Joey Wahler (Host): We're discussing LGBTQ+ care at MIT Health. Our guests from MIT Health, Colleen McDonald, Family Nurse Practitioner for family medicine and primary care and clinical director of student health, and Allie Sherwood, who's a Family Nurse Practitioner.

This is Conversations with MIT Health. Thanks for joining us. I'm Joey Wahler. Hi there, Colleen and Allie. Welcome.

Allison Sherwood, NP: Thank you.

Host: Great to have you both aboard. So first, tell us your preferred pronouns and how long have each of you been with MIT Health? Colleen.

Colleen McDonald, NP: My preferred pronouns are she, her. I welcome they. I have been at MIT for 17 years now.

Host: And Allison.

Allison Sherwood, NP: I'm Allie Sherwood. I use she, her pronouns, and I've been at MIT nearly five years.

Host: And so what are each of your roles as LGBTQ+ allies at MIT Health? And how would you say working there differs from at other places, Colleen?

Colleen McDonald, NP: One aspect of care we provide is connecting with the MIT wider community, be it with the Rainbow Lounge, which is the LGBTQ+, uh, safe space for students or the employee ERG group which is more focused on staff, connecting with them and their efforts and their organizations, doing some education or helping sponsor programs with those organizations

to any LGBTQ+related events. Another aspect of our roles are to literally provide the care to the LGBTQ + community. And while doing that, act as resources to other staff and clinical providers at MIT Health and helping support their care of LGBTQ+ population.

Host: Gotcha. And how about you, Allie?

Allison Sherwood, NP: I'd say similar to Colleen. I think our role is equally as important inside and outside of the exam room. So utilizing the information we gather to advocate for gender affirming care for our patients requires our voice to be outside of the exam room, both in our facility and on campus and even sometimes advocating further than that. I think our role is very important, both for providing individualized care, but then on a population based level as well.

Host: Okay. And so speaking of which, back to you, Colleen, why is it in a nutshell so important that MIT Health offer this LGBTQ+ care for students, employees and their families, retirees, really that entire community. Why is it so important?

Colleen McDonald, NP: It's really important to provide a safe space for people to explore their identities, integrate all of their identities. I think if you look at MIT's mission and MIT Health's mission, it is to help people become and become their best selves so that we can bring our best selves out into the world. And to be able to integrate safely and feel free with all aspects of your identity can only really enhance your development and enhance all that you bring to MIT and the world.

Host: Allie, I alluded to this very briefly at the top of our conversation, but research shows that LGBTQ+ patients typically rate their healthcare experiences as less satisfying than other people. And so what specific challenges do you find from your experience that they face? And how does MIT Health try mitigating those?

Allison Sherwood, NP: Yeah, Joey, it's an excellent question, and it's an unfortunate statistic. I think I like what, you know, starting at a place of what Colleen mentioned as safe. And when I think of patient safety, I think we think of that as how do we provide experiences that are going to allow our patients to feel safe, safe to come to us, safe to feel as though they can share their experiences with us.

And maybe it has been because previous experiences they've had within other healthcare facilities or unfortunately in school settings or in places they grew up or in their families haven't allowed them to feel safe. We wanna make sure that we maximize our potential as a primary care facility to provide safe spaces that are going to be dynamic.

And if that means, looking at optimizing our electronic health record to gather appropriate pronouns, to gather appropriate name changes, to gather appropriate gender markers, we want to do that and we continue to work on that. And some of those aren't easy processes, but we really work to be dynamic and make sure that we can meet those changing needs to create what we believe to be the most important part of a patient safety, which is their acceptance.

Host: And also just to follow up, Allie, I would imagine that since so many of those you serve are students, probably many of those have not had a whole lot of experience getting medical attention, right? And so I would imagine if nothing else, you want one of their early experiences to be a positive one, yes?

Allison Sherwood, NP: Absolutely. I think you're meeting an intersection of a student who really hasn't navigated the healthcare system on their own and so we're helping them build that independence and sometimes that means helping them to gain access to our patient portal, helping them to gain access to understanding when their next appointments are, keeping their visits, showing up, getting to the lab when we're asking them to.

So I think that that's one of the best things that we can do as a primary care facility, which is helping our students through these, this, big transition of time. And I think that we do that particularly well because we, you know, offer this range of ambulatory services and provide good access for our patients and students during, again, this really dynamic transition and change.

Host: And when you mentioned there, Allie, about services, you led me beautifully into my next question. And Colleen, Allie talking there mainly about kind of making things safe and comfortable, providing the right kind of environment for patients. How about some of the specialized services you provide?

