Dr. Koorosh Shirkool, a Krembil Brain Institute neurologist, has spearheaded the initiative to open a clinic geared to neurology patients who identify as 2SLGBTQIA+. (Photo: Koorosh Shirkool)

A new neurology clinic is opening at Toronto Western Hospital, part of Krembil Brain Institute at UHN, geared to patients who identify as 2SLGBTQIA+ and live with neurological conditions.

The outpatient clinic provides inclusive, comprehensive, and individualized assessment and care to persons identifying as 2SLGBTQIA+ for a full range of neurological conditions that affect the brain, spinal cord, and nerves.

It is believed to be the first of its kind in Canada.

"Historically, many people who identify as 2SLGBTQIA+ tend to have more negative experiences with the healthcare system than the general population," says Dr. Koorosh Shirkool, a neurologist with Krembil Brain Institute.

"In addition to that, this community has specific medical needs, often due to other medical issues that they are dealing with.

"A woman of trans experience with epilepsy, for example, may be on hormone replacement therapy, which may affect the underlying condition and impact treatment options."

This issue has been highlighted in recent studies, including one that found "higher rates of stroke in lesbian, bisexual, and transgender women" and another that identified "higher rates of migraine in sexual minority men and transgender women."

As well, a further study found that "LGBTQ+ patients with multiple sclerosis change neurologic care providers more often and are referred for psychological care less frequently than their cisgender, heterosexual counterparts."

The Progress Pride flag, also known as the Inclusive flag, was designed in 2018. It incorporates the traditional six stripes of the Rainbow flag from 1978, the white, pink and light blue stripes of the Transgender Pride flag from 1999, and black and brown stripes to represent racialized members of the community. The purple circle on yellow background represents the intersex community.   

Dr. Shirkool, who spearheaded the initiative to open a neurology clinic dedicated to 2SLGBTQIA+ patients, believes that connecting with patients in an open, honest and accepting way will help them get the care they need, when they need it.

"When it comes to medical professionals, many of us don't get enough training as to how to approach people who come from different backgrounds than we are used to," says Dr. Shirkool. "We're not explicitly taught how to address people, which pronouns to use, how to document properly based on this information.

"There is a need in neurology for more training, more empathy in this regard. We hope this clinic will help to close the gap in our society."

In 2019, a survey sent to more than 1,000 members of the American Academy of Neurology found that "only slightly more than half recognized sexual orientation and gender identity (SOGI) as social determinants of health, and 43 per cent of respondents felt that SOGI should not be considered when tailoring the management of neurologic diseases.

"Most residents reported that they did not routinely ask patients SOGI data. This contrasts with studies that have demonstrated that both cisgender, heterosexual, and LGBTQ+ patients have high levels of acceptance and willingness to be asked SOGI questions."

Dr. Shirkool recently saw a patient who identifies as non-binary and they had already changed their name, but the specialist they had seen previously refused to address them by their new/chosen name or by their preferred pronoun, as it was not yet on the official chart – a painful experience for the patient, who did not feel comfortable returning to their doctor.

"It's a simple thing, to tell a patient that you see them and respect them, that you want to help them take care of themselves and their health," says Dr. Shirkool.

"We hope patients will see our clinic as a safe space."

The clinic is currently soliciting referrals from across Ontario. Read more about submitting a referral.

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