LGBT Research and Why It's Lacking

In LGBT health, research is currently being conducted, but there is still research lacking in some areas.  There is currently research being done to determine the healthcare needs of the LGBT community.  Healthy People 2020 (2012) states, “Research suggests that LGBT individuals face health disparities linked to societal stigma, discrimination, and denial of their civil and human rights.”  It has been shown LGBT persons have high rates of psychiatric disorders, substance abuse, and suicide.  There is significant research showing the increased prevalence of sexually transmitted diseases, including HIV/AIDS and sexually transmitted infections.  We know that sexual minorities are more likely to have breast cancer, hepatitis A, B, and C, stress related conditions, obesity and homelessness. 

While research has helped reveal the need for LGBT healthcare, more research is needed.  While it has been shown that there are increased risks for diseases such as breast cancer and obesity, little is known about the reasons these are prevalent.  More research is needed to determine why the LGBT community faces greater prevalence of substance abuse, alcoholism, and smoking.  There is a lack of research about LGBT health improvement thus far including improvement of access to health and mental services, support services, and status of disease transmission and progression (Healthy People, 2012).

            Research in LGBT health is lacking for many reasons.  Information is often hard to come by due to poor access and many sexual minorities prefer to be private.  There is a lack of interest in gaining information about LGBT health and statistics.  Much of the research done has shown that there is a higher prevalence of diseases and different health needs than the general public.  The research is generally stopped there, without access to reasons for these differences.  

Healthy People 2020. (2012). 2020 Topics and objectives: Lesbian, Gay, Bisexual, and Transgender 

      Health. Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020  

      /overview.aspx?topicid=25

Mayer, K. H., Bekker, L. G., Stall, R., Grulich, A. E., Colfax, G., & Lama, J. R. (2012). Comprehensive 

      clinical care for men who have sex with men: an integrated approach. Lancet, 380(9839), 

      378-387.

Current LGBT Research

        While I was looking into what research is currently being conducted to assist in the healthcare of the LGBT community I stumbled upon a great website called ThinkProgress.org which has all kinds of articles relating to LGBT news and health.  I was very inspired by how many fresh looks they had related to LGBT health and news. Two of the articles I found were particularly interesting included updating sex education, and new information on HIV treatments. 

            The first article, titled “Kindergartners Shouldn’t Be Taught Sex Ed, and Other Myths Endangering America’s Youth” was a discussion on the debate of how Chicago public schools have begun implementing teaching sex-ed to kindergartners. This education would initially focus on basic anatomy, reproduction, healthy relationships, and personal safety. Some argue that 5 year olds are much too young to be even considering such “adult” topics, while others insist that teaching children about their reproductive health at an early age will help them be more comfortable with their sexuality later in life.

            The next article was incredibly uplifting and explained that research has shown by treating patients who are newly diagnosed with HIV early and aggressively, there have been patients who are “functionally cured” of their infections.  This impressively includes that ten of the fourteen men and women studied haven’t needed to take any HIV drugs for anywhere from 4-6 years. This finding has been encouraging for researchers in treating, finding a cure for, and even as far as vaccination possibilities for HIV/AIDs, which has affected too many individuals in the LGBT community for far too long. 

Culp-Ressler, T. (2013).  Think Progress. Retrieved from http://thinkprogress.org/health/issue/

Healthcare Professionals Must Advocate for LGBT Patients

The Institute of Medicine has highlighted specific healthcare concerns that greatly affect the health of LGBT members. The following is a list of healthcare areas that have been reported to be most prevalent and problematic. It has been reported that homosexual populations have higher rates of cardiovascular disease and obesity, an increased risk of lung, ovarian, endometrial, cervical, breast, and stomach cancer, and higher rates of mental health problems (O’Hanlan et al., 2004). Due to the increased risk factors for heart disease and multiple types of cancers, researcher efforts are geared towards the development of culturally competent risk reduction strategies to eliminate heath disparities and equalities among the LGBT population.

The Department of Health and Human Services has developed and summarized a list of health challenges faced by homosexual individuals. Many of these problems are related to the access of preventive service such as Pap smears for lesbians. Research has found that some physicians have incorrectly informed lesbians that they do not require a Pap smear because they are in a low risk category (O’Hanlan et al., 2004). This situation depicts the cause of health disparities due to the lack of knowledge and sensitivity of the LGBT population.

