When someone walks into my office, my goal is to make them feel at home. I want my patient to know that not only did I look at their chart, but I also extensively reviewed their medical history and am ready and able to meet them. I want them to know that my office is a place in which they can feel comfortable and safe. I want my younger patients to feel like I am someone to whom they can talk to without judgment, and give them a sense of safety in what could be an uncomfortable place.

While I have always been an advocate and ally for the LGBTQ+ community, once I began practicing as an orthodontist in Cleveland, I realized that many practitioners and colleagues do not understand the vast importance of understanding the needs of this community.

Let’s back up a bit. LGBTQ+ is an acronym for lesbian, gay, bisexual, transgender and queer; the “plus” is intended as an all-encompassing representation of sexual orientations and gender identities. My goal with this article is to try to educate present and future practitioners as well as educate the public on some of the specific needs of the LGBTQ+ community with whom we live and interact with each and every day.

I want my office to be a safe, inclusive space for anyone, no matter what they have gone through or what they are currently going through. I’m going to discuss working with specifically LGBTQ+ youth, in the dental office and beyond. I want to share some larger observations that I have made in working with youths and teens.

Being a place to go

Depression and loneliness are very common in LGBTQ+ youth. Teenagers are going through many changes in their bodies and minds. Sometimes these changes are easy to discuss with parents or friends. Sometimes these changes are not easy to discuss with anyone. We should be a welcome place for all youth going through these life-altering changes.

As an orthodontist, I am often aware that kids come into my office with a lot on their minds. They may not just have teenage “angst,” they may have just left an uncomfortable situation at school or have questions on their minds about how to better “fit in” or if they want to or need to “fit in” at all. I want them to know that no matter what, my office is a place they can go where they can feel included, safe and seen.

I am a person they can talk to and will support them in whatever they are going through. Teens are often referred to therapists as an “outside” or “impartial” resource to bounce ideas off in a non-attribution environment. However, we, as orthodontists, see teens more often than they see therapists, so these issues do not need to be relegated to the therapist’s office alone. I bring up this observation because I’m hoping that professional adults of all stripes get more comfortable with LGBTQ+ kiddos, and can offer them a safe space. There is a significantly higher suicide rate for this demographic than their straight counterparts. These youth are vulnerable and need a community looking out for them. Some don’t have access to therapists, counselors at school or parents. If they felt comfortable in your office, that could mean the world of difference to them.

Gathering information, respecting that information

Studies have shown that effective communication is based on open communication, trust, reflective listening, confidentiality and involvement. I gather information about my patients, discuss their possible gender transformation medications (rare in youth, more common in patients older than 20) and make sure that they are comfortable and confident that I am keeping this confidential. I am fully involved in their medical history. This holistic approach to their treatment builds trust.

That leads me to the next point.

Being supportive, showing you are understanding

Why do “pronouns matter” (a pin I wear on my coat)? Pronouns are used in every day speech and writing to take the place of people’s names. We frequently use them without thinking about it. Using someone’s correct gender pronouns is one of the most basic ways to show your respect for their identity. Let the LGBTQ+ youth guide you, as pronouns are important and personal; ask about their pronoun preference if you aren’t sure.

Understanding transitional changes

I have had patients cross out “male” or “female” and write in “non-binary.” Non-binary people aren’t confused about their gender identity or following a new fad – non-binary identities have been recognized for millennia by cultures and societies around the world. Be open to learn about non-binary gender identity, and respect patients by providing them a place to show up as they are and chose their own pronouns and identity markers. Some patients may or may not speak up about what makes them comfortable.

The most important points that I want to make is to be open-minded, be supportive and make all patients feel welcome at your office and in your lives. Routine medical and dental appointments can be the most intimidating spaces for LGBTQ+ youth; providing an office environment that supports rather than discourages them can truly save a day, week, or life. Follow the lead of your patients: they may request a different pronoun than you might assume because of a gender-assumed name. That small change for you will make a huge impact on them.

Take home points

• We can all work together to create a safe space for the LGBTQ+ youth community in this world

• No person or patient should ever feel as though there isn’t a place for them, especially at the dental office

• Those of us that have consistent contact with this community should be seen as a safe place

• The simplest act of wearing a “pronouns matter” pin or having a rainbow sign up at your place of work or home is a sign of comfort for these youth

• Understanding and respecting LGBTQ+ youth is so important during such a transformative time in their lives.


Dr. Mindy J. Streem is a diplomate of the American Board of Orthodontics and a specialist of orthodontics and dentofacial orthopedics. She practices with Dr. Stephan Parker at Parker & Streem Orthodontics in Mayfield.

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