Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Lesbian, Gay, Bisexual, and Transgender health

Creating safe spaces and caring for patients with cultural humility

Kuzma, Elizabeth K. DNP, FNP-BC (Clinical Assistant Professor); Pardee, Michelle DNP, FNP-BC (Clinical Assistant Professor); Darling-Fisher, Cynthia S. PhD, FNP-BC (Clinical Assistant Professor)

Journal of the American Association of Nurse Practitioners: March 2019 - Volume 31 - Issue 3 - p 167–174
doi: 10.1097/JXX.0000000000000131
Clinical and Case Study Article

Background and purpose: This article provides foundational information about 1) the significant health disparities LGBT individuals face, which are associated with persistent discrimination, oppression, and stigmatization in both societal and healthcare settings; and 2) how cultural humility can help nurses to create safe spaces and provide optimal care for all patients.

Methods: CINAHL, Medline, PsychInfo, and GoogleScholar databases were searched to identify theoretical and empirical literature regarding LGBT health, health disparities, barriers to accessing care, unconscious bias, cultural humility, and creating safe spaces to better meet the healthcare needs of the LGBT population.

Conclusions: LGBT patients' health needs are not being adequately met in many healthcare settings due to inadequate education and preparation of healthcare providers, including nurses. Lack of access to safe, appropriate, and affirming healthcare services increases the risk of poor health and persistent health disparities.

Implications for practice: As the largest professional healthcare workforce, nurses can have a significant role in reducing the health disparities LGBT patients face. When armed with the tools to care for LGBT patients with cultural humility, nurses can lead clinical change within their institutions to create safe, accepting, affirming, inclusive, and welcoming environments for all patients.

Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan

Correspondence: Elizabeth K. Kuzma, DNP, FNP-BC, Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, 400 North Ingalls, Room 3181, Ann Arbor, MI 48109. Tel: 734-647-0149; Fax: 734-647-0351; E-mail:

Competing interests: The authors report no conflicts of interest.

Authors' contributions: E. K. Kuzma, M. Pardee, and C. S. Darling-Fisher provided substantial contributions to the conception and design of the manuscript. E. K. Kuzma wrote the initial draft. E. Kuzma, M. Pardee, and C. S. Darling-Fisher revised it critically for important intellectual content, made a final approval of the version to be published, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy and integrity of any part of the work are appropriately investigated and resolved.

Received June 04, 2018

Accepted August 10, 2018

© 2019 American Association of Nurse Practitioners
You currently do not have access to this article

To access this article:

Note: If your society membership provides full-access, you may need to login on your society website