If you’re making a visit to an urgent care center, you’re likely not feeling too great. But for those who are LGBTQ+, if a medical provider doesn’t offer culturally competent or gender affirming care, a trip to urgent care can be especially uncomfortable.
Advocates out there are pushing for urgent care centers to up their game when it comes to working with the LGBTQ+ population. Still, they have a long way to go to guarantee effective, culturally competent care at the 10,000 or so urgent care centers in the United States.
Health hurdles
The LGBTQ+ population is already at higher risk of mental and physical health issues, due to societal and cultural stressors. As more and more Americans identify as LGBTQ+, a record 5.6% in 2021, it’s vital that the medical world adapts and learns how to provide adequate, culturally competent care.
Unfortunately, it’s still quite difficult for LGBTQ+ folks to find medical providers that offer this. And fears of discrimination can wreak havoc on the decision to seek treatment in the first place. In many instances, these fears are not misplaced: An estimated 7 in 10 LGBTQ+ patients have experienced negative care.
The surprising role of urgent care
Because of these barriers to traditional care, many in the LGBTQ+ population turn to urgent care centers as their primary source of medical treatment.
“Urgent care center clinicians serve vulnerable populations on a daily basis,” says Kim Youngblood, chief governmental affairs officer at the Urgent Care Association. Though these clinics can be used for acute illness or injury, they’re also a relatively low-friction choice for those who may not have traditional insurance or a regular doctor, due to cost and convenience.
Of course, urgent care centers present their own sources of friction. In these settings, for instance, it’s highly unlikely that patients will be seeing staff or practitioners they’ve seen before. This may mean needing to “come out” all over again, or fielding questions that seem repetitive or invasive. Urgent care clinics also operate on a walk-in capacity, which often means that a patient needs to explain who they are and what they need in front of a waiting room of strangers.
Whether or not these challenges are handled sensitively depends on the specific urgent care center and who happens to be working that day.
While we have no clear data about what type of culturally competent care exists across urgent care centers in the US, we know one thing is true: it’s inconsistent. There are advocates in the industry working hard to eradicate those inconsistencies.
A path forward
Groups like the UCA, as well as individual urgent care centers or networks, are working to raise the bar when it comes to LGBTQ+ care. They provide free resources (like the LGBTQ health toolkit from the American Academy of Family Physicians) and offer continuing medical education courses.
“It’s hard to speak to the situation of every urgent care center, but many of them are part of large networks,” says James Cobb, a registered nurse and former emergency department director in Texas. “These networks, by and large, mandate cultural training for demographically significant groups in their service area.” Cobb points out that LGBTQ+ patients exist throughout the country, making this type of training fairly common.
In terms of specific goals, most advocacy groups focus on encouraging centers to implement several important concepts into their work with patients.
- Inclusive terminology. The language we use has immense power to make LGBTQ+ folks feel either welcomed or alienated. Advocates push for both administrative staff and clinicians to be trained on the most current inclusive terminology. This also means inclusive wording on forms, like leaving a blank line for gender.
- Conscious front desk protocol. The front desk is the very first minefield at an urgent care center, and can set the tone for a patient’s experience. Untrained front desk staff might be thrown off by discrepancies between presented gender and what’s on the patient’s ID, or between chosen name and legal name. The Journal of Urgent Care Medicine advises staff ask, “What would you like to be called?” at the outset to avoid the potentially traumatic misstep of “deadnaming” someone. (Deadnaming someone means to use the name they had before undergoing a transition.) Staff should also be trained to have these conversations discreetly.
- Familiarity with methods of gender-affirming care and other LGBTQ-specific health concerns. This includes becoming knowledgeable about common gender-affirming care methods (for instance, hormones or surgery) and associated complications, as well as the increased risk of certain health concerns for LGBTQ+ populations.
- Robust referral networks. Many urgent care visits require follow-ups with specialists, so it’s important for these centers to build relationships with culturally competent practitioners. That means not only LGBTQ+-friendly practitioners, but also clinics that specialize in relevant areas, like hormone management and gender-affirming care.
In an ideal world, culturally competent care would be the norm in all healthcare settings. But as long as urgent care centers remain a primary source of care for LGBTQ+ populations, it makes sense for them to be the front line of the effort.