OUTmed For Patients

Washington University School of Medicine, St Louis Children’s Hospital, and Barnes Jewish Hospital are committed to providing multidisciplinary, patient-centered care to people who identify as LGBTQIA+.  We encourage you to discuss all health matters with your primary care physician or specialist physician.   

Our policies support patients’ rights to equal care and visitation rights without fear of discrimination. The Health Equity Index (HEI) is a national LGBTQIA+ benchmarking tool created by the Human Rights Campaign (HRC). We are proud of our strong performance at Barnes-Jewish Hospital and St. Louis Children’s Hospital.   

If you are looking for an LGBTQIA+ friendly provider, check out our
LGBTQ Friendly – Provider Directory (pdf).

The providers listed are self-identified as having an interest in providing culturally competent care to LGBTQIA+ patients. OUTmed cannot guarantee the cultural competence of providers listed.  We recommend interviewing providers to find one who fits your needs and expectations.   

Click the tabs below to learn more about health services provided at Washington University School of Medicine.   

This information is not intended to substitute for professional healthcare. Always consult your healthcare provider for advice regarding your health and to learn more about your conditions.  

Information for LGBTQIA+ Health

LGBTQIA+: An acronym that stands for Lesbian (women attracted to women), Gay (men attracted to men), Bisexual (person attracted to more than one gender), Transgender (related to gender identity, a term for someone whose gender identity does not match what is usually associated with their sex assigned at birth), Queer (someone who identifies as other than heterosexual; also Questioning), Intersex (someone with a sex assigned at birth that is neither fully male nor female), Asexual (someone who does not experience sexual attraction).

Sexual orientation is someone’s identity related to sexual attraction to someone of the same, or another, gender. Lesbian, gay, and bisexual are all sexual orientations.

Sexual behavior refers to someone’s specific behaviors in sexual relationships, and may be different from what would be expected based on sexual orientation. A man may identify as straight but occasionally have sex with men; a woman may identify as bisexual but exclusively have sexual relationships with men. MSM (men who have sex with men) and WSW (women who have sex with women) are ways of describing sexual behaviors.

Transgender Health

Sex is assigned at birth and is usually based off the appearance of external sex organs, with different sexes being male, female, and intersex in addition to external sex organs.

Gender identity describes one’s personal sense as identifying as male, female, or neither with influence of societal structures, cultural expectations, or personal interactions. Cisgender individuals have a gender identity that corresponds to the culturally determined gender roles for sex assigned at birth, whereas the term transgender is an umbrella term used to describe the full range of people whose gender identities do not conform to what is typically associated with their sex assigned at birth.

Transgender Health involves providing the best possible care for transgender people. That includes cultural competency, services for mental health and well-being, and gender affirming care like hormones and surgery, among others.

Washington University School of Medicine has two transgender centers, one for adults and one for children and adolescents.

Information for Intersex Individuals

The Difference of Sex Development Program at St Louis Children’s Hospital offers support and treatment for intersex children and their families.

Information for HIV and PrEP

HIV (Human Immunodeficiency Virus) is a type of virus that weakens a person’s immune system if left untreated. It is primarily transmitted via sexual intercourse or through sharing of infection equipment such as needles.  While there is no current effective cure for HIV, treatment for HIV is available and it can be controlled with medication use, known as highly active anti-retroviral treatment (HAART). HAART is so effective these days, patients can have normal life expectancy on treatment and can reach undetectable viral loads in their blood, at which point they essentially cannot transmit HIV to their partners, with Undetectable = Untransmittable. Furthermore, its transmission can be reduced or prevented by taking a daily pill called PrEP, or HIV Pre-Exposure Prophylaxis, with condom use also being an effective method of reducing transmission.

Washington University offers HIV testing, HIV Care, and a PrEP clinic.

PrEP:
PrEP is a daily pill for people without HIV to reduce or prevent HIV infection.

You should consider taking PrEP if you are at high risk of acquiring HIV.  You are considered high risk if you have a partner who is HIV positive or if you have inconsistent condom use with more than one person. People who use intravenous (IV) drugs are also considered high risk.

HIV:

HIV Testing:

Information for Sexually Transmitted Infections (STIs)

According to the CDC, STIs are very common with millions of cases a year in the United States.  STIs are passed from one person to another through sexual or intimate physical contact.  STIs are the majority of the time asymptomatic, which is why it’s important to get screened regularly (every 6 months to annually)  if you’re sexually active with new sexual partners.

