or homophobia. "Nurses' attitudes may be critical in determining LGBTIQ adolescents' satisfaction with their healthcare," says Dysart-Gale.

"Nurses are frequently gatekeepers of the clinical encounter, administering the typically heteronormative nursing assessment," she says, adding that gains in LGBTIQ trust could be as simple as asking patients if they are "partnered" rather than inquire if they have a "girl or boy friend" and asking if they are "sexually active."

Dysart-Gale is concerned that many government-funded sex-education programs in the United States teach abstinence until marriage rather than safer and alternative sex practices.

"Such curricula pose particular dangers for LGBTIQ youth, who are implicitly taught that heterosexuality is the only sanctioned sexual behavior and attraction to same-sex peers is illegitimate," she says, stressing that nurses can help reduce transmission of sexually transmitted infections by discussing safe LGBTIQ sex practices.

Nurses should be nonjudgmental, tolerant and supportive of LGBTIQ individuals in both the clinic and the community adds Dysart-Gale. "Nurses can build bridges of trust to patients. In the clinic, nurses can combat homophobia by informing themselves about the needs of LGBTIQ clients, and maintaining open and positive communication. They can advocate for institutional policies that are fair and inclusive."

The five American teens who killed themselves might still be alive had school nurses been able to provide support.

"Over time, nurses became more sensitive to the different needs of ethnic communities and they need to be equally sensitized to the queer community," says Dysart-Gale. "When practitioners are given the proper tools and best practices, they apply them."