HIV+ (Human immunodeficiency virus positive): Having tested positive for a viral infection that affects CD4 cells, transmitted by contact with blood and body fluids infected with HIV. 84 LGBTQ: Lesbian, gay, bisexual, transgender, queer (also may include additional Q for questioning).
Youth have higher rates of homelessness, suicide, and mental health issues than their heterosexual peers. Many avoid or delay care or receive inappropriate or inferior care because of perceived or real homophobia, biphobia, transphobia, and discrimination by health care providers and institutions. Fear of and experiences with discrimination and stigma influence the decision whether to seek healthcare. Insurance coverage, cost, and lack of knowledgeable and experienced providers can cause a delay in seeking care. Health care providers can take meaningful, positive steps to promote the health of their LGBTQ patients by examining their practices, offices, policies and staff training for ways to improve access to quality health care for LGBTQ people and by following the recommendations made in this activity. This course discussed methods to create a welcoming environment with a focus on primary care. Healthcare professionals can still identify ways to create a more inclusive environment and address instances of outright bias observed or encountered. Change is reliant on the identification of a situation in need of a different outcome. References 1. Centers for Disease Control and Prevention: LGBT youth. 2017. Accessed February 6, 2022. https://www.cdc.gov/lgbthealth/youth. htm 2. Kates J, Ranji U, Beamesderfer A, Salganicoff A, Dawson L. Health and access to care and coverage for lesbian, gay, bisexual, and transgender (LGBTQ) individuals in the U.S. Kaiser Family Foundation (KFF). May 3, 2018. Accessed February 6, 2022. https:// www.kff.org/racial-equity-and-health-policy/ issue-brief/health-and-access-to-care-and- coverage-for-lesbian-gay-bisexual-and- transgender-individuals-in-the-u-s/ 3. Human Rights Campaign. (n.d). Glossary of terms. https://www.hrc.org/es/resources/ glossary-of-terms 4. American Psychological Association. Guidelines for psychological practice with transgender and gender nonconforming people. Am Psychol. 2015;70(9):832-864. doi:10.1037/ a0039906 5. Hembree WC, Cohen-Kettenis PT, Gooren L, et al. Endocrine treatment of gender- dysphoric/gender-incongruent persons: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2017;102(11):3869- 3903. doi:10.1210/jc.2017-01658 6. McNamara MC, Ng H. Best practices in LGBT care: a guide for primary care physicians. Cleve Clin J Med. 2016;83(7):531-541. doi:10.3949/ccjm.83a.15148 7. Drescher J. (2015). Out of DSM: depathologizing homosexuality. Behav Sci (Basel, Switzerland). 2015;5(4), 565-575. doi:10.3390/bs5040565 8. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. American Psychiatric Association; 2013.
9. Holzberg JL, Ellis R, Virgile M, et al. Assessing the feasibility of asking about gender identity in the current population survey: results from focus groups with members of the transgender population. Research and Methodology Directorate, Center for Survey Measurement Study Series (Survey Methodology #2018-05). U.S. Census Bureau. 2018. Accessed February 6, 2022. https://www.census.gov/content/dam/ Census/library/working-papers/2018/adrm/ rsm2018-05.pdf 10. Wang HL. 2020 census will ask about same-sex relationships. NPR. March 30, 2018. https:// www.npr.org/2018/03/30/598192154/2020- census-will-ask-about-same-sex-relationships 11. Lang N. The census’s sex question sucks. But LGBTQ people should still fill it out. 2020. https://www.vice.com/en/article/jgxev7/ census-LGBTQ-people-should-still-fill-out 12. Gallup; Jones JM. LGBT identification rises to 5.6% in latest U.S. estimate. February, 24, 2021. https://news.gallup.com/poll/329708/ lgbt-identification-rises-latest-estimate.aspx 13. Cannon SM, Shukla V, Vanderbilt AA. Addressing the healthcare needs of older lesbian, gay, bisexual, and transgender patients in medical school curricula: a call to action. Med Educ Online. 2017;22(1). doi:10.1080/10872981 .2017.1320933 14. Hoy-Ellis CP, Fredriksen-Goldsen KI. Depression among transgender older adults: general and minority stress. Am J Community Psychol. 2017;59(3-4):295-305. doi:10.1002/ ajcp.12138 15. Aisner AJ, Zappas M, Marks A. Primary care for lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) patients. J Nurse Pract. 2020;16(4)281-285. doi:10.1016/j. nurpra.2019.12.011 16. Dorsen C, Van Devanter N. Open arms, conflicted hearts: nurse-practitioner’s attitudes towards working with lesbian, gay, and bisexual patients. J Clin Nurs. 2016; 25(23-24):3716-3727. doi:10.1111/ jocn.13464 17. Sekoni AO, Gale NK, Magna-Atangana B, Bhadhuri A, Jolly K. The effects of educational curricula and training on LGBT-specific health issues for healthcare students and professionals: a mixed-method systematic review. J Int AIDS Soc. 2017; 20(1): 21624. doi:10.7448/IAS.20.1.21624 18. McNair RP, Hegarty K. Guidelines for the primary care of lesbian, gay, and bisexual people: a systematic review. Ann Fam Med. 2010;8(6): 533-541. doi:10.1370/afm.1173 19. Mead DR, Dana RC, Carson CA. The primary care approach to lesbian, gay, bisexual, transgender, and queer/questioning populations. Consultant 360. 2017;57(2). https://www.consultant360.com/articles/ primary-care-approach-lesbian-gay- bisexual-transgender-and-queerquestioning- populations?page=2
MSM: Men who have sex with men.
Non-binary (“NB” or “enby”): a person who does not identify with gender binary of male or female. 85 Pansexual: Person who is emotionally, physically, romantically, and/or sexually attracted to people regardless of those people’s gender identity. Queer: Individuals with non-normative gender identity, sexual orientation, or sexual anatomy (a term that has been used as a slur). Sex assigned at birth: Determined by physical genital anatomy. Sexual minority: “Those who identify as lesbian, gay, bisexual, or transgender or reported same-sex attraction.” 50 Transgender: Term for those whose gender identity does not match that assigned to their physical sex; may or may not use hormones or have had gender confirmation surgery. 86 Transman FtM/F2M: Transgender person who lives as a male but was assigned female gender at birth. 87 Transwoman MtF/M2F: Transgender person who lives today as a female but was assigned male gender at birth. 87 Transition: The period of time during which a person begins to live according to their gender identity. This time frame varies by individual and may or may not include changes in clothing, appearance, identification, hormone therapy, and gender confirmation surgery. 87
WSW : Women who have sex with women.
Ze: Non-gender pronoun used instead of “she” or “he”; ze (subject), hir (object), hirs (possessive pronoun), hirself (reflexive). Pronounced zee. 88 Conclusion As summarized in this learning activity, LGBTQ patients, in addition to having the same basic health needs as the general population, experience health disparities and barriers related to sexual orientation and/or gender identity or expression. LGBTQ health disparities exist throughout all age groups.
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