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International Journal of Environmental... Nov 2021Lesbian, gay, bisexual, and transgender (LGBT) people present poorer mental and physical health results compared to the heterosexual and cisgender population. There are...
BACKGROUND
Lesbian, gay, bisexual, and transgender (LGBT) people present poorer mental and physical health results compared to the heterosexual and cisgender population. There are barriers in the healthcare system that increase these health inequities.
OBJECTIVE
To synthesise the available evidence on how nurses can intervene in reducing health inequities in LGBT people, identifying their specific health needs and describing their experiences and perceptions of the barriers they face in the healthcare system.
METHODS
Systematic review. Between March and April 2021, a bibliographic search was carried out in the Cuiden, LILACS, PubMed, Dialnet, SciELO, Trip Database, and Web of Science databases and metasearch engines.
INCLUSION CRITERIA
Articles published in the last 5 years that address the specific health needs of LGBT people, their experiences and perceptions, or interventions in this group in which nurses may engage.
RESULTS
A total of 16 articles were selected. Health disparities were detected in the LGBT community, which exhibited higher rates of mental health problems, substance abuse, risky sexual behaviours, self-harm, and suicide. These inequalities were related to minority stress, and each of them differently impacted individual populations within the broader LGBT community depending on their sexual orientations and gender identities. The impact of these factors was, in turn, modified by the intersections of race/ethnicity, geographic region, and socioeconomic factors. LGBT people described discriminatory experiences by health professionals, as well as their distrust and fear in this setting. Nurses can carry out interventions such as inclusive education about sex and sexual and gender diversity and bullying and suicide prevention programmes, and can provide gender-affirming and family-centred care.
CONCLUSIONS
LGBT people experience health inequities and discrimination in the healthcare system. Nurses can implement diverse interventions to reduce these problems and, moreover, these health professionals are obliged to acquire cultural competence regarding LGBT health.
Topics: Bisexuality; Female; Health Inequities; Homosexuality, Female; Humans; Sexual and Gender Minorities; Transgender Persons
PubMed: 34831556
DOI: 10.3390/ijerph182211801 -
Health Services Research Dec 2019To examine reported experiences of discrimination against lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults in the United States, which broadly contribute to...
OBJECTIVE
To examine reported experiences of discrimination against lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults in the United States, which broadly contribute to poor health outcomes.
DATA SOURCE AND STUDY DESIGN
Data came from a national, probability-based telephone survey of US adults, including 489 LGBTQ adults (282 non-Hispanic whites and 201 racial/ethnic minorities), conducted January-April 2017.
METHODS
We calculated the percentages of LGBTQ adults reporting experiences of discrimination in health care and several other domains related to their sexual orientation and, for transgender adults, gender identity. We report these results overall, by race/ethnicity, and among transgender adults only. We used multivariable models to estimate adjusted odds of discrimination between racial/ethnic minority and white LGBTQ respondents.
PRINCIPAL FINDINGS
Experiences of interpersonal discrimination were common for LGBTQ adults, including slurs (57 percent), microaggressions (53 percent), sexual harassment (51 percent), violence (51 percent), and harassment regarding bathroom use (34 percent). More than one in six LGBTQ adults also reported avoiding health care due to anticipated discrimination (18 percent), including 22 percent of transgender adults, while 16 percent of LGBTQ adults reported discrimination in health care encounters. LGBTQ racial/ethnic minorities had statistically significantly higher odds than whites in reporting discrimination based on their LGBTQ identity when applying for jobs, when trying to vote or participate in politics, and interacting with the legal system CONCLUSIONS: Discrimination is widely experienced by LGBTQ adults across health care and other domains, especially among racial/ethnic minorities. Policy and programmatic efforts are needed to reduce these negative experiences and their health impact on sexual and/or gender minority adults, particularly those who experience compounded forms of discrimination.
Topics: Adolescent; Adult; Female; Healthcare Disparities; Housing; Humans; Male; Sexual Harassment; Sexual and Gender Minorities; Surveys and Questionnaires; Telephone; United States; Young Adult
PubMed: 31659745
DOI: 10.1111/1475-6773.13229 -
Archives of Sexual Behavior Nov 2021The study's purpose was to describe a population of individuals who experienced gender dysphoria, chose to undergo medical and/or surgical transition and then...