As a healthcare professional and advocate, one must demonstrate competent care for all patients regardless of their cultural beliefs, sexual orientation, and ethical values. To advocate and provide equal care for the LGBT population, healthcare professionals must know how to competently care for the needs of these patients. The article Lesbian, Gay, Bisexual, and Transgender Health: Is Nursing Still in The Closet?, stated that to break the silence regarding the proper care for LGBT patients, scholarly disclosure must be addressed in the classroom and curriculum of nursing schools, in research, and at the bedside (Lim & Levitt, 2011). For example, nursing school curricula lack focus on the LGBT population. The implementation of case studies and clinical scenarios geared towards the LBGT population problems will increase the competency and equality of care delivered by healthcare professional. To practice competently as a health professional it is imperative that nursing educators, researchers, and registered nurses have to ability and understanding how to address and provide the appropriate care for the health needs of these patients. To remain faithful to the profession’s mission, healthcare professionals must take a proactive approach to addressing the needs and safety of LGBT patients (Lim & Levitt, 2011).

Policies and standards must change within the institution to end the discrimination against homosexuality and inequality of all LGBT patients. Policy statements should note and reinforce that it is against the professional code of ethics to deny lesbians insemination or obstetrical services and to deny adoption to individuals based on sexual orientation. It is not only important to readdress these standards with the employees, but also ensure all patients and visitors of the hospital or clinic are aware of these policies. A printed sample of the policy may be posted in patient rooms, waiting rooms, or hallways to reinforce the institutions nondiscrimination approach to providing equal care to all patients (O’Hanlan et al., 2004).

O’Hanlan, K., Dibble, S., Hagan, H, & Davids, R. (2004). Advocacy for women’s health should include lesbian 

          health. Journal of Women’s Health, 13(2), 227-234.

Lim, F., & Levitt, N. (2011). Lesbian, gay, bisexual, and transgender health. American Journal of Nursing,  

          111(11), 11. 

Republican and Democratic Views

As of the recent election, we know that the LGBT community was highly involved in their issues and also the supporting population that walk beside them. The LGBT community, with evidence from the past recent presidential elections, mostly relate vote for the democratic party. In 2000, democratic candidate won 70% of the LGBT votes, a significant amount. In 2004, John Kerry also won 70% of their vote and in 2008 Obama surpassed both with winning 77% of the LGBT community. These statistics show that this population primarily identify more with the Democratic party rather than Republican.

The three primary issues have been gay marriage, civil unions and equal rights, and the repeal of the "don't ask, don't tell," policy of the military. The democratic party repealed the policy of "don't ask, don't tell" from the military, so they believed that the sexual orientation of a person should not effect your right to serve your country. The republicans continue to oppose same-sex marriage, taking away a basic human right of marriage. The democratic party is more supportive toward LGBT issues, hence why the populations vote goes mostly towards the democratic stance.

These issues such as marriage effect the health aspect because issues such as end of life termination, require a decision from a partner that you are legally married to. With this being said, those partners in those situations do not get that same benefit for important decision-making.
The LGBT community is becoming more proactive and dominant in getting their voice across to the political parties continuously. The LGBT community and their support system continue to strive for their issues to come through and get approved.

BSB


Valelly, R. (2012, March 08). Lgbt politics and american political development . Retrieved from http://www.annualreviews.org/doi/full/10.1146/annurev-polisci-061709-104806

Gupta, V., & Smith, R. (2010). Issue brief- lgbt voting behavior. Retrieved from http://academiccommons.columbia.edu/catalog/ac:137497

Suggested Research and Gaps in Data

Many gaps exist in the current research done on LGBT health. According to a report released by the Institute of Medicine and the National Institute of health, there is a lack of research regarding the health issues affecting these individuals. It claims that more research needs to be done regarding social influences, differing needs of different generations of LGBT individuals and barriers to quality health care. The report claims that because of this lack of research, health care providers are not well educated on the issues affecting LGBT health. They do not know what questions to ask regarding sexual behavior, gender identity, and mental health. This information matters so that the health care provider can make proper referrals, evaluate support at home and with peers, and provide adequate mental and health care. With further research, better health care can be provided for these individuals and policy makers can fund preventative programs which may be needed for these individuals.

One barrier to further research is many members of the LGBT community not wanting to come forth and openly identify themselves as lesbian, gay, bisexual, or transgender and do not want to discuss health issues, sexual behavior, and mental health problems. Another barrier is a political push to get questions regarding LGBT health on federally funded surveys.  Although federally funded surveys ask questions about similar populations, so far it has not included LGBT research questions and would be considered a big step in the advancement of LGBT health outcomes and disparities if one day included.

