Lesbians, gays, bisexuals, and transgendered people do not routinely receive medical care because they fear the lack of sensitivity on the part of their physician or therapist will cause them embarassment or rejection. As larger numbers of lesbian, gay, bisexual, and transgender people open up to their medical providers there is a growing need for knowledge and understanding. Many health care staff have not been trained to be sensitive and respectful in their treatment of alternative families and those with unique gender presentations. To increase their knowledge of sexual and gender identity development and how that impacts maturation throughout the life-cycle RAI has developed a curriculm specifically designed to meet the medical health needs of lesbians, gays, bisexuals and transgendered.

The curriculum is divided into eight primary modules. The training we provide can be presented on any of these individually or as a "package", grouped in whatever way is most approrpiate for your needs.

Module 1: Barriers to Quality Health Care Services
This introductory module describes the additional unique health care concerns of members of the LGBT community. The barriers that compound those unique concerns and how they put LGBT people at greater risk are explored.

Module 2: Gender and Identity: Understanding Cross-Gender Expression
This module identifies the various health and human service needs of those who are transgendered; this includes those who are coping with cross-gender identity and/or gender dysphoria, as well as those defined as transsexual and intersexed. A newly emerging area for health and human service providers, transgender medicine, which challenges the traditional dimorphic gender system is explored.

Module 3: Domestic Violence, Sexual Abuse, Sexual Assault, Bias-Related Violence and other Trauma Issues
LGBT people seeking assistance from the medical and mental health communities for trauma-relat2ed issues have special needs. This module explains how to recognize trauma-related behavior, how to conduct sensitive interviewing, and how to assist in the recovery issues facing LGBT people who have been the victims of domestic violence, sexual abuse, sexual assault, and bias-related violence.

Module 4: Relationships and Parenting in the LGBT Community
Many LGBT people develop long-term domestic relationships and become parents through donor insemination, adoption, surrogacy, foster parenting, and step-parenting. In this module, the knowledge and skills essential for asssisting LGBT people in healthy family building are provided.

Module 5: Substance Abuse, Addictions, and Recovery Issues in the LGBT Community
LGBT people experience difficulty with substance use and addictions in numbers higher than the population at large, but the recovery resources available to them are limited. This module details the unique needs impacting their reasons for abusing substances, their relationship to the bars as a social outlet, issues of stress and stigma-management, as well as barriers to obtaining quality treatment services.

Module 6: Sexual and Gender Development--Children and Youth Issues
The development of sexual orinetation and gender identity is a normal part of the life-cycle of all children, but those who are gender variant, or express same-sex desires are often taunted, abused, and ostracized. This module describes the social services needed to address the families of these children, as well as the services which should be offered to the youth themselves. Compassionate psychotherapeutic services can help them develop ego strengths and healthy self-concepts.

Module 7: Aging Issues in the LGBT Communities
Older LGBT persons may face discrimination based on their age and sexual orientation. Consequently, they may not feel comfortable either in organizations serving older people or in LGBT community organizations, and thus may not receive useful services from either of these groups.

Module 8: Suicide Prevention
It is especially important that LGBT folk be able to recognize when someone is at risk. In the New York Capital District almost TWO PEOPLE PER WEEK kill themselves. Those of us who are Gay, Lesbian, Bisexual or Transgendered are at higher risk for suicidal ideation and for suicide attempts. The number of Gay and Bisexual men reporting an attempt is 11.9%. And an estimated 30% of youth who die by suicide identify as GLBT or Q. These LGBT teens, in addition to the usual stressors associated with growing up, must deal with the added emotional distress of stigmatization, victimization, and antigay hostility.

Module 9: Other Important LGBT Health Issues
The U.S. Department of Health and Human Services ten-year federal plan for improving the nation's health (Healthy People 2010) recognized the health disparities experienced by LGBT people. This module addresses seven remaining areas covered in that report: Immunization and Infectious Diseases, Mental Health and Mental Disorders, Nutrition and Weight, Sexually Transmitted Diseases (Infections), Tobacco Use, HIV/AIDS, and Cancer.