Culture, Climate, and Advocacy



Institutional culture and visibility are key elements for providing a safe environment for inclusive and equitable Lesbian, Gay, Bisexual, and Transgender (LGBT) patient care. Culture and climate are also important for establishing a welcoming learning environment for LGBT students, faculty, and staff. The purpose of this chapter is to examine the impact of LGBT health-related institutional climate, culture, and advocacy on patient care and health education. This chapter will also provide practical suggestions for improving institutional climate.


Climate Culture Advocacy Visibility Patient care Health education Institutional improvement Practical tools Change management 


  1. 1.
    Advancing effective communication, cultural competence and patient- and family-centered care for the LGBT community. The Joint Commission; 2011.Google Scholar
  2. 2.
    Dhaliwal JS, Crane LA, Valley MA, Lowenstein SR. Perspectives on the diversity climate at a US medical school: the need for a broader definition of diversity. BMC Res Notes. 2013;6:154.PubMedCentralCrossRefPubMedGoogle Scholar
  3. 3.
    The Fenway Institute: About.
  4. 4.
    Healthy People 2020. Lesbian, gay, bisexual, and transgender health.
  5. 5.
    Human Rights Campaign Healthcare Equality Index.
  6. 6.
    Gay and Lesbian Medical Association (GLMA).
  7. 7.
    Grant JM, Mottit LA, Tanis J. Injustice at every turn: a report of the national transgender discrimination survey. 2011.Google Scholar
  8. 8.
    Krehely J. How to close the LGBT health disparities gap. Washington, DC: Center for American Progress; 2009.Google Scholar
  9. 9.
    National Healthcare Disparities Report: 2011. US Department of Health and Human Resources. Agency for Healthcare Research and Quality; 2011.Google Scholar
  10. 10.
    Risdon C, Cook D, Willms D. Gay and lesbian physicians in training: a qualitative study. CMAJ. 2000;162(3):331–4.PubMedCentralPubMedGoogle Scholar
  11. 11.
    Robb N. Fear of ostracism still silences some gay MDs, students. CMAJ. 1996;155(7):972–7.PubMedCentralPubMedGoogle Scholar
  12. 12.
    Snowdon S. Equal and respectful care for LGBT patients. The importance of providing an inclusive environment cannot be underestimated. Healthc Exec. 2013;28(6):52, 54–5.PubMedGoogle Scholar
  13. 13.
    The health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding. Institute of Medicine (US) Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities. Washington, DC: National Academies Press; 2011.Google Scholar
  14. 14.
    When health care isn’t caring: Lambda Legal’s survey of discrimination against LGBT people and people with HIV. New York: Lambda Legal; 2010.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  2. 2.Department of NeurologyNYU Langone Medical CenterNew YorkUSA

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