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July 23, 2019; 93 (4) Contemporary Issues

American Academy of Neurology members' preparedness to treat sexual and gender minorities

Nicole Rosendale, Tasha Ostendorf, David A. Evans, Allison Weathers, Jason J. Sico, Julie Randall, Holly E. Hinson
First published June 14, 2019, DOI: https://doi.org/10.1212/WNL.0000000000007829
Nicole Rosendale
From the Department of Neurology (N.R.), University of California San Francisco Medical Center; American Academy of Neurology (T.O.), Minneapolis, MN; Texas Neurology (D.A.E.), Dallas; Information Technology Division (A.W.), Cleveland Clinic, Beachwood, OH; Departments of Neurology and Internal Medicine (J.J.S.), Center for NeuroEpidemiological and Clinical Research, Yale School of Medicine, New Haven, CT; Portland State University (J.R.), OR; and Department of Neurology (H.E.H.), Oregon Health & Science University, Portland.
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Tasha Ostendorf
From the Department of Neurology (N.R.), University of California San Francisco Medical Center; American Academy of Neurology (T.O.), Minneapolis, MN; Texas Neurology (D.A.E.), Dallas; Information Technology Division (A.W.), Cleveland Clinic, Beachwood, OH; Departments of Neurology and Internal Medicine (J.J.S.), Center for NeuroEpidemiological and Clinical Research, Yale School of Medicine, New Haven, CT; Portland State University (J.R.), OR; and Department of Neurology (H.E.H.), Oregon Health & Science University, Portland.
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David A. Evans
From the Department of Neurology (N.R.), University of California San Francisco Medical Center; American Academy of Neurology (T.O.), Minneapolis, MN; Texas Neurology (D.A.E.), Dallas; Information Technology Division (A.W.), Cleveland Clinic, Beachwood, OH; Departments of Neurology and Internal Medicine (J.J.S.), Center for NeuroEpidemiological and Clinical Research, Yale School of Medicine, New Haven, CT; Portland State University (J.R.), OR; and Department of Neurology (H.E.H.), Oregon Health & Science University, Portland.
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Allison Weathers
From the Department of Neurology (N.R.), University of California San Francisco Medical Center; American Academy of Neurology (T.O.), Minneapolis, MN; Texas Neurology (D.A.E.), Dallas; Information Technology Division (A.W.), Cleveland Clinic, Beachwood, OH; Departments of Neurology and Internal Medicine (J.J.S.), Center for NeuroEpidemiological and Clinical Research, Yale School of Medicine, New Haven, CT; Portland State University (J.R.), OR; and Department of Neurology (H.E.H.), Oregon Health & Science University, Portland.
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Jason J. Sico
From the Department of Neurology (N.R.), University of California San Francisco Medical Center; American Academy of Neurology (T.O.), Minneapolis, MN; Texas Neurology (D.A.E.), Dallas; Information Technology Division (A.W.), Cleveland Clinic, Beachwood, OH; Departments of Neurology and Internal Medicine (J.J.S.), Center for NeuroEpidemiological and Clinical Research, Yale School of Medicine, New Haven, CT; Portland State University (J.R.), OR; and Department of Neurology (H.E.H.), Oregon Health & Science University, Portland.
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Julie Randall
From the Department of Neurology (N.R.), University of California San Francisco Medical Center; American Academy of Neurology (T.O.), Minneapolis, MN; Texas Neurology (D.A.E.), Dallas; Information Technology Division (A.W.), Cleveland Clinic, Beachwood, OH; Departments of Neurology and Internal Medicine (J.J.S.), Center for NeuroEpidemiological and Clinical Research, Yale School of Medicine, New Haven, CT; Portland State University (J.R.), OR; and Department of Neurology (H.E.H.), Oregon Health & Science University, Portland.
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Holly E. Hinson
From the Department of Neurology (N.R.), University of California San Francisco Medical Center; American Academy of Neurology (T.O.), Minneapolis, MN; Texas Neurology (D.A.E.), Dallas; Information Technology Division (A.W.), Cleveland Clinic, Beachwood, OH; Departments of Neurology and Internal Medicine (J.J.S.), Center for NeuroEpidemiological and Clinical Research, Yale School of Medicine, New Haven, CT; Portland State University (J.R.), OR; and Department of Neurology (H.E.H.), Oregon Health & Science University, Portland.
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Citation
American Academy of Neurology members' preparedness to treat sexual and gender minorities
Nicole Rosendale, Tasha Ostendorf, David A. Evans, Allison Weathers, Jason J. Sico, Julie Randall, Holly E. Hinson
Neurology Jul 2019, 93 (4) 159-166; DOI: 10.1212/WNL.0000000000007829

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Abstract

Objective To measure the attitudes and knowledge of American Academy of Neurology (AAN) member neurologists in caring for sexual and gender minority (SGM) patients (e.g., those who identify in the lesbian, gay, bisexual, transgender, queer, or questioning [LGBTQ+] spectrum) to inform future educational offerings.

Methods A questionnaire was created in an iterative process by the LGBTQ+ Survey Task Force, consisting of 21 questions examining self-reported knowledge, attitudes, and clinical preparedness in caring for SGM patients. Participants responded to each statement with a 5-point Likert scale (“strongly disagree” to “strongly agree”). The survey was distributed via electronic and conventional mail to a random, representative sample of 1,000 AAN members.

Results The response rate was 13.5% (n = 135). Most respondents (60%–66%) were aware of local and national barriers that inhibit SGM individuals from using health care services; the majority (73%–91%) felt comfortable assessing SGM patients. Over half believed sexual orientation (SO) and gender identity (GI) to be social determinants of health (61% and 57%, respectively). Yet a third would not tailor neurologic care based on a patient's SGM identity, and 43% believed that SO/GI has no bearing on the management of neurologic illness.

Conclusions Most neurologists surveyed were aware of overarching barriers to care experienced by SGM individuals; however, a minority of respondents recognized the intersection of SGM identity with neurologic health. Our results highlight awareness gaps that could be addressed via targeted educational opportunities, ensuring that neurologists provide high-quality neurologic care to patients of all sexual orientations and gender identities.

Glossary

AAN=
American Academy of Neurology;
LGBTQ+=
lesbian, gay, bisexual, transgender, queer, or questioning;
SGM=
sexual and gender minority

Footnotes

  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Editorial, page 143

  • Received December 19, 2018.
  • Accepted in final form April 29, 2019.
  • © 2019 American Academy of Neurology
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