Here are a  list of places you can get tested for STIs in St Louis:

Information for Mental Health Resources/Counseling

LGBTQIA+ people are at increased risk of mental health concerns, in large part due to prejudice, abuse and discrimination from the world at large. It is important to keep in mind that these forms of trauma are the main cause of worse mental health in LGBTQIA+ people.

Anxiety disorders are the most common mental health problems. One in five people in the US struggles with an anxiety disorder every year, but most don’t get treatment. Many people don’t even know they have an anxiety disorder. People with anxiety often have trouble controlling worries, to the point that they have trouble living their everyday lives. Worries may get in the way of socializing, sleeping, or relaxing. A combination of medication and psychotherapy (talk therapy) is the best way to treat anxiety disorders.

Depression is also very common. People with depression feel sad or down, or less interested in their usual activities, for at least two weeks in a row. Low energy, changes in sleep or appetite, and feeling hopeless are also common. In some cases depression leads to suicidal thoughts. Thoughts of suicide are an emergency, and someone dealing with them should go to the nearest emergency room. The good news is that depression gets better with treatment! A combination of medication and psychotherapy (talk therapy) is the best way to treat depression.

  • SQSH: St Louis Queer+ Support Helpline, a helpline Fri-Mon 1-7pm, staffed by trained LGBTQ+ individuals with support from LGBTQ+ aware and competent mental health professionals. SQSH can connect you with a queer-friendly food pantry, a gender affirming therapist, or just talk through the stresses (and joys) of coming out.
    PH: 314-380-7774
  • TransLifeLine: Peer support line run by and for trans folks: you can call to discuss coming out, coping, or to talk through a crisis. TransLifeLife does NOT perform non-consensual active rescue (ie, will not call police or EMS unless the caller asks for this).
    PH: 877-565-8860
  • The Trevor Project: Support for LGBTQ+ youth and young adult mental health, including crises—online and via text and chat:
  • Safe Connections: Provides support for survivors of all genders and orientations dealing with histories of sexual abuse or assault, domestic or dating violence.
    PH: 314-531-2003
  • Behavioral Health Response: In crisis? Need to connect with longer-term resources, like a therapist or case management services? BHR is St. Louis-based and there for you 24/7.
    PH: 1-800-811-4760
Alcohol and Substance Abuse

Substance abuse and addiction are more common in LGBTQIA+ populations due mostly to the discrimination and trauma LGBTQIA+ people experience. In one survey, 26% of transgender people reported using drugs or alcohol specifically to cope with the stress of being trans in a world that is often not accepting. There is also a long history of LGBTQIA+ social spaces including drugs or alcohol, like bars. Some programs for recovery are also homophobic or transphobic, which can make seeking help harder. The good news is recovery is possible, and there are many helpful programs that celebrate LGBTQIA+ folks just as they are.

Here are some links to learn more about substance abuse:

Here are St Louis Resources:

Information on Intimate Partner Violence

Intimate Partner Violence (IPV) touches people of all genders and sexual orientations. IPV may include physical abuse, like hitting or shoving. It may include verbal or emotional abuse—insults, threats and humiliation. It may even include sexual abuse, like forcing someone into sexual activity, or making someone feel like they can’t say no. Many studies show LGBTQIA+ people are more likely than the general population to experience IPV.

LGBTQIA+ people can face special barriers when seeking help for IPV. Abusers may threaten to “out” someone if they leave or call the police. Some shelters and services – including the legal system – are not friendly toward LGBTQIA+ people.

EVERYONE deserves to be safe. Abuse is never OK. There are ways to get out of abusive relationships, and there are several resources in St. Louis that provide housing, legal assistance, and counseling for survivors of all genders and sexual orientations.

Learn more about IPV:

Local Resources:

Information on Family Planning

If you are interested in starting a family through artificial insemination or through in vitro fertilization or surrogacy, you should consider speaking with a fertility specialist.

Contraception is a term that describes various ways to prevent pregnancy. However, it’s important to note that people are on contraception for other health advantages. If you’re interested in contraception, you should speak with your primary care physician or obstetrician/gynecologist which one may be the right option for you.

How To Address Specific Concerns With Your Provider
  • Your health is the highest priority. Sharing information about your identity can be difficult.  Because LGBTQIA+ patients have unique needs, physicians may ask about sexual orientation, gender identity and expression, and/or sexual behaviors to best take care of you and your health.
  • All information you share with your provider is confidential and protected like other medical information.
  • Recommendations for routine healthcare screenings and vaccinations can be different based off your gender identity and sexual orientation.
  • Across the country, you will notice healthcare providers more frequently asking about sexual orientation and gender identity. This is being done so that providers can take better care of LGBTQIA+ patients. If you’d like to read more about this, go to: doaskdotell.org