# Strengthening Health Standards: A Toolkit For LGBTQIA+ Affirming Healthcare

Lesbian, gay, bisexual, transgender, queer, intersex, asexual , and other  gender-diverse people (LGBTQIA+) face various forms of health disparities owing to the lack of availability of LGBTQIA+ specific and affirming care, which is exacerbated by stigma and discrimination both within and outside of the healthcare settings. This stigma and discrimination, both institutional and societal, place LGBTQIA+ people at [higher risk](https://www.tandfonline.com/doi/full/10.1080/15538605.2021.1868373) of developing preventable health conditions, and poverty, among other forms of marginalization.

In Malaysia, LGBTQIA+ people often [delay seeking preventive care](https://www.tandfonline.com/doi/full/10.1080/17441692.2015.1134614) and have trouble accessing lifesaving resources [due to high levels of distrust](https://pubmed.ncbi.nlm.nih.gov/31145000/) towards healthcare providers in providing confidential care.  

Evidence points to how adopting an LGBTQIA+ affirming practice in healthcare settings is a cost-effective measure as it [reduces the burden on the healthcare system](https://www.tandfonline.com/doi/full/10.1080/15538605.2021.1868373) caused by delayed care or hesitation by LGBTQIA+ people to seek medical care due to prejudice. 

Additionally,LGBTQIA+ affirming care  also [demonstrates a positive causal link](https://pubmed.ncbi.nlm.nih.gov/31581798/) in reduced likelihood of accessing mental health treatment due to the overall [reduction in depression, anxiety, and suicidality](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8881768/) among the LGBTQIA+ people.   Evidence indicates  that having an LGBTQIA+ affirming provider is [positively associated with higher rates](https://www.ajpmonline.org/article/S0749-3797\(22\)00497-4/abstract) of annual checkups, flu shots, HIV tests, colorectal cancer screenings, and management of a chronic mental health condition, compared with individuals whose regular healthcare provider was not LGBTQIA+ affirming. 

Healthcare providers [can regain trust with LGBTQIA+ people](https://www.who.int/publications/i/item/9789241564984) by taking meaningful steps in making their clinical services more affirming to foster better health outcomes. The purpose of this toolkit is to provide guidance on how to create and maintain an LGBTQIA+ affirming healthcare practice.

{% hint style="success" %}
The acronym LGBTQIA+ is used in this toolkit when applicable to a spectrum of identities comprising, but not limited to, lesbian, gay, bisexual, transgender, queer, intersex, and asexual.

The  ‘+’ in the acronym is used in this toolkit to include gender-diverse people, as well as other queer and sexual minorities.   Where it does not apply to intersex people and asexual people, the term LGBTQ+ will be used.
{% endhint %}

## Who is this toolkit for?

This toolkit is for those who provide services and care to LGBTQIA+ persons. This includes: 

* Healthcare providers, including those working in the public and private sector.
* NGO service providers and/or human rights defenders whose work relates to delivering services and care to LGBTQIA+ persons.

## What does this toolkit contain?

This toolkit contains a variety of sections with information and suggested guidelines on:

* [Summary of LGBTQIA+ people’s issues and concerns with access to healthcare](https://rainbowforward.gitbook.io/lgbtiqa+-affirming-healthcare-toolkit/section-1/barriers-faced-by-lgbtqia+-people-in-accessing-health-services)
* [Summary of health issues faced by LGBTQIA+ people](https://rainbowforward.gitbook.io/lgbtiqa+-affirming-healthcare-toolkit/section-2/health-disparities-faced-by-lgbtqia+-people), 
* [Concerns on ethics and LGBTQIA+ people](https://rainbowforward.gitbook.io/lgbtiqa+-affirming-healthcare-toolkit/section-3/standards-of-health), and
* [Suggestions for creating and maintaining an LGBTQIA+ affirming healthcare service and practice](https://rainbowforward.gitbook.io/lgbtiqa+-affirming-healthcare-toolkit/section-4/checklist-how-to-make-healthcare-services-friendly-and-accessible).