Colleen McDonald, NP: The specialized services we provide are for transgender individuals, we do medical therapy, which is gender affirming hormone therapy. And we also, are connected with many of the resources in the community for referrals for different needs around surgery, voice training, hair removal. We're quite connected with the community around those things. For the rest of the LGBTQ+ populations, it's, you know, it's understanding, what screening tests apply to the population and if they apply differently based on their identity as an LGBTQ+ person. And, as Allie said, knowing, you know, what questions to ask and the language to use when you're asking certain questions.

Host: And also, Colleen, just to follow up there, I would imagine that in addition to the specialized services, much of what you provide is just quote unquote routine care, but in a setting that makes this population of the community feel more safe and comfortable, yes?

Colleen McDonald, NP: It's really important to do that. It's really important to let people show you who they are. And in order to do that, the language that you use has to be neutralized. The questions that you asked have to be curious and open ended and not categorical. And I think our primary care colleagues are just always striving to make this a really safe place for LGBTQ+ people to come. Understanding, some of the sensitive topics around that identity and the life of an LGBTQ+ person.

Host: So, Allie, having said all of the above so far, what would you say your message is for potential patients of MIT Health's LGBTQ+ health team, or maybe just for such patients in general?

Allison Sherwood, NP: I think the message is, come meet us. We are welcoming. We are continuing to work on providing the best experience for our patients. We provide a individualized care model, which is to say that there's no cookie cutter process that our patients are going to experience when wanting to talk about their sexuality or their gender. We want to make sure that everyone feels that they have an individualized care plan. We want to build relationships with you. We understand that you're going through a lot outside of getting medical care. So we want to help through these transitions and we want to help navigate the care in which you'd like to receive. And again, we're here to understand your needs and advance as best we can while learning those.

Colleen McDonald, NP: Can I give my message to the patients?

Host: Sure, please do.

Colleen McDonald, NP: Any person who walks into this building for health care, you maintain your agency. You, you come, you meet us, you tell us what your health care goals are, the tools that you have, and we can share with you the tools that we think might work for you to reach your health care goals. Give us a shot at that.

Host: And in summary for both of you here, I wonder how rewarding it is servicing LGBTQ+ patients, not only helping fill a big need in the community, as we've discussed.

Allison Sherwood, NP: I think it's extremely rewarding. It's, what keeps me coming back each day, wanting to meet new patients, understand patient experiences to further the training that I go to, the further, further the information that I want to gather, further the care that I want to provide. It's also extremely rewarding to work with fellow colleagues. Colleen it's extremely rewarding to work with you and it's extremely rewarding to work with other colleagues and PCPs who want to advance this work and who want to continue to enhance the care that we can provide. So it's a very dynamic setting in which we're all wanting to learn and grow together with all of our patients.

Host: And Allie, this really obviously means a whole lot to you, to say the least.

Allison Sherwood, NP: Absolutely, yeah, I think I look back and it was definitely a different experience that I would have had maybe growing up in healthcare settings that I was in and I think it's pretty passionate that we want to try to change this experience for patients.

Host: Well, Colleen, I want to get your thoughts on how rewarding this work is for you, but first to pick up on what Allie was just mentioning, how far would you say things have come in regard to servicing this particular part of the community during the time you've been with MIT Health?

Colleen McDonald, NP: It has come a, a long way some in part because of the general public's knowledge and I would have to say exposure, connectedness to the LGBTQ+ community. There's no longer bookstores on Boylston Street that you have to find and walk in to connect with any LGBTQ+ literature.

It is a more public phenomenon to be a part of this community. And with that, we have seen the volume of people seeking care in this specialty just continue to go up and the demand from the LGBTQ+ community to meet specific needs within this community. And, and I think that's been tremendous.

And I think MIT Health has been there every step of the way, opening doors and saying, yes, we need to do this. Let's continue to do this. Yes, let's build a standard of care for this and figure out the best quality of care around this community.

Host: Well, folks, we trust you're now more familiar with LGBTQ+ care at MIT Health. Colleen, Allie, a pleasure, keep up the great work, and thanks so much again.

And for more information, as well as to connect with a provider, please visit health.mit.edu/services/LGBTQ-health.

And please remember to subscribe, rate and review this podcast and all the other MIT Health podcasts as well. For health tips and updates, please follow MIT Health on your social channels. If you found this podcast helpful, please share it on your social media. And thanks again for being part of Conversations with MIT Health.