Overview

Overview

We provide world-class healthcare through a multidisciplinary, team-based approach for LGBT patients in partnership with our clinical Institutes. Our providers are committed to creating a safe environment that maintains the respect and dignity of all patients.

Mission

We provide comprehensive and compassionate care for all patients regardless of sexual orientation or gender identity. Lesbian, gay, bisexual, and transgender (LGBT) patients have historically been an underserved community with unique health needs. We aim to eradicate long-standing health disparities while furthering the care, research, educational, and service goals of the Cleveland Clinic enterprise.

Healthcare Equality Index

For the second year, Cleveland Clinic and its regional hospitals, as well as Cleveland Clinic Florida have earned the coveted recognition as a 2016 Leader in LGBT Healthcare Equality.

The honor is based on the Human Rights Campaign's Healthcare Equality Index. This national benchmarking tool evaluates healthcare facilities for equity and inclusion of LGBT patients, visitors and employees.

Healthcare facilities must meet the “Core Four” criteria for LGBT patient-centered care:

  • Patient non-discrimination
  • Equal visitation
  • Employment practices
  • Training in LGBT-centered care

The Human Rights Campaign evaluated more than 2,000 hospital systems for this year’s list. Less than 500 healthcare providers joined Cleveland Clinic facilities in receiving leader status.

Center for LGBT Care

Cleveland Clinic’s Center for Lesbian, Gay, Bisexual and Transgender (LGBT) Care offers healthcare services at the Chagrin Falls Family Health Center and Lakewood Family Health Center. Embedded in a primary care practice, the center provides care for all patients in a safe and welcoming environment. It includes providers who understand the health needs of LGBT patients, and access to specialists with expertise in LGBT care.

Health Care Disparities

Health Care Disparities

National research has shown that lesbian, gay, bisexual, and transgender (LGBT) patients are at increased risk for substandard, insensitive, or even abusive care due to stigmatization. This has led to a number of inequalities in the delivery and quality of healthcare to members of this group, which include:

  • Patients are more likely to delay needed regular medical care.
  • LGBT individuals are more likely to be dependent on alcohol, tobacco, or drugs.
  • Gay men and transgender patients are at higher risk of sexually transmitted infections, including HIV.
  • Lesbian women are more likely to be overweight and are less likely to have regular cancer screenings.
  • Youth are more likely to experience significant mental health problems, have a higher risk of suicide, engage in risky behaviors, and become the victims of violence.
  • Elderly LGBT patients are at risk for poor social support due to stigmatization.

We strive to decrease healthcare disparities through education, training, and the delivery of world-class health care to LGBT patients.

For Patients

For Patients

Gay and Bisexual Men Health

Gay men and men who have sex with men (MSM) have many similar health challenges when compared with their heterosexual counterparts, but they also face additional obstacles to health which are often not well understood by health care providers. Fear of rejection or embarrassment often contributes to a delay in accessing needed preventive or disease management services by these men. Limited information about culturally competent providers does not allow for patients in a community to be matched with practitioners possessing necessary training and experience to best address their unique health care needs. Furthermore, gay men and MSM may feel as though their confidentiality will not be protected among health care staff or with insurance providers, or that they may face a hostile response from front desk, nursing or ancillary staff when addressing deeply personal matters. These fears and resulting actions, when examined at a population level, lead to health care disparities.

Health care disparities for gay men and MSM include:

  • An increased risk for mental health concerns including depression, anxiety disorders, and suicidal thoughts and actions. Stigmatization by society has been identified as an important factor in the development of these conditions. A lack of effective wellness models for the gay and MSM community is also a contributor.
  • A higher frequency of sexually transmitted and other infectious diseases is seen in gay men, including the human immunodeficiency virus (HIV). This is especially true in younger men and in men who are also members of a racial or ethnic minority community.
  • Gay men and MSM are more likely to smoke and to abuse or become dependent on alcohol and drugs.
  • Young gay men and MSM are more likely to be the victims of violence, to be homeless, and to engage in risky behaviors in general.
  • Gay men and MSM are at an increased risk for certain types of cancers (both HIV and non-HIV related).
  • Elderly gay men and MSM have additional struggles maintaining health due to isolation and the absence of appropriate social support and health care providers sensitive to their needs.

Services

To help address these disparities, Cleveland Clinic offers the following services to gay men and MSM:

  • Primary Care. General preventive health, screening for disease including cancer and infectious disease, immunizations, and counseling related to healthy behaviors. While all health care providers have a basic knowledge to care for many types of patients, the Cleveland Clinic has identified a group of providers who have a specialty interest in the care of lesbian, gay, bisexual and transgender (LGBT) patients.
  • Behavioral Health. Behavioral health services offer providers with special interest in LGBT psychological health needs.
  • Specialty Care. Cleveland Clinic has worked to identify providers within the majority of sub-specialty disciplines who have an interest in the care of LGBT patients.

