[Home](https://healthequity4all.org/) / [All Insights](https://healthequity4all.org/insights.html) / Beyond the One-Hour Session: Making LGBTQ+ Affirming Care Last # Beyond the One-Hour Session: Making LGBTQ+ Affirming Care Last By Ace Robinson · November 6, 2026 · Last updated November 7, 2026 ## Key Takeaways - A one-hour training raises awareness. Lasting change needs an assessment first, changes to forms and records, and follow-up. - Collecting sexual orientation and gender identity information well, and making your space welcoming, are part of the work. - Leaders need their own briefing, and your organization needs people who can keep training going when staff leave. - Long-term leadership programs, such as GLMA's two-year HEAL Fellowship, build the people who will change systems from the inside. ## In This Article - [Start With an Assessment](#start-with-an-assessment) - [Fix the Paperwork](#fix-the-paperwork) - [Practice, Don't Only Listen](#practice-don-t-only-listen) - [Plan for the Day Staff Leave](#plan-for-the-day-staff-leave) - [Brief Your Leaders Separately](#brief-your-leaders-separately) - [Grow the Next Generation of Leaders](#grow-the-next-generation-of-leaders) - [A Simple Plan for the Next 90 Days](#a-simple-plan-for-the-next-90-days) - [Sources](#sources) Everyone in the room liked the training. A month later, the intake form still asks two questions that don't fit half your patients, and the new hire never heard any of it. What went wrong? Nothing went wrong with the training. It was only ever the first step. ## Start With an Assessment Organizations that do this work well begin by measuring. The National LGBTQIA+ Health Education Center, which supports health centers, runs two surveys before it trains anyone: one for all staff and one for leadership. They look at knowledge, attitudes, preparedness and the care environment, and staff also review key documents and policies. The training that follows is built from those results. You can do a version of this yourself. Ask your staff five plain questions: What terms do you feel unsure about? What would you do if a patient's name on the chart didn't match the name they use? Who would you ask for help? Then ask your leaders the same questions, and compare the answers. The gap between the two groups is often the most useful finding. ## Fix the Paperwork Training fades. Forms stay. Three places to look: - **Intake and registration.** How do you ask for name, pronouns, sexual orientation and gender identity? Is the information stored where clinicians can see it, and kept private? - **The electronic health record.** Can it show a chosen name alongside a legal name? Does it have fields for the information you collect? - **The space itself.** Waiting rooms, signs and restrooms tell patients whether they're expected. The National LGBTQIA+ Health Education Center offers short consultations on exactly these items: forms, policies and health records, along with how to collect and manage sexual orientation and gender identity data and how to make physical spaces inclusive. If you can't afford a consultant, give one person the job of walking your patient path from the front door to the exit and writing down every place it assumes a patient is straight or cisgender. ## Practice, Don't Only Listen Some providers now use simulation. OutCare Health, with a simulation partner, offers a standardized patient visit by video, followed by feedback. Practicing the conversation, even once, does more than hearing about it. If a simulation isn't in your budget, role-play the three hardest conversations your staff have named in your assessment. ## Plan for the Day Staff Leave Turnover is the quiet enemy of every training program. Two ways to protect your investment: - **Train your own trainers.** Three-hour train-the-trainer sessions exist so your own people can run the training again for new hires. - **Keep an online space for questions.** Moderated peer groups and expert discussion groups give staff somewhere to ask the questions they won't ask in front of a class. ## Brief Your Leaders Separately Executives and board members need a different conversation from clinicians. They decide on budgets, policies and hiring. Ask for a short executive briefing, and ask what you're deciding afterward: what you'll fund, what you'll measure, who will be accountable. We recommend keeping that session separate from staff training so people can speak freely. ## Grow the Next Generation of Leaders Changing a system takes years, and it takes people who stay. GLMA: Health Professionals Advancing LGBTQ Equality runs the HEAL Fellowship, a two-year program for early-career LGBTQ+ and BIPOC health professionals and advanced graduate students. It pairs training in health inequity, policy and advocacy with mentorship and leadership placements. Its first cohort began in 2025, and applications for that cohort closed on August 31, 2025. The page doesn't report outcomes yet, so it's too early to judge results. It does show a model worth watching, and a reason to ask your own organization how it develops its LGBTQ+ and BIPOC staff into leaders. ## A Simple Plan for the Next 90 Days 1. **Weeks 1 to 3:** Survey staff and leaders with the same short questions. Compare the results. 2. **Weeks 4 to 6:** Walk the patient path. Fix the forms and the record fields first. 3. **Weeks 7 to 10:** Run the training, with separate sessions for staff and for leaders. 4. **Weeks 11 to 13:** Check in. What changed? What did staff say they still don't know? Name an owner and a date for each gap. Our [LGBTQ+ equity training for healthcare](https://healthequity4all.org/trainings.html) is built around the people in the room and ending with written commitments and a 60-day check-in. If you'd like help with the assessment or the plan, [start a conversation](https://healthequity4all.org/contact.html). Onward. Together. ## Sources - National LGBTQIA+ Health Education Center, [Training and Technical Assistance](https://www.lgbtqiahealtheducation.org/what-we-offer/training-technical-assistance/). - OutCare Health, [LGBTQ+ Affirming Healthcare Training](https://www.outcarehealth.org/training/). - GLMA: Health Professionals Advancing LGBTQ Equality, [HEAL Fellowship](https://www.glma.org/HEALFellowship). - Equitas Health, [Education and Training](https://equitashealth.com/education-training/). Our automated tool could not open this page, so Ace should read it directly. - American Medical Association Ed Hub, [LGBTQ+ course](https://edhub.ama-assn.org/course/265). This page needs a sign-in, so Ace should read it directly. [Talk to us about your work](https://healthequity4all.org/contact.html)