LGBT+Health

Numerous topics in medicine are pertinent to lesbian, gay, bisexual, and transgender individuals. Apart from HIV/AIDS, the US Gay and Lesbian Medical Association (GLMA) reports that LGBT health issues include breast and cervical cancer, mental health, hepatitis, substance use disorders, alcohol use, tobacco use, depression, access to care for transgender people, marriage and family recognition issues, conversion therapy, refusal clause legislation, and laws intended to “immunise health care professionals from liability for discrimination.”

LGBT individuals may encounter challenges to healthcare access due to their sexual orientation and/or gender identity or expression.

Many avoid or delay care, or receive insufficient or substandard care, as a result of perceived or actual homophobia or transphobia and discrimination by healthcare providers and institutions; in other words, negative personal experience, the assumption or expectation of negative personal experience based on knowledge of other LGBT people’s history of such experience, or both.

Issues affecting LGBT people generally

• According to a review of published data, there are no significant differences in major health concerns between LGBT individuals and the overall population, while LGBT people typically tend to have lower health, with no information on common and serious diseases, malignancies, or long-term health. 
• LGBT people appear to have lower mental health than the overall population, with depression, anxiety, and suicidal ideation being 2–3 times as prevalent. 
• There appear to be higher rates of eating disorders and self-harm, but similar rates of obesity and domestic violence in comparison to the general population; lack of exercise and smoking appear to be more prevalent, and drug use appears to be more prevalent, while alcohol consumption is comparable to the general population. 
• Lesbians were shown to have higher polycystic ovaries and infertility than heterosexual women. 
• The research identifies significant barriers between LGB patients and health professionals, with homophobia, assumptions of heterosexuality, a lack of knowledge, misunderstanding, and over-caution being suggested as possible causes; institutional barriers were also identified as a result of assumed heterosexuality, inappropriate referrals, a lack of patient confidentiality, discontinuity of care, the absence of LGBT-specific healthcare, and a lack of relevant psychosexual training. 
• Around 30% of all completed suicides were caused by a sexual identity dilemma. The Students who are identified as, bisexual, homosexual, transgender or lesbian report being five times more likely to miss school due to feelings of insecurity following bullying for their sexual orientation.

Mental Health

Transgender advocates Rebecca Allison asserts that transgender persons are; “They are disproportionately susceptible” to depression and anxiety: “In addition to the loss of family and friends, they suffer job stress and the possibility of unemployment. Transgender individuals who have not transitioned and continue to identify as their biological gender are extremely susceptible to sadness and anxiety. Suicide is a possibility both during and after the transition. The management of sadness and/or anxiety is a critical element of the transgender therapy interaction.” 

Depression is highly associated with discrimination encountered. Sixty-two per cent of trans women in San Francisco reported experiencing despair, according to a survey. In a 2003 study of 1093 trans men and women, 44.1 per cent reported having clinical depression and 33.2 per cent reported having anxiety.

Suicide attempts are not uncommon among transgender individuals. Majority of the transgender people have attempted suicide at least once. 41% of respondents to the National Transgender Discrimination Survey admitted to making a suicide attempt. This figure was much higher among specific populations – 56% of American Indian and Alaskan Native transgender respondents, for example, had tried suicide. 

By comparison, 1.6 per cent of the American population has made a suicide attempt. All minority ethnic groups (Asian, Latino, black, American Indian, and mixed-race) had a greater suicide attempt rate than white people in the sample. Suicide attempts were also shown to be associated with life difficulties – 64% of those surveyed who had been sexually assaulted attempted suicide. 76 per cent of those assaulted by teachers or other school personnel attempted to flee.

The Trans Mental Health Study was undertaken by the Scottish Transgender Alliance in 2012. 74% of respondents who had transitioned reported an improvement in their mental health following their transition. 53% had self-harmed at some point in their lives, and 11% are presently self-harming. 55% had been diagnosed with depression or were currently being treated for it. Additionally, 33% said they were currently depressed or had been depressed in the past but had not been diagnosed. 5% were now or previously diagnosed with an eating disorder. 19% said they had suffered from or were now suffering from an eating disorder but had not been diagnosed. 84 per cent of the sample had considered suicide and 48 per cent had attempted suicide. 3% had made more than ten suicide attempts. 63 per cent of those who transitioned reported having fewer thoughts about and attempts at suicide following their transition. Other research has discovered comparable outcomes.

Trans women appear to be at a larger risk of suicide than trans men and the general population. However, trans men are more likely than trans women to attempt suicide.

Transgender people frequently suffer from personality issues.

LGBT health and social support networks

Social support networks, friends, and family have a significant impact on LGBT health outcomes. Gay-Straight Alliances (GSAs) are one type of support network that is now available to certain LGBT adolescents. GSAs are clubs that aim to improve the climate for LGBT youth at their schools and educate students and staff about LGBT issues. 

To explore the effects of GSAs on LGBT adolescents, 149 college-aged students who self-identified as LGBT completed a survey assessing the climate in their high school for LGBT youth, as well as their current health and alcohol use results. When participants with a GSA at their high school (GSA+ youth) were compared to those without a GSA, they reported greater feelings of belonging, less at-school victimisation due to their sexual orientation, more favourable outcomes related to their alcohol use behaviours, and more favourable outcomes related to depression and general psychological distress (GSA- youth). Among other confounding characteristics, the large majority of schools with a GSA were located in urban and suburban regions, which are generally safer and more welcoming to LGBT persons.

Additionally, family and social support networks are associated with the mental health trajectory of LGBT youth. Family rejection following a youth’s “coming out” might have negative health consequences. Indeed, LGBT youth who faced family rejection were 8.4 times likelier to attempt suicide, 5.9 times likelier to have increased levels of despair, and 3.4 times likelier to use illegal substances than LGBT youth who received family acceptance. Family rejection can occasionally drive adolescents to flee or be kicked out of their homes, which contributes to the high rate of homelessness among LGBT youth. In consequence, homelessness is associated with a variety of negative health effects, which are frequently the result of homeless LGBT teens’ increased rates of prostitution and survival sex.

Conclusion

Every community has members who are lesbian, gay, bisexual, or transgender (LGBT). They are diverse, come from all walks of life, and consist of people of all races and ethnic origins, all ages, all socioeconomic positions, and from all regions of the United States. LGBT people’s viewpoints and needs should be consistently acknowledged in public health efforts to enhance general health and eradicate inequities in health.

Along with taking LGBT people’s needs into account when developing programmes to promote the health of entire communities, there is a need for culturally competent medical care and prevention services tailored to this demographic. Social inequality is frequently related to ill health, and sexual orientation has been linked to a variety of health risks. When compared to their straight contemporaries, members of the LGBT community face an elevated risk of a variety of health problems. While some of these discrepancies are due to differences in sexual behaviour, others are due to societal and structural injustices, such as the shame and prejudice faced by LGBT communities.