The Healthcare System and the LGBTQ+ Community
By: Kiara Sahi, Contributing Writer.
Edited by: Fauzia Haque, Editor; Eve Nevelos, Editor in Chief
The LGBTQ+ community has been discriminated against in almost every aspect of their lives. Giving this community the support and safety they need is pertinent, so that they do not stand alone and can fight against bigotry and bias in the workplace, educational institutions, social circles, or at home. This encourages the freedom to express their authentic identities and also helps in making this world a kinder place.
Access to safe and reliable healthcare, as well as inclusive, scientifically accurate, and exhaustive healthcare data is a basic human right and must be provided to all. The LGTBQ+ community needs a steady and strong healthcare system to fall back on, one that they can trust and approach without fear of mistreatment. This is why understanding the healthcare needs of this community, inclusivity, proper representation in health surveys and hospital forms, training of healthcare providers pertaining to the community, and the delivery of appropriate healthcare to this community is the need of the hour.
Increased health risks faced by the LGBTQ+ community, and inconclusive data.
As per The Center for Disease Control and Prevention’s HIV Surveillance Report 2014, male-to-male sexual contact accounted for 70% of HIV infections. Another study also reported that men who engage in sexual intercourse with men are 44 times more likely to be diagnosed with HIV than heterosexual men. HIV is also prevalent among the transgender population. In addition to this, gay men are at an increased risk of prostate, testicular, colon, and anal cancer, while lesbian and bisexual women are at an increased risk of ovarian, breast, and endometrial cancers. Gay men also run a higher risk of contracting an STD, such as hepatitis or syphilis. Many members of the LGBTQ+ community deal with anxiety, depression, and suicidal thoughts due to peer victimization, sexual abuse, verbal and physical harassment, and struggles with family acceptance (NCBI). According to The Center for Disease Control and Prevention, 48% of students belonging to the LGBTQ+ community considered suicide, 33% were bullied, and 22% were coerced into sexual intercourse.
While the aforementioned statistics are the results of previous study, the healthcare data on the LGBTQ+ community is not sufficient. This can be attributed to two factors. The first being the lack of appropriate criteria relating to sexual orientation and gender identity in national health surveys. For instance, inconclusive data regarding cancer incidence and mortality among the LGTBQ+ community is chiefly due to the lack of appropriate questions unique to the LGBTQ+ population in cancer registries (NCBI). The second being the hesitancy of members of the LGBTQ+ community to approach health care providers. This particular factor is the root cause of delayed medical diagnosis and intervention.
Negative encounters with health care providers and fear of mistreatment.
Proper healthcare and suitable treatment can only be provided to a patient if there is a clear, two-way path of communication between the health care provider and the patient. It is also an absolute necessity that the patient feels comfortable and safe. The majority of the LGBTQ+ youth, however, is apprehensive about disclosing information regarding gender identity and sexual orientation to their health care providers. A study conducted in Washington DC revealed that 68% of youth belonging to a sexual minority group did not discuss their sexual orientation with their health care providers, while 90% had second thoughts about disclosing their sexual orientations to their clinicians. Another study used purposive sampling to select nine women, belonging to a sexual minority student group between the ages of 18 and 24 years. Upon interviewing them, it was made clear that the disclosure of their sexual orientations and the attitudes of their healthcare providers were significant factors that caused negative encounters with the healthcare system and healthcare providers (NCBI). According to a study that examined the experiences of young adults belonging to the LGBTQ+ community with disclosure and nondisclosure of their gender identity and sexual orientation to health care providers, the patients that did disclose their LGBTQ+ identity experienced discriminatory behaviour and attempts at invalidation as well as affirming and respectable behaviour from their health care providers (NIH).
Training healthcare providers and delivery of appropriate treatment: cultural competence.
Various steps can be taken by the healthcare system to form a solid backbone for the healthcare needs of the LGBTQ+ community. Cultural competence is an integrated system of education and training and is an essential program that must be executed in all healthcare institutions. Cultural competence includes education regarding the use of gender-neutral language and the several health disparities experienced by the LGBTQ+ community, promoting inquiries of the patient’s gender identity and sexual orientation directly instead of making otherwise harmful assumptions. It also encourages the healthcare institutions to create an LGBTQ+ friendly environment, among the staff as well as with patients. To gather conclusive healthcare data regarding the LGBTQ+ population, health surveys must make an effort to include all the necessary criteria pertaining to sexual orientation and gender identity (NCBI).
The LGBTQ+ community is a diverse and unique community that deserves proper representation. With something as crucial as proper healthcare, there must be no room for error, and this healthcare system must work to deem itself fit for every human being, no matter their race, ethnicity, sexual orientation, or gender identity.
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