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Challenges of the LGBT Community in Health Care: Focus on Heart Failure

  • Author Footnotes
    1 Dr. Yehya received honoraria from Merck, Zoll, Akcea therapeutics, and CareDx.
    AMIN Yehya
    Correspondence
    Reprint requests: Amin Yehya, MD, MS, FACC, FHFSA, Medical Director, MCS Program, Sentara Heart Hospital, Assistant Professor of Medicine, Cardiology, Eastern Virginia Medical School, Norfolk, VA.
    Footnotes
    1 Dr. Yehya received honoraria from Merck, Zoll, Akcea therapeutics, and CareDx.
    Affiliations
    Sentara Heart Hospital, Norfolk, Virginia; and the Eastern Virginia Medical School, Norfolk, Virginia
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  • Author Footnotes
    1 Dr. Yehya received honoraria from Merck, Zoll, Akcea therapeutics, and CareDx.
Published:February 01, 2022DOI:https://doi.org/10.1016/j.cardfail.2021.12.021
      When one of our heart transplant patients began rescheduling her appointments, an atypical practice for her, it caused concern for the transplant coordinator who had followed the patient before and after the heart transplantation. Fortunately, because of the well-established relationship between the two, the experienced coordinator was able to convince the patient to return for her routine follow-up appointment. Upon entry into the examination room, the patient's anxiety was undeniable; she avoided eye contact, her voice was tremulous, and her hands were restless. She began crying when we inquired about any potential barriers precluding her from attending her follow-up appointments. She then shared that she had been going through a “big change” in her life. “After my heart transplant, I have been given a new chance to live the life that I want and to be happy and live my true self,” she said. She also mentioned that she had begun estrogen therapy as part of her transitioning process. She disclosed that she had been avoiding her follow-up appointments in fear of judgment, or even worse, exclusion from the clinic. It was a very emotional day for not only the patient, but for all members of the care team in that room as well, who witnessed firsthand the potential downstream effects of bias and health inequities on patients. To her surprise, we shared both our support and joy of her decision to pursue her journey to transition. Our patient's vulnerability and resilience was inspiring and elucidates many of the challenges the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community faces in accessing health care.

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