1. Simpson, Kathleen Rice PhD, RNC, CNS-BC, FAAN

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In October 2020, the National Academies of Sciences, Engineering, and Medicine (NASEM, 2020) released a new report on the health and well-being of lesbian, gay, bisexual, transgender, queer or questioning, intersex, nonbinary, and gender-nonconforming (LGBTQI+) populations. This is a much-needed follow-up to their 2011 report (Institute of Medicine, 2011) as a lot has changed in the last 10 years. Demographic data about the various individuals who comprise this diverse population are not collected systematically or nationally and therefore it is difficult to know how many people are members of one or more of these groups; however, it is estimated there are at least 11 million sexual and gender-diverse people in the United States.


Nurses by far are the largest group of health care professionals in the United States, nearly 4 million strong (American Nurses Association, 2020). Nurses care for all populations including the LGBTQI+ population, in all types of settings such as maternity, neonatal, and pediatrics. Therefore, nurses must make efforts to acquire knowledge about their specific health care needs. Simple things like using affirming and inclusive language can go a long way (Spatz, 2020). A lot of the aspects of maternal-child nursing care include routine use of words that imply gender roles that some do not identify with or want to be described as such as mother or father and birthing woman (Griggs et al., 2021). Ask patients what words they use to describe themselves and use those words. If you make a mistake in language or assumptions and misgender the patient, apologize and do your best to get it right. Do not ask about sexual preferences or pronoun preferences. These are not preferences. Individuals do not prefer to be members of the LGBTQI+ population; rather that is who they are. Gender-affirming, welcoming, encouraging, respectful care is critical. Nurses can lead the way in supporting, providing, and role-modeling this type of care. It is well known that members of the LGBTQI+ population experience long-standing discrimination and stigma that occurs on an individual, group, and structural level (NASEM, 2020). The effects of discrimination and stigma have serious and ongoing negative effects on their health and well-being. Discrimination and stigma have no place in nursing. Examining our biases and lack of knowledge, becoming informed, being kind, and treating others as you would like to be treated or would treat a loved one are ways we can do better. Supporting facility, local, state, and national policies that recognize the rights and acknowledge the various individual attributes of the LGBTQI+ community in partnership is something we all can do. Be an ally.


The NASEM (2020) report is rich with information. It is available to download without charge. The many gaps in the literature are identified. There are a number of recommendations for moving forward. Although there have been significant changes in the social, political, and legal status of LGBTQI+ individuals, much more work needs to be done (NASEM, 2020). I encourage all nurses to read the report, be informed, consider the recommendations, and make plans to be a positive force and role-model to make sure all patients get the care they need and deserve.




American Nurses Association. (2020). The nursing workforce.[Context Link]


Griggs K. M., Waddill C. B., Bice A., Ward N. (2021). Care during pregnancy, childbirth, postpartum, and human milk feeding for individuals who identify as LGBTQ. MCN. The American Journal of Maternal Child Nursing, 46(1), 43-53.[Context Link]


Institute of Medicine. (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. The National Academies Press.[Context Link]


National Academies of Sciences, Engineering, and Medicine. (2020). Understanding the well-being of LGBTQI+ populations. The National Academies Press.[Context Link]


Spatz D. L. (2020). Using gender-neutral terms in lactation. MCN. The American Journal of Maternal Child Nursing, 45(1), 61.[Context Link]