This article has been written by Abraham T. Philip pursuing a Remote freelancing and profile building program from Skill Arbitrage.

This article has been edited and published by Shashwat Kaushik.

Introduction

In layperson’s language, LGBTQ+ stands for Lesbian, Gay, Bisexual, Transgender, and Queer (or Questioning). The “+” represents an inclusive term for other sexual orientations, gender identities, and expressions. They comprise people of all races, ethnic and religious backgrounds, and socioeconomic backgrounds. The term LGBTQ+ is a way to encompass various identities and experiences related to sexual orientation and gender diversity.

Before 1973, most shunned medical care due to the taboo attached to their sexual inclinations. Healthcare has changed a lot for them post-1973. However, there is still a lot of room for improvement. With each passing day, the inclusivity of various gender groups has increased with the mainstream ones. The lines of disparity in medical care for such former marginalised communities seem to blur away with time.

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Understanding LGBTQ+ identities

To grasp the needs of LGBTQ+ populations, we must first define sexual orientation and gender identity. Sexual orientation refers to how someone describes their emotional and sexual attraction to others. Think of it in three parts: behaviour (what they do), attraction (what they feel), and identity (how they label themselves). These aspects don’t always align; for example, someone may engage in same-sex behaviour but not identify as gay.

Recent studies in the U.S. found that less than half of those who had same-sex experiences identified as gay, lesbian, or bisexual. This means you can’t assume someone’s identity based on their behaviour or vice versa. Health professionals need to be aware of this, understanding that behaviour doesn’t necessarily reveal someone’s identity, and identity doesn’t always predict behaviour.

The unique health challenges of LGBTQ+ health disparities

Varying levels of health disparities have always existed between the LGBTQ+ community and the heterosexual, cisgender community. The class of people referred to as Cisgenders are people whose gender matches their assigned sex at birth. Health issues related to body weight, body image, and obesity have always concerned the LGBTQ+ community.

As per the National Library of Medicine, 40% of LGBT youth experience homelessness. To add to their woes, they are most vulnerable to physical or sexual abuse, STDs, and mental health issues.

Substance abuse

The incidence of alcohol misuse is very high in the LGBTQ+ community. Men who are into drugs and who have sex with men often fall victim to sexually transmitted diseases. The targeted marketing campaigns by Tobacco Companies have significantly increased its consumption among LGBTQ+ communities. A National Survey on Drug Use and Health undertaken in 2020 stated that one’s sexual orientation is a causative factor in determining how people use substances. In 2020, adults aged 18 constituted 41.3% of people who reported using marijuana in the past year. The user percentage is much higher compared to the overall adult population, where only 18.7% reported marijuana use.

Misused prescription opioids or heroin in 2020 among sexual minority adults constituted 6.7%. In contrast, only 3.6% of the general adult population reported the same. Likewise, about 21.8% of sexual minority adults had an alcohol use disorder in the past year. This is higher than the overall population, where 11.0% reported facing alcohol use disorders.

Mental health challenges

“Minority stress,” stemming from negative experiences, contributes to mental health issues. They include suicidal thoughts, depression, and anxiety. LGBTQ+ youth facing bullying and victimisation also experience mental health disparities.

As per data from the National Longitudinal Study of Adolescent Health, sexual minority youth remain disconnected from social networks. This resulting estrangement compounds the risk of depressive symptoms among sexual minority males. Likewise, bisexual males and females exhibit similar depressive symptoms as their heterosexual counterparts.

Lack of awareness among healthcare providers

The medical community worldwide has traditionally neglected the health concerns of LGBTQ+ communities. Glaring medical disparities in treating such sidelined communities have come to light. Complementary, integrative health providers like chiropractors, naturopaths, acupuncturists, and massage therapists top the list of such medical defaulters.

Fast forward to this day, what are the advances in LGBTQ+ healthcare?

The United Nations calls upon the nations of the world to end violence and marginalisation practiced against sideline sections of society based on their sexual orientations. International human rights remains the watchdog to ensure human rights are assured without distinction to every person. Nevertheless, millions of LGBTQ+ individuals worldwide still have to battle human rights violations. The failure of the international human rights machinery to uphold the dignity of the LGBTQ+ community is a cause for alarm and action. The thought of assimilating the LGBTQ+ community will become a reality only when community religious and political leaders, workers’ organisations, the private sector, health providers, civil society organizations and the media play an active role.

