IOM Tackles Disparities in LGBT Health Care
Lesney, Mark S., Clinical Psychiatry News
Lesbian, gay, bisexual, and trans-gender individuals face disparities in health care and health status, compared with their heterosexual counterparts, caused in part by social stigmatization and exacerbated by limited data and research on the unique medical needs of the LGBT community, according to a report released by the Institute of Medicine.
The report, "The Health of Lesbian, Gay Bisexual, and Transgender People: Building a Foundation for Better Understanding," was requested by the National Institutes of Health. It was designed to assess current knowledge of the health status of the LGBT population, to identify research gaps and opportunities, and to propose specific research goals for NIH to implement in future.
The authors proposed seven specific recommendations, with the long-term goal of improving the status of health care in the LGBT community:
* NIH should implement a research agenda designed to advance knowledge of LGBT health.
* Data on sexual orientation and gender identity should be collected in federally funded surveys administered by the Department of Health and Human Services and other relevant federally funded surveys.
* Data on sexual orientation and gender identity should be collected in electronic health records.
* NIH should support the development and standardization of sexual orientation and gender identity measures.
* NIH should support methodological research relating to LGBT health issues.
* A comprehensive research training approach should be created to strengthen LGBT health research at NIH.
* NIH should encourage grant applicants to explicitly address the inclusion or exclusion of sexual and gender minorities in their samples.
To back up these recommendations, the report detailed the broad historical and current difficulties faced by the LGBT community with regard to health care, citing small studies and anecdotal evidence of specific known issues for different age groups.
In childhood and adolescence, "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," according to the report. In addition, rates of smoking, alcohol consumption, and substance abuse may be higher among LGB youth, and the homeless youth population comprises a disproportionate number of LGB youth and transgender women. There are also increased levels of violence, victimization, and harassment reported by LGBT youth, compared with heterosexual and non-gender-variant youth.
Importantly, "the burden of HIV falls disproportionately on young men, particularly young black men who have sex with men."
These issues were found to continue throughout the lifetimes of LGBT individuals. …