Lesbian and Bisexual Women Health

Lesbian women and women who have sex with women (WSW) require routine health care maintenance like all patients, but they are also at increased risk for certain medical and mental health conditions. Unfortunately, access to good health care can sometimes be a challenge for this community. Improved access starts with a better understanding by both providers and patients about the type of care that is needed.

We recommend that in addition to routine medical care, WSW and lesbian patients also undergo screening for the conditions listed below.

  • WSW have specific risk factors that may put them at increased risk of developing cancer of the reproductive organs and yearly pelvic examination should be performed for all women.
  • WSW have specific risk factors that may put them at risk for breast cancer, and these women should undergo routine screening with mammography, and should also be taught how to perform breast self-examination.
  • WSW are at no less risk for cervical cancer than heterosexual women, and all lesbians and WSW should undergo cervical cancer screening.
  • All women should undergo routine screening for colon cancer, and guidelines should be followed according to the woman's age, and personal or family history of colon cancer.
  • Population studies have shown that the rate of substance abuse is higher in the lesbian community than in the general population, and patients should routinely be screened for alcohol and illicit substance abuse. As such, patients should also be offered counseling and education regarding substance abuse and risk-taking behaviors.
  • Population studies also show that WSW have higher rates of tobacco use than the general population, and patients should be screened for this and provided with counseling and education about smoking cessation.
  • WSW have a slightly higher rate of obesity than the general population. Compounded with their higher rate of tobacco use, routine screening for heart disease is necessary. In addition, patients should be offered weight loss counseling and provided with information about healthy lifestyle behaviors and choices.
  • Depression, anxiety, and post-traumatic stress disorder (PTSD) occur at higher rates among WSW, often as a result of poor social supports, and these conditions should be screened for regularly, and addressed by medical providers.
  • Individuals who engage in risk-taking behaviors such as substance abuse and unprotected sex are at risk for sexually transmitted infections, including HIV. Patients who present with these risk factors should be screened for these infections.
  • Studies show that many WSW also engage in sexual activity with men, and therefore, family planning services such as pregnancy-related care and contraceptive counseling are important aspects of routine health care for this community.

Services

Below are the services we currently provide for our lesbian and women who have sex with women (WSW) patients. We offer comprehensive care through a multi-disciplinary team of providers that are housed amongst our many institutes at Cleveland Clinic.

  • Primary Care. Routine health care maintenance, surveillance of chronic medical conditions, access to providers for acute medical visits, smoking cessation, management of and referral for psychiatric conditions such as mood disorders and substance abuse problems.
  • Gynecologic Care. Routine gynecologic care including cancer screening, pelvic examinations, management of chronic or acute gynecologic conditions, contraceptive counseling and management, fertility consultation and treatment, evaluation and treatment of sexual pain.
  • Endocrinology and Metabolism Care. Specialty help for metabolic disease and obesity through consultation with nutritionists, endocrinologists, and bariatric surgery.
  • Specialty Care. Cleveland Clinic has worked to identify providers within the majority of subspecialty disciplines who have an interest in the care of LGBT patients.
  • Behavioral Health. Cleveland Clinic's behavioral health services offer providers with special interest in LGBT psychological health needs.

Transgender Health

Transgender individuals require routine health care maintenance like all patients, but they are also at increased risk for certain medical and mental health conditions. Unfortunately, access to good health care can sometimes be a challenge for this community. Improved access starts with a better understanding by both providers and patients about the type of care that is needed.

We recommend that in addition to routine medical care, transgender patients also undergo screening for the conditions listed below:

  • Metabolic conditions such as hypertension (high blood pressure), glucose intolerance (diabetes), liver dysfunction, and dyslipidemia (high cholesterol) can develop as a result of long-term hormonal (both estrogen and testosterone) therapy.
  • Transgender men and women have a slightly higher rate of obesity. Compounded with their long-term hormone use and higher rate of tobacco use, routine screening for heart disease is necessary.
  • Transgender women (male-to-female) should have cancer screening for cancers of the breast, prostate, and anus.
  • Screening for cancer of the reproductive organs should be done for all symptomatic transgender men. Transgender men (female-to-male) should also need cancer screening for cancers of the breast, cervix, and anus, depending upon anatomy and stage of transition.
  • Population studies have shown that the rate of substance abuse is higher in the transgender community than in the general population, and patients should routinely be screened for alcohol and illicit substance abuse. As such, patients should also be offered counseling and education regarding substance abuse and risk-taking behaviors.
  • Population studies also show that transgender men and women have higher rates of tobacco use than the general population, and patients should be screened for this and provided with counseling and education about smoking cessation.
  • Depression, anxiety, and post-traumatic stress disorder (PTSD) occur at higher rates among transgender individuals, often as a result of poor social supports, and these conditions should be screened for regularly, and addressed by medical providers.
  • Individuals who engage in risk-taking behaviors such as substance abuse and unprotected sex are at risk for sexually transmitted infections, including HIV. Patients who present with these risk factors should be screened for these infections.

