Promoting the Health of Gender and Sexual Minorities _ ____________________________________________
The fourth crosscultural communication skill area requires acknowledging that mistakes will be made [156]. Heterosexual bias is not the fault of the individual healthcare professional, so expect to make honest mistakes. Some GSM individuals have children, so assuming, during conversation, that someone with children is not gay could lead to a communication mistake [87]. Communication with adolescents should focus on developing rapport. When discussing the subject of sexual orientation, teens feel more comfortable if the healthcare professional uses a non-confrontational, casual approach [65]. When communicating with older GSM individuals, remember that diverse views exist related to disclosure of their sexual orientation. Providing a comfortable clinical environment, one that visually demonstrates awareness of the LGBTQIA community, will assist with the decision to self-disclose. As a result, the opportunity for more complete health data collec- tion is possible so that unique health and safety needs may be identified and addressed. Learning communication recovery skills will help the health- care professional accomplish more positive outcomes when providing healthcare or health consultation [156]. Recovery skills include apologizing for an error, focusing on another health need until rapport is re-established, or reversing roles and asking the patient to help you with a problem or informa- tion need [156]. For example, if a patient seems offended by something you have asked or said, simply apologize and offer a brief explanation about why the information is necessary to provide good care. Explain, if you can, why the mistake was made. Perhaps you did not have the awareness you needed. Later, if appropriate, you can ask about another health need (e.g., immunizations) and work toward re-establishing rapport. Learn from the mistake. Remember, it may take time for the LGBTQIA person to trust. Most errors will be forgiven if recovery efforts are made with sincerity. Like all cultures, the gay subculture is dynamic. Many changes have and are taking place within the subculture and within the general population’s attitudes toward the subculture. Ongoing education is necessary to remain culturally competent. CONCLUSION The GSM population is a diverse subculture, representing men and women of all ages and all socioeconomic, ethnic, educational, and religious backgrounds. The population has been described as “hidden and invisible,” “marginalized,” and “stigmatized.” As a result, the unique health and safety needs of the population have often been overlooked or ignored. Healthcare professionals have been seeking more information about this population’s health promotion and care needs. More research about the subculture’s characteristics, physical and mental health promotion needs, and strategies to address these needs has been requested.
It has been suggested that the available sexual identity models are “fast becoming antiquated” and that they lack explanation for the multifactorial nature of human development [162]. There must be continued effort toward identifying “normal” developmental issues and tasks for the GSM individual. Unique issues related to identity development and mainte- nance, career development, race/ethnicity/social class, coping with antigay violence, AIDS, same-sex coupling, and parenting also require further clarification and validation [147]. Both nurses and physicians have indicated that they need more knowledge and skills to meet the needs of LGBTQIA adoles- cents [65]. For example, a survey of pediatricians indicated a need and desire for further training related to the health of sexual minority youth [163]. The American Psychological Association and the National Association of School Psychologists have advocated fund- ing and support efforts for applied research and scientific evaluations of interventions and programs that are designed to address the issues of lesbian, gay, and bisexual youth in the schools [164]. In 2012, the National Institutes of Health announced a funding opportunity for extensive research into LGBTQIA health, including research related to cancer risk, depression, suicide, obesity, long-term hormone use, substance use/abuse, and HIV/AIDS and STIs [165]. Together, the National Institute of Child Health and Human Development, the National Institute of Mental Health, and the National Institute of Child Abuse have called for grant applications for the study of behavioral, social, mental health, and substance abuse research in the sexual minority communities [164]. The American Public Health Association has identified the need for public health research on gender identity and sexual orientation [12]. AMA Policy H-160.991 indicates that more research is needed to provide improved care to the GSM popu- lation [13]. The Department of Health and Human Services has worked to include subpopulations of women, including lesbian women, in research trials [30]. Other examples exist, but few studies have examined the experiences of older lesbian, gay, and bisexual adults [166]. There are serious challenges to designing research that results in accurate data. From the discipline of counseling, use of the four crosscultural communication skill areas provides a framework for identifying strategies that a healthcare provider may use to promote culturally competent care for the GSM community. Just as learning about other cultures requires ongoing education as the cultures change over time, learning about the gay subculture also requires continuous education as more information becomes available.
WORKS CITED https://qr2.mobi/sx-minorities
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MDDC1026
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