The Nation's LGBT Health Checkup

Article excerpt

Many government reports are quickly forgotten. In another era, the well-documented, but ineffectual study might gather dust on library shelves. Today, it's merely a PDF file no one bothers to download.

LGBT advocates are hoping that won't happen to "The Health of Lesbian, Gay, Bisexual and Transgender People: Building a Foundation for Better Understanding," a 348-page report published by the Institute of Medicine (IOM), an independent, nonprofit organization that investigates health issues on behalf of the National Academy of Sciences.

"This is historic," says Bradley Jacklin, public policy manager at the National Gay and Lesbian Task Force. "This is the first time the federal government has laid out a blueprint of the health challenges facing the LGBT community."

That blueprint gives LGBT health advocates and researchers a powerful, new tool.

"This is a game changer because it reframes everything from a very scientific perspective," says Robert Garofalo, MD, MPH, a Northwestern University Feinberg School of Medicine professor who served on the IOM committee. "Everything about how the IOM conducts its business speaks specifically to science. In some ways, that's exactly what this community needed."

Change is already in the works.

The U.S. Department of Health and Human Services (HHS) recently announced that it would begin collecting data on sexual orientation and gender identity within the context of national health surveys by 2013, including those conducted by The National Center for Health Statistics. The IOM report was cited as the reason for the change.

"We are taking critical steps toward ensuring the collection of useful national data on minority groups, including for the first time, LGBT populations," says Kathleen Sebelius, HHS secretary. "The data we will eventually collect in these efforts will serve as powerful tools and help us in our fight to end health disparities."

Says Garofalo, "The HHS decision should be applauded as a significant major step in the right direction."

During a lecture on the IOM report sponsored by the University of Minnesota's Program in Human Sexuality, Garofalo noted that most existing LGBT health research was done from an HIV/AIDS paradigm. When it came to the health of gay men specifically, researchers tended to focus on "diseases between the navel and the knees," he said.

Advocates hope the IOM report will prompt research on a wide range of health issues - breast cancer, obesity, smoking, alcohol consumption, depression and more - affecting LGBT communities.

"This is the first time the government has taken a comprehensive look at LGBT health issues," says Brian Moulton, chief legislative counsel at the Human Rights Campaign.

IOM findings and recommendations

A 17-member committee chaired by Robert Graham, MD, a professor of family medicine at the University of Cincinnati College of Medicine, researched and wrote the report, which included a comprehensive analysis of the existing literature.

The report listed more than a dozen key findings for LGBT people throughout the lifespan, including:

" Childhood/Adolescence

* The burden of HIV falls disproportionately on young men, particularly young black men, who have sex with men.

* LGB youth are at increased risk for suicidal ideation and attempts as well as depression. Small studies suggest the same may be true for transgender youth.

* Rates of smoking, alcohol consumption and substance use may be higher among LGB than heterosexual youth. Almost no research has examined substance use among transgender youth.

Early/Middle Adulthood

* As a group, LGB adults appear to experience more mood and anxiety disorders, more depression and an elevated risk for suicidal ideation and attempts compared with heterosexual adults. [Studies with small sample sizes suggest the same may be true for transgender adults. …