This toolkit is premised on the belief that all people, including individuals belonging to SGM communities, deserve equitable access to quality care. While most healthcare clinics attempt to provide equal access, a policy based on the belief that all people should be treated the same regardless of clinical need, equitable access instead recognizes that clinical needs may differ from patient to patient. Accurate assessment of a patient’s clinical need is essential in determining where to direct resources, ensuring that all patients receive optimal care for their specific health concerns.50 To make certain that patients receive equitable access, organizational change—an effective and strategic approach for bringing about shifts in policy or practice in a healthcare setting—may be necessary. In this toolkit, we advocate for three fundamental tenets to improve care for SGM patients:
- Patients can safely seek and receive healthcare services, be treated with dignity and respect, and be confident that their care is tailored to who they are as a person, including their unique needs as an SGM person.
- Several intersecting factors shape diversity in SGM communities, including gender identity and expression, sexual orientation, race and ethnicity, ability, place of geographical residence, socioeconomic status, country of origin, housing situation, and age. All of these factors must be key considerations in patient care.
- The reported history of adversity faced by SGM patients when accessing and receiving services should be acknowledged and addressed using trauma-informed approaches to ensure that all patients feel respected, cared for, and safe when coming to a clinic (Appendix B).
The unique healthcare considerations and experiences of SGM patients inform these principles. However, adherence to these principles is likely to improve access to equitable care for all patients. The tools offered here can facilitate such adherence, helping providers and staff to pursue organizational change in ways that are respectful and mindful of the varying needs of the clinic’s clientele.