A Prescription for Healthcare Equality

I want to add here that the additional health risks that LGBT people face are correlated directly to adverse experiences in childhood; exposure to family and social rejection, hostility, neglect, bullying, and discrimination, which often precipitates the use of alcohol, drugs, tobacco, and overeating in any person subjected to these stressors in early development, when more adaptive coping strategies to deal with those traumas are not yet available to the young. The stress alone affects the immune system, independent of any substance abuse issues, and if substance abuse does develop it compounds an already at risk health situation for many of us. These stresses and risk factors are deeply intertwined, so LGBT people are too often playing "catch up" in preserving our health and well being in a hostile world. This is not to be confused with being somehow innately "defective", it is merely the inevitable outcome of severe, and often relentless trauma so many of us experience.

Treatment for a medical condition is not different, based on the gender identity or sexual orientation of the patient. But, the social support team may be different, the trust in the provider may be lower, the feeling of safety in bringing one's whole self into the treatment room can be compromised. Lower health insurance rates and previous negative experiences with the healthcare system have kept us from having feeling safe, coming out, and, more importantly, keeping up with regular check ups and cancer screenings. Surely the LGBT body is not physiologically different, but the stress of living as sexual and gender minorities has led to behaviors that compromise our health. Higher rates of tobacco use, alcohol us and abuse, higher rates of HPV, etc, contribute to our health disparities. For more information about the latest research on all of these issues, see the new Institute of Medicine Report on LGBT health, http://www.iom.edu/~/media/Files/Report%20Files/2011/The-Health-of-Lesbian-Gay-Bisexual-and-Transgender-People/LGBT%20Health%202011%20Report%20Brief.pdf

Actually LGBT people do have multiple additional risk factors for stress related illnesses and the complications from our population wide increased use of alcohol, tobacco, and drugs from an early age on into adulthood. That places us as a whole at greater risk for cancer, pulmonary disease, and other stress induced conditions from an early age. Individual LGBT people may not smoke, abuse alcohol, drugs, food, etc, but as a whole we need to raise provider awareness of these increased risk factors. Just as not every Black person has sickle cell, not every LGBT person has these conditions, but medical providers need to be educated about heightened risk associated with different populations, as well as to be sensitive to the fears of discrimination that prevent LGBT people from even attempting to access health care. This is about providing culturally competent medical care, and providers must be educated.

Agreed. Mental health care is certainly a different beast, but in terms of physical health care, there really shouldn't be any difference between hetero and homo. An STD is an STD, doesn't matter who has it. The only thing that needs to be addressed is administrative procceedures. This article is more divisive than helpful, it makes it seem like we need special rules, when in reality all we need is to be treated the same as others.

I think we need to be careful about pushing the idea that LGBT folks somehow have different health care needs. Take HIV and STDs for example; in my case I'm 45 and have had just three sexual partners in my life. I've been in a committed relationship for the last 5 years. My risk for HIV and STDs is actually lower than for most straight people; but because I'm gay it would be easy to assume a risk is there when it isn't. The most relevant information when evaluating risk for HIV and STDs is sexual history, not sexual orientation. Having said that, giving healthcare workers information on the "language" of our community and on alternatives to the "traditional" family that they may encounter would definitely be a positive thing.