How do you find a professional who’s LGBTQIA+ friendly

Diversity training is a must for doctors, as a lack of it will lead to adverse outcomes while treating the LGBTQ+ community. Until recently, there was complete apathy in medical circles when it came to addressing the medical concerns of such people. 

It would be great if older medical professionals, too, came forward to update themselves with diversity training. Tips on finding healthcare professionals in the U.S. who are LGBTQIA+ friendly:

Local LGBTQ centres and clinics- One can find LGBTQ-friendly clinics like Callen-Lorde Centre in New York City and the Whitman Walker Clinic in Washington, D.C.

Google Maps- While searching for a similar place on Google Maps, enter keywords like “clinic near me + LGBTQIA” or similar search terms.

Medical associations for gays and lesbians- You can find medical professionals who are welcome to the idea of treating the community in a directory issued by the Gay and Lesbian Medical Association (GLMA).

A health education centre to help medical professionals know more about the LGBTQ+community- Are you a healthcare professional interested in opening doors to the LGBTQ+ community? The National LGBTQIA+ Health Education Centre can be of great help. It has surplus resources for LGBTQIA+ folks. You will find many webinars, hotlines and an exhaustive list of health initiatives.

CentreLink LGBT Community Centre Member Directory- It is a database where you can discover the closest community centre, regardless of your global location. Just enter your nearest location and find your nearest community to call them for healthcare recommendations.

Planned Parenthood- It is a giant online repository of sexual and reproductive health information dedicated to LGBTQIA+ patients. The platform also has a dedicated chatbot, Roo, which people of any sexual orientation can access.

The Trevor Project- The Trevor Project invests in crisis intervention and suicide prevention services for youth in LGBTQIA+ communities. Their goal is to provide mental health support. The project is also helpful in enabling people to access other resources that meet their private health needs.

One medical- Based in Arizona, it is a national primary care provider. The facility offers practitioners who are experts in LGBTQIA+ health issues. They cover everything from allergies and asthma to STI testing and skin infections. Regarding sensitive STI screenings, One Medical offers screening through their on-site labs.  The best part is that they don’t insist on an office visit for STI screening. Patients are allowed to opt for video calls that offer more comfort and privacy.

Out2Enroll- Out2Enroll is on a mission to align people who are LGBTQIA+ or similar with health insurance coverage options. It involves benefits like gender-affirming care. It mainly focuses on Affordable Care Act plans. Still, it has links to local organisations that can lend financial and insurance-related advice.

World Professional Association for Transgender Health- It is an online directory aimed at helping transgender people come into contact with similar people and affirming professionals.

National LGBT Chamber of Commerce- The National LGBT Chamber of Commerce (NGLCC) identifies and certifies businesses as LGBTQIA-friendly. It also categorises ventures owned and operated by LGBTQIA+ individuals nationwide. Click on the Affiliate Chambers tab after entering your details to find a healthcare professional in almost every state. The site also hosts resources on local healthcare providers, neonatal concerns, adoption, gender-affirming surgery and more.

Access to gender-affirming care

Gender-affirming care encompasses a wide range of medical and social interventions designed to support and affirm a person’s gender identity. It recognises that gender identity is a complex and multifaceted aspect of human experience and that for transgender individuals, their gender identity may not align with the sex assigned to them at birth. Gender-affirming care aims to address the physical, psychological, and social challenges faced by transgender individuals by providing a safe and supportive environment in which they can explore and express their gender identity authentically.

Essential components of gender-affirming care include:

  • Hormone therapy: Hormone therapy involves the administration of hormones such as estrogen, testosterone, or other medications that align with the person’s gender identity. Hormone therapy can significantly alleviate gender dysphoria, a psychological distress caused by the incongruence between one’s gender identity and physical sex characteristics.
  • Gender-reassignment surgeries: Gender-reassignment surgeries are medical procedures that alter a person’s physical sex characteristics to match their gender identity. These surgeries may include procedures such as chest reconstruction, facial feminization surgery, or phalloplasty. Gender-reassignment surgeries can significantly improve a person’s physical well-being and reduce gender dysphoria.
  • Legal name and gender marker changes: Legal name and gender marker changes are essential components of gender-affirming care as they recognise and affirm a person’s gender identity in legal documents. These changes allow transgender individuals to align their official documentation with their gender identity, reducing the risk of discrimination and facilitating access to services such as healthcare, employment, and education.

