What biological, psychological, environmental, socio-cultural, behavioral, and health system factors might be contributing to the failure of LGBT to use health care services?
Anti-LGBT bias in healthcare is an issue that has continuously affected the access to care and health-seeking behavior of LGBT individuals for a long time. Homosexuality was considered as a disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM) until 1973, and it is only until 2013 that the transgender status shifted “gender identity disorder” to gender dysphoria. This lack of knowledge about LGBT resulted in the LGBT members being subjected to reparative therapies like castration or electroshock treatments in pursuit of a pathologic understanding of transgender identity and homosexuality. These experiences of poor and hostile treatment, therefore, causes many LGBT patients to conceal their gender identity or sexual orientation to their providers, yet this information is essential for proper healthcare.
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There are several health disparities that affect the members of LGBT groups, and these are mainly caused by minority stress and the lack of informed healthcare. Minority stress is the internalized homo and trans-phobia, discrimination, and stigma that LGBT individuals encounter on a daily basis. This minority stress for LGBT individuals is mostly intersected with social class, race, and ethnicity. Furthermore, LGBT individuals are twice more likely to be avid smokers and have unhealthy weight control behaviors compared to their heterosexual counterparts. Also, lesbian, gay, and bisexual individuals are more likely to experience anxiety and depression issues ("Understanding the Health Needs of LGBT People", 2016) . While social acceptance for LGBT individuals is continuously increasing, there are still issues of victimization and violence, which keep these individuals from accessing timely treatment.
For a long time, LGBT individual has had a harder time accessing healthcare compared to their heterosexual counterparts. One of the key concern is the notable differences in access to health insurance, and for LGBT females, access to a mammogram test is hard. Secondly, most LGBT groups, particularly transgender and MSM women are faced by a key concern of sexually transmitted infections. Approximately two-thirds of the people who are diagnosed with HIV in the United States annually are MSM or transgender, despite the fact that this group comprised of just two percent of the general population ("Understanding the Health Needs of LGBT People", 2016) . This disparity in HIV incidence is mainly a result of factors such as poor access to antiretroviral therapy and lack of information about the infection.
What population health nursing interventions might promote more effective use of services?
It is important to eliminate LGBT health disparities and be intentional about improving LGBT health to help these individual enjoy long and healthy lives. LGBT health information is essential because it helps reduce the transmission and progression of diseases, promotes physical and mental well-being, reduces health care costs, and fosters longevity. The first step towards promoting the effective use of health services by LGBT individuals is by creating an inclusive environment for them. LGBT patients admit that they are always on the lookout for subtle cues that determine acceptance in the environment (Krehely, 2009). These cues come in simple forms such as office practices, forms, and signage. For instance, health record forms could be adjusted to include gender identity and sexual orientation. The confidentiality and appropriate use of this information should also be guaranteed. Clinicians could also go a step further by educating themselves about LGBT health issues and also fostering a welcoming environment in their examination rooms. All in all, efforts towards promoting LGBT health and wellness goes beyond just social acceptance to deeper details of intentional support and care ("Understanding the Health Needs of LGBT People", 2016).
References
Krehely, J. (2009). How to Close the LGBT Health Disparities Gap - Center for American Progress. Retrieved from https://www.americanprogress.org/issues/lgbt/reports/2009/12/21/7048/how-to-close-the-lgbt-health-disparities-gap/
Understanding the Health Needs of LGBT People. (2016). NATIONAL LGBT HEALTH EDUCATION CENTER , 1 (1), 3-11. doi: 10.1089/lgbt.2013.0003