The study's purpose was to describe a population of individuals who experienced gender dysphoria, chose to undergo medical and/or surgical transition and then detransitioned by discontinuing medications, having surgery to reverse the effects of transition, or both. Recruitment information with a link to an anonymous survey was shared on social media, professional listservs, and via snowball sampling. Sixty-nine percent of the 100 participants were natal female and 31.0% were natal male. Reasons for detransitioning were varied and included: experiencing discrimination (23.0%); becoming more comfortable identifying as their natal sex (60.0%); having concerns about potential medical complications from transitioning (49.0%); and coming to the view that their gender dysphoria was caused by something specific such as trauma, abuse, or a mental health condition (38.0%). Homophobia or difficulty accepting themselves as lesbian, gay, or bisexual was expressed by 23.0% as a reason for transition and subsequent detransition. The majority (55.0%) felt that they did not receive an adequate evaluation from a doctor or mental health professional before starting transition and only 24.0% of respondents informed their clinicians that they had detransitioned. There are many different reasons and experiences leading to detransition. More research is needed to understand this population, determine the prevalence of detransition as an outcome of transition, meet the medical and psychological needs of this population, and better inform the process of evaluation and counseling prior to transition.
Topics: Bisexuality; Female; Gender Dysphoria; Gender Identity; Homosexuality, Female; Humans; Male; Sexual and Gender Minorities; Surveys and Questionnaires; Transgender Persons
PubMed: 34665380
DOI: 10.1007/s10508-021-02163-w -
Current Opinion in Psychology Dec 2022This article is organised into sections that explore three key themes. The first is overarching and cuts across the literature, where within recent bisexuality research... (Review)
Review
This article is organised into sections that explore three key themes. The first is overarching and cuts across the literature, where within recent bisexuality research there has been increased inclusion of those whose identities are defined by attraction to multiple genders (e.g., pansexual, queer, and others). This has sometimes been in the form of an amalgamated bisexual+ category, but recent attention has also been given to definitions of bisexuality and pansexuality and how bisexual and pansexual identities might compare. The second theme explores mental health including substance use/abuse and sexual violence/victimisation. The third section notes that there has, to some extent, also been an interest in bipositivity and positive aspects of bisexual identification.
Topics: Female; Humans; Male; Bisexuality; Sexual and Gender Minorities; Gender Identity; Substance-Related Disorders
PubMed: 36371973
DOI: 10.1016/j.copsyc.2022.101489 -
Tijdschrift Voor Psychiatrie 2022LGBT+ (lesbian, gay, bisexual, transgender and other) youth have a higher risk to experience trauma and develop mental health problems including anxiety, depression and... (Review)
Review
BACKGROUND
LGBT+ (lesbian, gay, bisexual, transgender and other) youth have a higher risk to experience trauma and develop mental health problems including anxiety, depression and suicidality then their straight cisgender peers.
AIM
To explore underlying factors for this elevated risk. To provide insight in LGBT+ inclusive mental healthcare.
METHOD
Overview of the literature and explanatory models. Contemplation of the current youth mental healthcare and advices for clinical practice.
RESULTS
The elevated risk for mental health problems in LGBT+ youth could be explained by minority stress, trauma, social exclusion and family problems. For these young people, the current healthcare system lacks sufficient knowledge, skills, safe environment and availability of expert care. Interventions that could contribute to inclusive care are: signaling the link between mental health problems and LGBT+ identity, using inclusive language; supporting youth in exploring their own identity; ensuring safety; support coping with minority stress; an organizationscan exploring institution's environments; providing both general and expertise care.
