Podcast on the Challenges and Recommendations to Address Unmet Needs in MS for LGBTQ+ Populations in the United States

William L Conte; Mark Cascione; Amy B Sullivan

doi:10.1007/s40120-023-00506-4

Podcast on the Challenges and Recommendations to Address Unmet Needs in MS for LGBTQ+ Populations in the United States

Neurol Ther. 2023 Oct;12(5):1399-1407. doi: 10.1007/s40120-023-00506-4. Epub 2023 Jun 23.

Authors

William L Conte¹, Mark Cascione², Amy B Sullivan³

Affiliations

¹ Comprehensive MS Center, Neuroscience Institute, Methodist Hospitals, 200 E 89Th Avenue, Merrillville, IN, 46410, USA. billy.conte@gmail.com.
² First Choice Neurology/South Tampa Multiple Sclerosis Center, 2919 Swann Avenue, Suite 401, Tampa, FL, 33609, USA.
³ Mellen Center for MS Treatment and Research, Cleveland Clinic, 9500 Euclid Avenue/U10, Cleveland, OH, 44195, USA.

Abstract

In general, individuals who are lesbian, gay, bisexual, transgender, queer or questioning, plus other identities (LGBTQ+) living with multiple sclerosis (MS) have less favorable healthcare experiences and poorer overall health than cisgendered heterosexual individuals. They may experience further challenges in addition to managing their MS, including psychological or emotional problems, and an increased risk of comorbid diseases and substance abuse. Transgender individuals specifically face additional unique challenges, including high rates of mental health distress and effects from long-term exogenous hormone use and gender affirmation surgery. These findings highlight disparities in both quality of care and health outcomes of LGBTQ+ individuals. Unmet needs and drivers of these disparities relate to a lack of inclusivity in healthcare environments, poor communication between healthcare professionals (HCPs) and LGBTQ+ patients, inadequate HCP knowledge of LGBTQ+ health issues, and gaps in research into the impact of sexual orientation and gender identity in MS. Although data are limited, recommendations to improve the experience and care of LGBTQ+ individuals with MS include increasing HCP awareness of the challenges LGBTQ+ individuals face and provision of inclusive care, with the overarching goal for HCPs to be allies to the LGBTQ+ community. Improvements may be achieved through diversity and cultural awareness training of HCPs on sexual orientation and gender identity, and ensuring a friendly, open, and supportive healthcare environment. Use of sensitive and gender-neutral language by HCPs, representation of LGBTQ+ individuals in patient materials, and access to LGBTQ+ MS support groups are also recommended. HCPs should aim to integrate discussion of sexual orientation and gender identity and sexual and mental health into routine assessments and collaborate with other HCPs as needed. By addressing the challenges and unmet needs of LGBTQ+ individuals with MS, this should help resolve disparities in their quality of care and improve their overall health.

Keywords: Access to care; LGBTQ+; Multiple sclerosis; Patient–provider communication.