3. Complex support (less time + less barriers + more insurance advocates + appropriate paperwork) of the ideal healthcare system include less barriers and reduced time for desired results as well as incorporating insurance advocates fighting to improve insurance coverage. It also includes intake forma and charts that doctors use which also should include information on preferred name pronoun, family dynamics pertinent to LGBTQ+ patients. This support can also include informed consent for hormone replacement therapy and affirming therapists who are open to write letters for transition surgeries. 4. Acceptance is the most important factor and means allowing someone to fully be who they are without excess judgement or hostility. One of the ways it can manifest itself is in using patient preferred pronoun without questioning them. Another participants said that affirming health care system for LGBTQ+ patients is the one where LGBTQ+ doctors, nurses and assistant choose to work. 5. Continuing self-initiated learning among providers: One survey participants shared with us that one of the characteristics of LGBTQ+ affirming health care systems is “When dealing with mental health struggles (that include readiness of its providers to do their sexuality struggles) he [the doctor] spent the time and own learning and research without researcher/tried every option in order to best help me. expectation of a patient to educate a Even with just being sick, he researches what could most provider. It is systems in which a likely be the issue as well as will best help. He is very openprovider humanizes the interaction minded, listens, and show little to no bias.” with an LGBTQ+ patient, centers their health and do not see them as a (LGBTQ+ adult) “teachable moment” or “problem patient”
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