Services

Below are the services we currently provide for our transgender patients. We offer comprehensive care through a multi-disciplinary team of providers that are housed amongst our many institutes at Cleveland Clinic.

  • Primary Care. Routine health care maintenance, surveillance of chronic medical conditions, access to providers for acute medical visits, smoking cessation.
  • Gynecologic Care. Routine gynecologic care including cancer screening, pelvic examinations, management of chronic or acute gynecologic conditions, contraceptive counseling and management, fertility consultation and treatment, evaluation and treatment of sexual pain.
  • Hormone Therapy & Surveillance.Initiation, maintenance, and surveillance of cross-sex hormones.
  • Behavioral Health. Diagnosis of gender dysphoria, treatment and management of other comorbid conditions (depression, anxiety, PTSD), management of substance abuse problems.
  • Obesity Services.Multidisciplinary approaches to weight loss and maintenance, referral to bariatric surgery.
  • Surgical Services.Referral within Cleveland Clinic to providers who perform gender confirmation procedures.

LGBT or "Questioning" Youth Health

Sexuality and sexual orientation are often challenging topics for youth and their parents. They are subjects that can be difficult to openly talk about and sometimes are actively avoided. Yet we know that children and teens who are (or are questioning whether they may be) gay, lesbian, bisexual or transgender are at much greater risk of:

  • Engaging in unhealthy behaviors and/or of being bullied or victimized
  • Experiencing anxiety, depression, and other emotional symptoms at a much higher rate than their peers
  • Engaging in self-harm (including suicide) at a higher incidence

For these and many other reasons, physical and psychological health care are essential for these individuals and their families. Like their adult counterparts, however, LGBT youth may be hesitant to seek care due to fear of stigmatization or lack of understanding by healthcare providers.

Similarly, issues related to gender and gender identity are frequently sensitive subjects and parents as well as youth may be fearful of the response if such topics are raised to healthcare providers. Gender identity develops differently in every child and gender differences can present at almost any age, sometimes in early childhood, sometimes much later. “Gender non-conforming” and “transgender” (the “T” in LGBT) are terms used to describe individuals whose gender expression or gender identity do not conform to that typically associated with the gender they were assigned at birth. Being gender non-conforming is not a disorder, but many youth who demonstrate a consistent and persistent pattern over time that they wish to be (or “are”) the opposite gender experience very significant distress living with the body that they have.

Services

Cleveland Clinic Children’s provides a full array of healthcare services for LGBT youth and their families. All care is individualized, designed to meet the needs of each unique situation while at the same time complying with the standards and best practices for this population.

Services available include:

  • Pediatric providers with understanding of and sensitivity to the issues of LGBT youth
  • Psychological services offered by LGBT affirmative behavioral health providers (including specialized assessment related to referral for hormone consultation/treatment or other transgender services)
  • Affirmative support and education for youth and families regarding LGBT issues and challenges

Specialized healthcare services can be an essential part of improving the overall health and well-being for transgender youth. These include affirmative and understanding support and education for youth and families as well as assistance in the process of transitioning to the preferred gender. Cleveland Clinic Children’s GUIDE program (Gender Understanding, Identity, and Expression) includes a multidisciplinary team of healthcare providers with expertise in helping transgender youth and their families as they consider the range of options available to them. GUIDE provides education, support, psychological services, pediatric endocrinology services (for possible hormone suppression and/or hormone treatments), psychiatric consultation, and gynecology and urology services.

Staff

Staff

Contact

Contact

While all Cleveland Clinic providers are committed to creating a safe environment that maintains the respect and dignity of all patients, some providers have specific interests in working with the LGBT community.

The following doctors below all have listed “Lesbian, Gay, Bisexual, and Transgender (LGBT) Health” on their profiles.

  • You can also access our Find A Doctor tool at anytime to find these same medical professionals by searching for LGBT health and other related terms.