Access to gender-affirming care has been shown to significantly improve the mental and physical well-being of transgender individuals. Studies have demonstrated that gender-affirming care reduces symptoms of depression, anxiety, and suicidal ideation. It also enhances self-esteem, body image, and overall quality of life.

Moreover, gender-affirming care can have a positive impact on transgender individuals’ social well-being. It fosters greater acceptance and inclusion within families, communities, and society at large. By recognising and affirming transgender individuals’ gender identities, gender-affirming care promotes a more inclusive and equitable world for all.

Advocacy and policy changes

Advocating for LGBTQ+ healthcare rights is essential to addressing the systemic barriers that prevent members of this community from accessing quality and equitable healthcare. Policy changes are urgently needed to dismantle these barriers and ensure that LGBTQ+ individuals have the same rights and opportunities as everyone else.

One critical step is to enact anti-discrimination laws that protect LGBTQ+ people from being denied healthcare services based on their sexual orientation or gender identity. These laws would provide legal recourse for individuals who face discrimination and help to create a more welcoming and inclusive healthcare environment.

Another critical step is to ensure that insurance coverage includes gender-affirming care, such as hormone therapy, gender-affirming surgery, and other treatments that can improve the physical and mental health of transgender and gender non-conforming individuals. Gender-affirming care is essential for the well-being of transgender people, and denying coverage for these treatments is a form of discrimination.

LGBTQ+ organisations play a vital role in raising awareness about the healthcare needs of LGBTQ+ people and advocating for healthcare equality. These organisations provide support and resources for LGBTQ+ individuals, conduct research on LGBTQ+ health issues, and work to educate healthcare professionals about the unique needs of LGBTQ+ patients. Their efforts are essential to creating a more just and equitable healthcare system for all.

In addition to policy changes and the work of LGBTQ+ organisations, there are several other things that can be done to improve healthcare for LGBTQ+ people. Healthcare providers need to be educated about the unique health needs of LGBTQ+ patients and how to provide culturally competent care. LGBTQ+ individuals also need to be aware of their rights and have access to information about healthcare providers who are LGBTQ+-friendly.

By working together, we can create a healthcare system that is inclusive and welcoming for all LGBTQ+ people.

Anti-discrimination laws for the LGBTQ community are essential to protect individuals from being treated unfairly or denied opportunities based on their sexual orientation or gender identity. These laws promote equality and ensure that all members of society are treated with respect and dignity.

Here are some of the key components of anti-discrimination laws for the LGBTQ community:

  • Employment: LGBTQ individuals must be protected from discrimination in hiring, firing, promotion, and other employment-related decisions.
  • Housing: LGBTQ individuals must be able to rent or buy housing without being discriminated against based on their sexual orientation or gender identity.
  • Public accommodations: LGBTQ individuals must be able to access public accommodations, such as restaurants, hotels, and transportation, without being discriminated against.
  • Credit: LGBTQ individuals must be able to obtain credit on the same terms as others, without being discriminated against based on their sexual orientation or gender identity.
  • Government services: LGBTQ individuals must be able to access government services, such as healthcare, education, and social security, without being discriminated against.

Anti-discrimination laws for the LGBTQ community are important for a number of reasons. First, they help to create a more just and equitable society for all. Second, they promote economic growth by ensuring that LGBTQ individuals can fully participate in the workforce. Third, they improve public health by reducing the stigma and discrimination that LGBTQ individuals often face.

Conclusion

The LGBTQ+ community has come a long way, making strides in healthcare and gaining social acknowledgement. Despite the progress made to date, there is still a lot of scope for targeted interventions to keep reducing mental health and substance abuse disparities. While international advocacy emphasises human rights at the helm of affairs, violations still exist and have not been stemmed out. So, training the doctors to cater to such a community is paramount. Alongside, the resources invested will educate the masses on planned parenthood Trevor Project roles.

Moving forward, there is a clarion call to embrace diversity to create a healthcare landscape where people with varying sexual orientations or gender identities feel respected and understood. People with sexual inclinations are usually secretive about their sexual tastes unless they meet someone who behaves similarly. They are typically not open to declaring it openly for fear of attracting societal disdain. They need to be helped out of their default cocoons by mainstream society, which identifies them as strictly males or females. 

The onus is not to prove whether such inclinations are right or wrong. So, while differences of opinion remain, making such folks equal recipients of all the benefits regular society enjoys is imperative.

References

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