How UPMC Children’s Promotes Healthcare Equality for LGBTQIA+ Youth

Kids and their loved ones come to UPMC Children’s Hospital of Pittsburgh in their most vulnerable moments. They need to know they won’t face intolerance due to their sexual orientation or gender identity.

UPMC Children’s staff members need to know the same: That their employer cares about their rights and freedoms.

UPMC Children’s has been a Healthcare Equality Index Leader for seven years. We lead the way in caring for kids, their loved ones, and staff members who identify as LGBTQIA+. LGBTQIA+ stands for Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, Intersex, Asexual/Aromantic/Agender, and more.

This means UPMC Children’s has unique programs to care for transgender and gender-diverse kids. But that’s not all.

“Children’s has done a lot of work to improve care for LGBTQ+ people and to improve the experiences of LGBTQIA+ staff members over the past several years,” says Joy Gero, PsyD. She manages the UPMC LGTBQIA+ Health Quality program.

False and distorted facts around LGBTQIA+ communities are at an all-time high. People who identify as LGBTQIA+ often fear for their safety. That’s why this work is so relevant.

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UPMC Children’s Recognized as HEI Leader

The Healthcare Equality Index (HEI) is a ranking by the Human Rights Campaign. This is America’s largest civil rights group set on achieving LGBTQIA+ equality.

Hospitals use the HEI to gauge how inclusive they are to people who identify as LGBTQIA+. This applies whether they’re getting care, are our employees, or just visiting.

UPMC Children’s work to achieve HEI Leader status began in 2014, Dr. Gero says. The goal was to ensure that people who identify as LGBTQIA+ get the same high-quality care across the hospital.

For example, kids and their loved ones report feeling affirmed when they visit clinics like the Gender and Sexual Development Program. “We used the information from our earlier surveys to improve the patient experience at Children’s at every clinic LGBTQIA+ kids and their loved ones visit,” she says. They also wanted to know about the thoughts of LGBTQIA+ staff. Did they feel supported? What could be better?”We used the results of the initial survey as a gap analysis,” Dr. Gero says. The Hospital knew some areas it needed to improve. And by 2016, they achieved Leader status.

When trying to get the HEI designation, hospitals get scored in these areas:

  • Non-discrimination and staff training.
  • Patient services and support.
  • Employee benefits and policies.
  • Patient and community engagement.

UPMC Children’s has worked on adding to or updating these areas.

While they had gender-affirming care, they wanted more staff training. The entire Executive Leadership Team was required to take non-discrimination training.

Another task was finding and updating outdated language, Dr. Gero says.

It’s become standard to include gender identity when writing less biased policies. But seven years ago, it was just worded as “gender.” They’ve worked on adding gender identity and making sure that “sexual orientation” replaces any mentions of “sexual preference.”

They also updated the health record to be able to start taking a person’s chosen name and pronouns.

Even visuals matter. For example, the Hospital’s fish tanks have clownfish. Clownfish can change sex when needed.

“We put posters on the fish tanks that talk about how the fish can change from a boy to a girl and a girl to a boy,” she says. It’s one more reference for a child questioning gender — to see that it happens in nature.

“It’s important to passively communicate through art and visuals in a kid’s hospital, so that all different types of people feel affirmed,” Dr. Gero says. “We want people to walk into our hospital and say, this feels like home to me.”

Being a Leader in LGBTQIA+ Issues for Staff

We treat people who identify as LGBTQIA+ and their loved ones with dignity. But that only takes you halfway to HEI Leader status. It’s also about making sure staff members who identify as LGBTQIA+ feel welcomed and supported.

To that end, UPMC has an employee resource group called PRIDE Health. The group supports those at the hospital who identify as LGBTQIA+ with advocacy and education.

That UPMC Children’s is making the workplace LGBTQIA+ friendly matters greatly. “As someone who is part of the queer community, I didn’t want to work for a place that wasn’t caring for members of my community,” Dr. Gero says.

There’s also the matter of employee benefits.

UPMC is both a health care provider and a health care insurer. “As soon as UPMC added gender care benefits to the health plan, those benefits were available to employees,” Dr. Gero says.

Our health plan covers all gender care options, which is unusual. “We are in a class of 1% of insurance companies in terms of what we pay for.”

They also reviewed domestic partner benefits. When marriage equality expanded to all 50 states, many companies stopped paying domestic partner benefits. “But UPMC decided that preserving these partner benefits was important because not all queer people want to get married,” Dr. Gero says.

As inclusive policies usually do, these changes will make things better for everyone. “You don’t have to be gay to have a domestic partner,” she says. Not all straight people want to get married, either.

Changing Health Outcomes Through Support

One main change exists between positive and adverse health results for transgender and gender-diverse people. It’s having supportive people and places.

That can and should start with the kid’s pediatrician and the nurses. And ultimately, the setting should be one where parents can also get the support they need.

“Parents come to us at all different stages of being supportive of their kiddos. We are here to help them be more supportive than they were when they first came to us,” she says.

The long-term outlook for LGBTQIA+ kids is also affected by economic, ethnic, and cultural differences. If you are queer and also have a non-dominant religion or are Black, the health disparities increase, she says.

“In the Pittsburgh region, we need to be mindful of how we care for the Black and brown trans and queer community, because white people are more likely to get appropriate care,” Dr. Gero says.

Virtual visits allow people from hours away to access care more easily. But living in rural areas can still make getting care harder. UPMC Children’s is also working to improve their reach to these areas.

Dr. Gero says she is proud to have been part of the effort to get HEI Leader status year after year. “But our goal is to keep improving,” she says. “We still have further to go.”

Find more info on for LGBTQIA+ people getting care and loved ones, or contact us with questions.

About Pediatrics

From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh is a national leader in pediatric care, ranking consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. We provide expert treatment for pediatric diseases, along well-child visits, urgent care, and more. With locations across Pennsylvania, Maryland, and West Virginia, you can find world-class care close to home. We also work closely with UPMC Magee-Womens Hospital, a national leader in care for newborns and their mothers. Our goal is to provide the best care for your children, from birth to adulthood and beyond. Visit our website to find a doctor near you.