Chronic Pain in LGBTQ+ Patients

Patients who identify as LGBTQ+ are more likely to have chronic pain than the general population. Poor healthcare experience and stigma can cause LGBTQ+ people to turn away from care, often leaving important medical issues untreated. One study has shown that nearly 1 in 6 LGBTQ+ people have avoided healthcare due to stigma and discrimination.

As a healthcare provider, you have an important role to make LGBTQ+ patients feel accepted and safe to keep them healthy. Speaking in a non-judgmental way and creating an open communication between your patient and yourself is crucial to their overall health and well-being.

Building Trust

To give LGBTQ+ patients the best care, you must start by building trust. This probably won’t happen in one visit. It will take time to build a relationship. Below are some things to consider in your conversations to help build trust.

View our Effective Conversations section for other ways to communicate well with patients.

Don’t assume gender identity or sexuality

You cannot tell someone’s gender identity or sexuality by looking at them. If it is necessary for their medical care, it can be appropriate to ask. Explain why you need this information. Here are some ways you may consider asking:

“I’m glad you are here, and I want to help keep you healthy. People who use injection drugs can be at a higher risk for some infections, including HIV. Since some of these infections can be sexually transmitted, I’d like to ask some questions about your sexual history. Is this ok with you?”
“We ask everyone about their sexual history to help us determine the best medications for you. Do you mind if I ask some questions?”

Ask patients how they would like to be addressed

This might include pronouns or nicknames. If you are unable to ask about your patient’s pronouns, here are some alternatives:

Keep it general by asking the patient how they would like to be called. They might say their pronouns, or their preferred name
Use neutral pronouns with every patient, such as “they/them”
When talking with other providers, you can refer to them as “the patient” instead of pronouns

Validate their feelings and experiences

When patients are vulnerable and share how they are feeling, or how they have been treated in the past, reflect back what you heard. This may look like:

“I’m sorry you were treated that way”
“You feel left out by the medical community”
“There have been situations where you feel very accepted”

Acknowledge that you won’t always get it right

The important part is that you apologize and ask what you can do to make the situation better. Understand that this learning will be ongoing for you and your team. Example language:

“I see that didn’t sit well with you, will you let me try again?”
“I’m sorry I made you feel that way. I’d like to learn how to respond better.”
“Thank you for correcting me, I understand now.”

Connect to LGBTQ+

Supported Resources

LGBTQ+ people can benefit by being connected with a provider or organization that specializes in LGBTQ+ care. Some of these resources are listed below.

For 24/7, free and confidential support for people in distress, prevention and crisis resources, call the National Suicide Prevention Lifeline at 988.

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