Overview

This independent guide from DTAPclinic covers clinic services and patient education for readers in Malaysia. Below we explain making sexual health inclusive for the lgbt+ community — malaysia patient guide in accessible language. Content is for education only and is not medical advice, diagnosis, or a substitute for care from a registered provider.

In the advent of Pride this June, we look at the unique sexual health challenges faced by the LGBTQ+ community and the steps we can take to alleviate it. After all, sexual health is for everyone, regardless of what your gender preference or biological sex is.

What are the unique challenges LGBTQ+ individuals face on sexual health?

Sexual health hasn’t always been easy to discuss – but the challenge is even tougher for LGBTQ+ individuals. In Malaysia, misconceptions and prejudices have manifested into troubling issues for the LGBTQ+ community seeking sexual health, such as:

Delayed consultation and treatment due to stigma and discrimination

The stigma against LGBTQ+ patients can discourage them from seeking medical advice and treatment. The fear of judgment, mistreatment, or the breach of confidentiality can be daunting and dishearten them from consulting a doctor regarding their sexual health concerns. At times, they might even be hesitant to disclose their sexual and gender identity, which can lead to doctors missing crucial information for appropriate care. In addition, stigma and phobia against STDs can dissuade patients from seeking medical assistance. According to the Infectious Disease Act, all new diagnoses of HIV need to be notified. For many non-citizen LGBTQ+ individuals, this instills a rational fear of having their student pass or work permit canceled because of a positive HIV test. This can thus cause delays in testing and lead to end-stage HIV without proper treatment for these patients. For older LGBTQ+ individuals, they may even already see themselves as outcasts and have accepted the fact that they are not going to receive help. This can lead to them stopping care for their chronic medical conditions entirely.

Lack of training and awareness for healthcare providers

As Malaysia is a heteronormative society, health issues for LGBTQ+ individuals are not included during medical school as part of the syllabus. There is a dearth of training in managing healthcare needs for these patients. As a result, not all healthcare providers have the expertise in managing the specific healthcare needs for LGBTQ+ patients, and this can cause inappropriate or inadequate care and advice. Healthcare providers with stigma against LGBTQ+ patients can also lead to biased assumptions and misdiagnoses for patients.

Lack of access to inclusive healthcare

In Malaysia, there is a disparity in access to healthcare for LGBTQ+ patients. Not all doctors or healthcare providers are deemed LGBTQ+ friendly—there might only be a few physicians trusted by LGBTQ+ patients to deal with their specific healthcare needs. A lot of healthcare providers also do not affirm LGBTQ+ support publicly for fear of persecution. Due to societal norms, lack of advertisement, and laws regulating medical advertisement, access to these doctors are mostly limited and passed on through word of mouth. In addition to that, socio-economic and lingual differences may limit patients in accessing healthcare providers sensitive to their needs.

How can healthcare providers ensure that their services are inclusive and welcoming for LGBTQ+ individuals?

There are many ways healthcare providers can be more inclusive and welcoming of members of the LGBTQ+ community. Here are some examples:

Use inclusive language

Communication can make or break the doctor-patient relationship, even more so for LGBTQ+ patients. Inclusive language that can acknowledge and respect diverse sexual orientations and gender identities should be encouraged. This includes using the preferred gender pronouns and/or names, and respecting how patients prefer to be addressed.

Avoid assumptions

Healthcare providers should avoid making assumptions about a patient's gender and sexual orientation. Open-ended questions should be utilized to allow patients to share their health issues and concerns.

Ensure competency

Healthcare providers who are looking to work with LGBTQ+ patients should look to understand and address their specific health concerns and needs. Issues such as sexual health, mental health, hormonal therapy, gender affirming care and preventive treatment may be relevant to the LGBTQ+ patients.

Establish networks

It can sometimes be difficult for healthcare providers to manage the diverse healthcare needs of their LGBTQ+ patients. That said, there are many other specialists and organizations out there that care for and support the LGBTQ+ community. For example, Oogachaga is a community-based, non profit organization that works with LGBTQ+ individuals. By establishing the network of support, LGBTQ+ patients can be assured that even if the healthcare provider is unable to address their concerns, they can be referred to someone else that does.

What steps can healthcare providers take to improve cultural competency and sensitivity when providing sexual health services to LGBT individuals?

Nowadays, healthcare providers can actively work toward creating a more open, welcoming environment for the LGBTQ+ community. Some of the ways they can do so include:

Education and training on LGBTQ+

Providers should seek education and training on LGBTQ+ cultural competency, which includes understanding the unique health needs, experiences, and disparities faced by LGBTQ+ individuals. This can involve attending workshops, conferences, or online courses that focus on LGBTQ+ inclusivity