LGBT health disparities Health equity

sexuality basis of health discrimination , inequity throughout world. homosexual, bisexual, transgender, , gender-variant populations around world experience range of health problems related sexuality , gender identity, of complicated further limited research.

in spite of recent advances, lgbt populations in china, india, , chile continue face significant discrimination , barriers care. world health organization (who) recognizes there inadequate research data effects of lgbt discrimination on morbidity , mortality rates in patient population. in addition, retrospective epidemiological studies on lgbt populations difficult conduct result of practice sexual orientation not noted on death certificates. has proposed more research lgbt patient population needed  for improved understanding of  unique health needs , barriers accessing care.

recognizing need lgbt healthcare research, director of national institute on minority health , health disparities (nimhd) @ u.s. department of health , human services designated sexual , gender minorities (sgms) health disparity population nih research in october 2016. purposes of designation, director defines sgm encompass[ing] lesbian, gay, bisexual, , transgender populations, sexual orientation, gender identity , expressions, or reproductive development varies traditional, societal, cultural, or physiological norms . designation has prioritized research extent, cause, , potential mitigation of health disparities among sgm populations within larger lgbt community.

while many aspects of lgbt health disparities heretofore uninvestigated, @ stage, known 1 of main forms of healthcare discrimination  lgbt individuals face discrimination healthcare workers or institutions themselves. systematic literature review of publications in english , portuguese 2004–2014 demonstrate significant difficulties in accessing care secondary discrimination , homophobia healthcare professionals. discrimination can take form of verbal abuse, disrespectful conduct, refusal of care, withholding of health information,  inadequate treatment, , outright violence. in study analyzing quality of healthcare south african men have sex men (msm), researchers interviewed cohort of individuals health experiences, finding msm identified homosexual felt access healthcare limited due inability find clinics employing healthcare workers did not discriminate against sexuality. reportedly faced homophobic verbal harassment healthcare workers when presenting sti treatment . further, msm did not feel comfortable disclosing sexual activity healthcare workers failed identify homosexuals, limited quality of treatment received.

additionally, members of lgbt community contend health care disparities due, in part, lack of provider training , awareness of population’s healthcare needs. studies regarding patient-provider communication in lgbt patient community show providers report significant lack of awareness regarding health issues lgbt-identifying patients face. component of fact, medical schools not focus attention on lgbt health issues in curriculum; lgbt-related topics discussed tend limited hiv/aids, sexual orientation, , gender identity.

among lgbt-identifying individuals, transgender individuals face significant barriers treatment. many countries still not have legal recognition of transgender or non-binary gender individuals leading placement in mis-gendered hospital wards , medical discrimination. seventeen european states mandate sterilization of individuals seek recognition of gender identity diverges birth gender. in addition many of same barriers rest of lgbt community, bulletin points out globally, transgender individuals face higher disease burden. 2010 survey of transgender , gender-variant people in united states revealed transgender individuals faced significant level of discrimination. survey indicated 19% of individuals experienced healthcare worker refusing care because of gender, 28% faced harassment healthcare worker, 2% encountered violence, , 50% saw doctor not able or qualified provide transgender-sensitive care. in kuwait, there have been reports of transgender individuals being reported legal authorities medical professionals, preventing safe access care. updated version of u.s. survey 2015 showed little change in terms of healthcare experiences transgender , gender variant individuals. updated survey revealed 23% of individuals reported not seeking necessary medical care out of fear of discrimination, , 33% of individuals had been doctor within year of taking survey reported negative encounters medical professionals related transgender status.

the stigmatization represented particularly in transgender population  creates health disparity lgbt individuals regard mental health. lgbt community @ increased risk psychosocial distress, mental health complications, suicidality, homelessness, , substance abuse, complicated access-based under-utilization or fear of health services. transgender , gender-variant individuals have been found experience higher rates of mental health disparity lgb individuals. according 2015 u.s. transgender survey, example, 39% of respondents reported serious psychological distress, compared 5% of general population.

these mental health facts informed history of anti-lgbt bias in health care. diagnostic , statistical manual of mental disorders (dsm) listed homosexuality disorder until 1973; transgender status listed disorder until 2012. amended in 2013 dsm-5 when gender identity disorder replaced gender dysphoria , reflecting identifying transgender not pathological , diagnosis instead distress transgender person may experience result of discordance between assigned gender , gender identity.

lgbt health issues have received disproportionately low levels of medical research, leading difficulties in assessing appropriate strategies lgbt treatment. instance, review of medical literature regarding lgbt patients revealed there significant gaps in medical understanding of cervical cancer in lesbian , bisexual individuals unclear whether prevalence in community result of probability or other preventable cause. incorrectly assumed lgbt women have lower incidence of cervical cancer heterosexual counterparts, resulting in lower rates of screening.  such findings illustrate need continued research focused on circumstances , needs of lgbt individuals , inclusion in policy frameworks of sexual orientation , gender identity social determinants of health.