LGBTQ+

LGBTQ+ Health Care

Authors: Colline Wong, Christopher Steele MD MPH

 

Introduction:

Members of the LGBTQ+ community are at increased risk for a number of health problems when compared to their heterosexual/ gender-binary peers. As a community, this population usually suffers from higher rates of depression, substance use, smoking, certain types of cancer, and HIV/AIDS. Furthermore, LGBTQ+ population has less access to the health care and may encounter bias from those taking care of them. This bias can cause both a mistrust in the medical field and delayed medical care. For instance, LGBTQ+ individuals are more likely to use the emergency room or delay getting care than their counterparts and are more likely to be refused health care services or be harassed by their health care providers.1

While some of these disparities are accounted for by differences in sexual behavior, many are associated with social and structural inequities experienced by LGBTQ+ populations. The stigma and discrimination faced by the LGBTQ+ community has been shown to cause poorer health outcomes. Similarly to other minority groups, the stress of micro-aggressions combined with outwardly discriminatory policies negatively affects this community’s health care.2 Similarly, using the wrong pronoun or assuming heterosexuality are common mistakes health care providers make that affect their overall health.

Unfortunately, LGBTQ+ health care access is strongly affected by the current political climate. The legalization of same-sex marriage, and the continued protection against employer discrimination on the basis of sexuality and gender identity improve health outcomes. Whereas, the Department of Health and Health Services’ recent repeal of protection against discrimination on the basis of gender identity in healthcare threatens LGBTQ+ health. 

The goal of this module is to provide insight into how you can help the LGBTQ+ community feel respected in the clinic. At the same time, up-to-date information on LGBTQ+ health disparities will help you advocate for LGBTQ+ patients and their health. 

 

Learning Objectives

By the end of the session, learners will be able to:

  1. Define the following sexual orientation and gender identity terms: sex, cisgender, gender identity, genderqueer, sexual orientation, sexual identity, transgender, transsexual.
  2. Explain important components of a thorough sexual history and considerations when obtaining one. 
  3. Describe unique clinical concerns and disparities of adult LGBTQ+ patients.
  4. Describe preventative care for sexual minority and transgender individuals.
  5. List resources and health clinics available in your state to address the variety of health needs of LGBTQ+ patients.

 

Required Review Materials

  1. Wong C. Introduction to Caring for LGBTQ+ Patients: https://youtu.be/MEgQNZeYeyA 
  2. Chan C. 155 LGBT Health in Primary Care. The Curbsiders. https://thecurbsiders.com/podcast/155-lgbt-health. Published 2019. Accessed July 21, 2021.

 

Optional Assignment

  1. Health Care for Lesbians and Bisexual Women. (2012, May). Retrieved September 20, 2020, from
    https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2012/05/health-care-for-lesbians-and-bisexual-women

 

Works Cited

  1. Harleman, E., Payne, C., & Steinauer, J. (2016). Chapter 32: The Care of Lesbian, Gay, Bisexual, and Transgender Patients. In T. E. King & M. B. Wheeler (Authors), Medical management of vulnerable and underserved patients: Principles, practice, and populations (2nd ed.). New York, New York: McGraw Hill Education.
  2. Gonzales, G. Same-Sex Marriage - A Prescription for Better Health: NEJM. Retrieved September 20, 2020, from https://www.nejm.org/doi/full/10.1056/nejmp1400254