 LGBT youth are at an increased risk for depression and suicide, and are frequently targets of bullying, discrimination and violence. It has also been shown that the gay population is at an increased for HIV, especially African American males. Many national health organizations are calling for further research regarding these topics. Mental health issues, as well as sexual behavior which may lead to health problems such as STD’s or HIV need to be further analyzed. Although research regarding the LGBT community is lacking, we are making advancements and hoping to one day better understand the health needs affecting these individuals.

ACM

LGBT Community 'Largely Ignored' By Health Research. (2011, June 1). Breaking   
            News and Opinion on The Huffington Post. Retrieved February 27, 2013,  
            from http://www.huffingtonpost.com/2011/04/01/doctors-lgbt-
            health_n_843275.html

LGBT inqualities need to be HISTORY

Soon after the civil rights movement to outlaw racial discrimination, the push to acknowledge gay rights surfaced in the public eye. The riot occurring at Stonewall Inn, initiated the turning point for gay liberation. During the gay liberation movement in the 1970’s many political groups and national organizations formed, including the National Organization for Women. In addition, the National Gay and Lesbian Task Force and the Human Rights Campaign expanded the acceptance of LGBT populations through political actions. Later in the 1980’s, gay rights protest and marches took place to bring awareness of inequality and support gay rights. It wasn't until the end of the 21^st century until same-sex civil unions were recognized, along with the acceptance of same-sex marriages among certain states, with Massachusetts being the first.

The federal government first acknowledged health issues of the LGBT population in the 2000. The Coalition was made up of 65 organizations who advocated for the need to include LGBT health issues in Healthy People 2010 objectives. The goals of the LGBT Coalition were as followed; to increase knowledge regarding LGBT health status and access to utilization of health care, to increase LGBT participation in the formation of public and private sector policy regarding health and related issues, to increase availability of, access to, and quality of physical, mental, and behavioral health and related service for the LGBT population, to increase professional and cultural competencies of providers and other engaged in health and social service delivery to the LGBT population, and finally to eliminate disparities in health outcomes of LGBT populations. With increased recognition of addressing the needs of the LGBT populations, the coalition successfully brought awareness regarding the means of equality for all populations. The LGBT Coalition has worked side by side with the Presidential Transition Team to discuss guidelines and policies to ensure the inclusion of LGBT concerns at all levels of the health care reform process.

Though LBGT populations and communities have gained more acceptance and support than ever before many issues regarding equal rights among these populations still exist. When focusing on health, a widespread of issues occurs due to the lack of LGBT sensitive and competent treatment providers. The LGBT Coalition is currently working with the U.S. Government of Health and Human Services to develop a curriculum to train staff and healthcare professional how to practice with cultural competency when working with the LGBT community. Actions and initiations, such as this must be taken to end the existence of LGBT inequalities. 

KDO

D. Mason, J. Leavitt, & M. Chaffee. (2012) Policy & politics in nursing and health care. St. Louis, MO: Elsevier Inc. 

R. Metha. (2012). The lesbian and gay movement and the state: Comparative insights into transformed relationship. American Sociological Association, 41(6), 828-829.

Intro to LGBT Health

Lesbian, Gay, Bisexual, and Transgender (LGBT) individuals exist in every community.  They encompass every race, culture, socioeconomic class, and age. We now know that the LGBT community face health disparities.  These are related to social stigma, differences in access to healthcare, discrimination, lack of knowledge, and denial of their rights.  We have also found with recent studies that LGBT persons have different healthcare needs, often related to psychiatric disorders (depression, substance abuse, and increased suicide rates) and differences in sexual behaviors.  The inequalities with LGBT individuals are associated with poorer health status.  With these findings, The National Coalition for LGBT Health was formed to focus on and advocate for clinical care and health needs of the LGBT community within the federal government in 2000.  This coalition was able to bring to light the needs of the LGBT community to Healthy People 2010, the nations 10 year health plan.  There is now an ongoing focus on these health needs in the new Healthy People 2020.  Being a new major focus in healthcare, the country was not far behind in making many advances for the LGBT community.  There are still, however, many adversities that continue to need changed. 

SMF

Healthy People 2020. (2012). 2020 Topics and objectives: Lesbian, Gay, Bisexual, and Transgender Health. Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=25

Center for Disease Control and Prevention. (2012). Lesbian, Gay, Bisexual, and Transgender Health: About LGBT Health. Retrieved from http://www.cdc.gov/lgbthealth/about.htm