Recognizing the importance of creating a culture of health amongst a vulnerable population that often avoids seeking care because of fear of disclosure to providers, the Los Angeles County Lesbian and Bisexual Women’s Health Collaborative (LBWHC) was founded in 2009. LBWHC is a collaborative network composed of representatives from the Iris Cantor-UCLA Women’s Health Education and Research Center, the LA County Department of Public Health’s Office of Women’s Health, USC, the City of West Hollywood, the LA LGBT Center, and knowledgeable and concerned individuals including Sue LaVaccare and Elaine Suranie, founding members of LBWHC who have a deep commitment to addressing the health care needs of lesbian and bisexual women.
The members of the Collaborative knew that many lesbian and bisexual women were not seeking care or disclosing their sexual orientation to providers. To ensure that providers and institutions were more welcoming of lesbians and bisexual women, and that institutions implemented equitable policies, practices and programs reflective of the needs of these patients, LBWHC set out to develop a curriculum for training healthcare professionals to deliver culturally competent and sensitive care to lesbian and bisexual women.
Aware that no one person or group could speak for the entire community, the Collaborative engaged a diverse group of stakeholders to identify challenges in health care access. In 2012, LBWHC organized five separate for lesbian and bisexual women who were age 25 or older, and identified as belonging to one or more of the following groups: African-Americans, Asian-Americans, Latinas, veterans, and/or age 65 and older.
Findings from these focus groups were deployed to further engage the community and resulted in LBWHC developing a curriculum to train health professionals and health care administrators in providing culturally competent care to lesbian and bisexual women. The Collaborative equally wanted to raise awareness within providers and institutions about the detrimental care and discrimination faced by many lesbian and bisexual women and the need for quality care and improved health outcomes for these women. The curriculum emphasizes educating providers and institutions about the “triple threat” experienced by minority lesbian and bisexual women: being a woman, being a woman of color, and being a lesbian or bisexual woman. LBWHC strives to make health care for lesbians and bisexual women more inclusive and reflective of their specific needs.
The curriculum was presented to community stakeholders and health care providers at a conference in December 2016. A revised curriculum focused on regulatory and policy issues was presented at a conference in May 2017 for health care administrators. Intentional outreach and engagement efforts ensured that stakeholders represented not only diverse lesbian and bisexual women, but also straight allies who shared a commitment to systematic changes in delivering care to lesbian and bisexual women.
The West Hollywood City Council has provided $15,000 in initial funding for LBWHC for the development of a training curriculum, holding conferences and onsite trainings for health professionals and health care administrators, and City of West Hollywood staff support.
The training program developed is now being delivered by LaVaccare and Suranie. The trainings are conducted across a vast geographic region of LA County. The curriculum has the potential to be replicated by other communities and to be scaled up for dissemination to a wider range of health professionals and health care administrators.
The focus on system change as a means of making care for lesbian and bisexual women more inclusive has not only benefited healthcare professionals and administrators, but it has equally moved LBWHC into new directions to incorporate health care training as a priority initiative and to address broader policy implications, visitation rights, and practices. As a result of LBWHC’s work in service integration, the Collaborative has gained recognition as the source for training health professionals and allied staff, and health care administrators. Requests for trainings range from rehabilitation centers, Planned Parenthood, County Departments of Public Health, hospitals, health care systems, community clinics, LA County women’s jail, cancer treatment centers, as well as outpatient medical facilities.
In advocating against inequities in healthcare for lesbian and bisexual women and helping make health care environments more welcoming and inclusive, LBWHC’s efforts have found ways to change systems at the larger level, while continuously engaging and learning from the lesbian and bisexual women’s community.