Zuzelo says everything from nursing textbooks to assessment tools to the language that nurses use when talking to patients and their families are hetero-focused. But it's not necessarily because the care provider is prejudiced against LGBT people; instead, nurses and others are often simply unaware of such issues and disparities.
"I have to believe that this is because leaders in healthcare are not even aware that this [issue] exists," Zuzelo says.
Nurse leaders are in a position to work toward reducing heterosexism in their own practices, among their peers and staff, and within their healthcare institutions. One place to start: by simply suggesting changes to assessments or patient paperwork, such as adding options beyond "male" and "female" to the gender question.
The healthcare industry is lagging what's happening in the general culture. Just this month Facebook started offering US users some 50 additional gender options, such as "transgender," "cisgender," "gender fluid," "intersex" and "neither."
But nurses don't have to start from scratch.