Sex, Lies and Healthcare- LGBTQ Healthcare Issues

One would think it’s 2013, the 21^st Century, people are more tolerant (yea right, just look at what’s going on in the political arena right now) and accept that LGBTQ folks just like you, me and the remaining 10% of the population, would not have issues when accessing healthcare, and that our specific healthcare needs would be addressed by our healthcare providers.

Sex – it is incredible how many of the average healthcare providers out there never broach topics of sex with their patients because of their lack of knowledge regarding their patients sexual orientation, ignorance on specific LGBTQ healthcare issues, patient fears that their provider is homophobic or the provider just never asks!

Lies– if someone fears that their provider is homophobic or does not feel comfortable with them then “we” the patient often omit vital health information and don’t tell our providers the entire story, the result: we get sub-standard care or no care and could have very serious medical conditions overlooked. The healthcare provider may also be ignorant and just lie to themselves that they are “not homophobic” or they are “tolerant” when in fact they are quite the opposite and are intolerant and judgmental, resulting in patient suffering and receiving substandard care.

Healthcare- In order for us to get the BEST healthcare available we MUST be selective in choosing our providers, make sure they are tolerant, accepting and non homophobic and judgmental, and that they are familiar with healthcare issues faced by our LGBTQ community. You are your best advocate when it comes to your health so you must feel absolutely comfortable with your provider so that you can tell him or her everything possible about you to maximize the best outcome. This includes discussion about your sexual orientation and sexual practices.

It is very difficult for some doctors to discuss sex with their patients- gay or straight, so make sure your doctor doesn’t have a problem discussing these issues.  About two thirds of physicians never ask their patients about their sexual orientation, some just assume everyone is heterosexual (go figure!), and if they are homophobic they just prefer to avoid the questioning all together. The lack of openness by the provider ultimately affects your outcome!

Here is a list of some of the Health Risks facing our community, risks that our providers must be aware of!

Depression and Suicide

All of us are aware of the long road we still have to travel for tolerance and acceptance of who we are in our communities and places of worship. The Rev Ed Bacon from All saints Episcopal Church in Pasadena said it best last October when he said “Being gay is a Gift from God”.

What is so sad is that so many religious leaders don’t have the same philosophy of love, compassion and inclusion, but instead hate, bigotry, fear and judgment, resulting in so many LGBTQ individuals struggling to come to terms with who they are, experiencing depression and oftentimes resulting in suicide.

Suicide is the leading cause of death for teenagers and LGBTQ youth account for 30 percent of completed suicides. Forty percent of LGBTQ youth have either attempted or seriously contemplated suicide. Gay men are six times more likely to attempt suicide than heterosexual men and lesbians are twice as likely to attempt suicide than are heterosexual women.

These stats are terrifying and reflect the society that we all live in. Every time I see an article (and it’s way way too often) of another gay teen that succumbed to bullying and the pain and torment at the hands of others, where their only way out is suicide….. it makes me weep. If society won’t protect our kids then we as a community must, and organizations like The Trevor Project , Matthew Shepard Foundation and It Get’s Better Project MUST be supported and heralded, and must be able to continue their great work and provide education and resources for communities and healthcare providers so that a teen NEVER commits suicide again.

Substance Abuse

Drug and alcohol use are also health issues within our community. Many LGBTQ individuals feel alienated, isolated and oppressed, and turn to alcohol or other drugs to try find solace.

Drugs of choice are marijuana, “poppers”, barbiturates, methamphetamine, as well as use of prescription medications with these drugs such as Viagra, Norvir and Truvada (T).

Thirty five percent of gay men and about forty three percent of lesbians report smoking cigarettes, which is much higher than their heterosexual counterparts at twenty seven percent for men and twenty two percent for women. Cigarette smoking has been linked to many diseases such as cancer, COPD, Heart disease, emphysema, diabetes and many more. Healthcare providers must discuss substance use, with their LGBTQ patients.

Antigay Violence

Many states still have laws on their books where it is legal to discriminate against an employee, by firing them, or refusing to hire them based solely on their sexual orientation. Most states do not include sexual orientation under hate crime laws. As a result many individuals are subject to antigay violence and harassment.

Health care professionals should create a safe, nonjudgmental environment for battered patients—such as posting sticker-notices to indicate safe zones for the lesbian, gay, bisexual, and transgender population—and take an active role in stopping the perpetration of antigay sentiment among colleagues. In addition, professionals should be aware of community support systems within schools and workplaces.

LGBTQ Youth

We have already discussed the high rate of depression and suicide amongst our LGBTQ youth. More than ninety five percent of LGBTQ youth feel separated and isolated from their peers because they feel different. Almost half are bullied either verbally or physically, and as a result drop out of school out of fear and despair or end up committing suicide.

There is also a high rate of substance abuse with LGBTQ youth, as well as homelessness, antigay violence and prostitution.

Lesbian Health

Many lesbians and healthcare providers think that lesbians are not at risk for cervical cancer and many have never had a PAP smear, this is not so. Lesbians are at risk for cervical cancer, as well as breast cancer, endometrial cancer and sexually transmitted diseases such as HIV, and Hepatitis C. Health care providers MUST be aware of this and women need to be able to feel comfortable to share their sexual orientation with their doctors.

Health care professionals should take a detailed sexual history, including the number and sex of previous partners, specific activities engaged in, and the use of preventive measures such as condoms, gloves, and dental dams. Practitioners should educate their lesbian and bisexual female patients on the risks of sexually transmitted diseases and the proper use of protective barriers.

Gay Male Health

Gay men have higher risks of eating disorders, sexually transmitted diseases such as HIV, Hepatitis C, Gonorrhea and Syphilis, as well as increased risk for anal cancer.

Risk factors for the development of anal cancer are a history of anal-receptive intercourse; history of genital warts; herpes simplex virus, type 2, infection; hepatitis B virus infection; history of chlamydial infection; and being a current smoker.

Transgender Health

Transgender individuals face even more challenges and discrimination than do gay, lesbian and bisexual individuals, and are at even greater risk for depression and suicide, substance abuse and antigay violence.

Transgender individuals may wish to undergo gender reassignment surgery, hormone treatments and healthcare providers treating their patient MUST be aware of the issues and how to treat their patients with respect, compassion and good medical care.

Our community has unique healthcare issues and our healthcare providers MUST be familiar with these issues. If you are not comfortable with your doctor and you feel you are not getting the care you need, you are probably right, so find a new doctor who understands you, your needs and who you feel comfortable with!