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Diversity and Inclusion

A work-in-progress resource for faculty, students, and administrators on creating more inclusive and diverse classrooms.

I Was A Spectacle…A Freak Show At The Circus”: A Transgender Person’s ED Experience And Implications For Nursing Practice

Full Text for Upstate Users

Cicero, Ethan Collin, and Beth Perry Black. 2015. "“I Was A Spectacle…A Freak Show At The Circus”: A Transgender Person’s ED Experience And Implications For Nursing Practice". Journal Of Emergency Nursing. doi:10.1016/j.jen.2015.08.012.

Excerpt: For most people, the decision to visit an emergency department is straightforward. Some persons consider their health care insurance coverage or their ability to afford the visit. Others wonder if their chief complaint is truly an emergency or if the problem can wait until their primary care providers office opens. Few worry about clinician competence or are concerned that they may be denied care; however, transgender persons contemplating an ED visit sometimes face these issues. The scarcity of clinical providers adequately prepared to care for transgender persons is a major barrier to seeking care. In addition, some transgender people encounter denial of services, discrimination, harassment, and even violence in health care settings. The accumulation of barriers causes some transgender people to avoid seeking even routine and preventive care.

The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding.

This 2011 report from the Institute of Medicine is available in full text via the URL below. 

Institute of Medicine (US) Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities. The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. Washington (DC): National Academies Press (US); 2011. Available from:

Abstract: At a time when lesbian, gay, bisexual, and transgender individuals—often referred to under the umbrella acronym LGBT—are becoming more visible in society and more socially acknowledged, clinicians and researchers are faced with incomplete information about their health status. While LGBT populations often are combined as a single entity for research and advocacy purposes, each is a distinct population group with its own specific health needs. Furthermore, the experiences of LGBT individuals are not uniform and are shaped by factors of race, ethnicity, socioeconomic status, geographical location, and age, any of which can have an effect on health-related concerns and needs. Researchers still have a great deal to learn and face a number of challenges in understanding the health needs of LGBT populations.

To help assess the state of the science, the National Institutes of Health (NIH) asked the IOM to evaluate current knowledge of the health status of lesbian, gay, bisexual, and transgender populations; to identify research gaps and opportunities; and to outline a research agenda to help NIH focus its research in this area. The IOM finds that to advance understanding of the health needs of all LGBT individuals, researchers need more data about the demographics of these populations, improved methods for collecting and analyzing data, and an increased participation of sexual and gender minorities in research. Building a more solid evidence base for LGBT health concerns will not only benefit LGBT individuals, but also add to the repository of health information we have that pertains to all people.

Racial And Ethnic Differences In Experiences Of Discrimination In Accessing Health Services Among Transgender People In The United States

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Kattari, Shanna K., N. Eugene Walls, Darren L. Whitfield, and Lisa Langenderfer-Magruder. 2015. "Racial And Ethnic Differences In Experiences Of Discrimination In Accessing Health Services Among Transgender People In The United States". International Journal Of Transgenderism 16 (2): 68-79. doi:10.1080/15532739.2015.1064336.

Abstract: Transgender/gender-nonconforming (GNC) individuals experience discrimination at high rates, including 19% in one study who reported having been refused medical care based on the their transgender/GNC identity. These individuals may also experience a lack of respect from medical personnel, a dearth of culturally competent knowledge and medical information around their medical needs, and concerns with safety when accessing medical care. Additionally, people of color experience higher levels of discrimination in health care than their White counterparts. This study examines the prevalence of discrimination faced by transgender/GNC people and compares by race/ethnicity those rates of discrimination when accessing medical services such as emergency rooms, doctors/hospitals, and ambulances/emergency medical technicians (EMTs).

Expectations of Gender in Medical Education

Full Text

McMullen, K., Janko, M., & Wittbold, K. (2012). Expectations of Gender in Medical Education. Virtual Mentor, 14(12), 989-992. 

Excerpt: In their recent paper, Isaac et al. [1] illuminated an intrinsic difference in the words used to evaluate the performance and behavior of male and female medical students. The investigators used a software program to categorize and analyze the text of deans’ letters (MSPEs) for 2009 applicants to the Diagnostic Radiology Residency Program at Dartmouth-Hitchcock Medical Center. The results suggest an underlying and pervasive cultural expectation of the roles and behaviors of men and women in medical school. In their words, men were more likely to be described as “responsible excellers and eager beavers,” while women were “enthusiastic worker bees with research experience” [2]. Medical students will not be shocked by these results. We live in a world of constant evaluation and rapid turnover, where busy residents have little time to get to know us, and where evaluations often consist of stock phrases and broad comparisons.

Minimizing Health Disparities Among LGBT Patients

Full Text for Upstate Users 

Rubin, R. (2015). Minimizing Health Disparities Among LGBT Patients. JAMA, 313(1), 15.

Excerpt: At its annual meeting in November, the Association of American Medical Colleges (AAMC) released comprehensive guidelines: “Implementing Curricular and Institutional Climate Changes to Improve Health Care for Individuals Who Are LGBT, Gender Nonconforming, or Born With DSD” ( (“DSD” refers to differences of sex development, such as Klinefelter syndrome or Turner syndrome.) As chair of the AAMC’s Advisory Committee on Sexual Orientation, Gender Identity, and Sex Development, Eckstrand, who has a PhD in neuroscience and will graduate with her MD this spring, served as the lead editor of the guidelines. The report, which identifies 30 competencies physicians should master, lists a number of health disparities between LGBT individuals and those who are not LGBT, with supporting references from the scientific literature 

From the Perspectives of Black LGBTs in the US

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Turner, Carlene Buchanan, Antonio (Jay) Pastrana, and Juan Battle. 2014. "From The Perspectives Of Black Lgbts In The US: Medical Providers’ Comfort With Patients’ Sexuality". Journal Of Black Sexuality And Relationships 1 (1): 45-64. doi:10.1353/bsr.2014.0010.

Abstract: For lesbian, gay, bisexual, and transgender (lgbt) people, being comfortable with medical professionals is important. A nation- wide sample of 1,374 Black lgbt people is used to examine the importance of identity, health, and demographics on the belief/perception that medical providers are comfortable with sexual identity issues. Logistic regression models reveal that respondents who were “out,” had family support, had regular healthcare provider, received their medical information primarily from their healthcare provider, had “happier” dispositions, and were male have more positive belief perceptions; that is, they are more likely to perceive that their medical professional seemed comfortable with their sexual identity.