Topics: Adolescent; Delivery of Health Care; Female; Humans; Mental Health Services; Sexual Behavior; Sexual and Gender Minorities; Transgender Persons
PubMed: 35420144
DOI: No ID Found -
International Journal of Environmental... Jul 2019Lesbian, Gay, Bisexual, Transgender, Intersex, and Queer (LGBTIQ+) people's experiences of homelessness is an under-explored area of housing and homelessness studies,... (Review)
Review
Lesbian, Gay, Bisexual, Transgender, Intersex, and Queer (LGBTIQ+) people's experiences of homelessness is an under-explored area of housing and homelessness studies, despite this group making up 20-40% of homeless populations. Despite this, much of the existing literature focuses on specific elements of LGBTIQ+ homelessness, and often does not consider the intersections of these elements, instead placing them into individual siloes. Our approach is an intersectional one; this paper identifies the key themes in the existing research, and analyses how these themes interact to reinforce the discrimination and stigma faced by LGBTIQ+ people who experience homelessness. This intersectional-systems thinking approach to LGBTIQ+ homelessness can be used to develop well-informed, culturally sensitive support programmes.
Topics: Female; Ill-Housed Persons; Humans; Male; Prejudice; Sexual and Gender Minorities; Sexuality; Social Stigma
PubMed: 31357432
DOI: 10.3390/ijerph16152677 -
American Journal of Pharmaceutical... Jul 2020An ally is defined as one who is associated with another as a helper that provides support and assistance in an ongoing struggle or effort. Pharmacists should be allies...
An ally is defined as one who is associated with another as a helper that provides support and assistance in an ongoing struggle or effort. Pharmacists should be allies to their patients by ensuring optimal health outcomes and by helping their patients achieve therapeutic objectives and goals. However, most colleges of pharmacy are currently not well equipped to train future pharmacists to counsel lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) patients. This commentary explores reasons for discrepancies in health care access for LGBTQ patients and how efforts can be advanced to meet the needs of this minority group. Pharmacists require adequate training to provide optimal care for a more diverse patient population and to be both an ally in health and a reassuring supporter for members of the LGBTQ community.
Topics: Bisexuality; Education, Pharmacy; Female; Health Services Accessibility; Humans; Male; Pharmacists; Sexual and Gender Minorities; Transgender Persons; Universities
PubMed: 32773835
DOI: 10.5688/ajpe7835 -
International Journal of Environmental... Sep 2022This article focuses on some of the social, cultural and psychological aspects of drug use in sexualized settings in gay and bisexual men (referred to as "chemsex").... (Review)
Review
This article focuses on some of the social, cultural and psychological aspects of drug use in sexualized settings in gay and bisexual men (referred to as "chemsex"). Using a narrative review approach, the article examines previous empirical research in this area and presents a novel theoretical approach for understanding and predicting chemsex behavior. Tenets of identity process theory from social psychology are drawn upon to offer an integrative theoretical framework within which the social, cultural and psychological underpinnings of chemsex can be collectively examined. Existing empirical research suggests that gay and bisexual men may experience sexuality-related stressors that can undermine feelings of self-esteem, self-efficacy, continuity and positive distinctiveness. Identity process theory examines how individuals react to threats to identity brought about by these stressors. In response to identity threat, gay and bisexual men may engage in chemsex as a coping response that encompasses and facilitates various, largely maladaptive, coping strategies and tactics. The more chemsex is perceived as enhancing identity processes and as averting identity threat, the more central it is likely to be to the identities of participants. The centrality of chemsex to one's identity may preclude self-withdrawal from the practice. Several directions for future research are presented based on existing work on chemsex viewed through the lens of identity process theory. These should form the basis of future empirical research in the sphere of sexual health among gay and bisexual men and the outcomes of this research should inform policy and practice in this area.
Topics: Bisexuality; Homosexuality, Male; Humans; Male; Sexual Behavior; Sexual Health; Sexual and Gender Minorities
PubMed: 36231424
DOI: 10.3390/ijerph191912124 -
AIDS and Behavior Aug 2022Successful use of biomedical forms of HIV risk-reduction may have predisposed many gay and bisexual men (GBM) to vaccination against COVID-19, which may, in turn, affect...
Successful use of biomedical forms of HIV risk-reduction may have predisposed many gay and bisexual men (GBM) to vaccination against COVID-19, which may, in turn, affect their sexual behavior. A total of 622 Australian GBM provided weekly data on COVID-19 vaccination history and sexual behaviour between 17 January 2021 and 22 June 2021. We identify factors associated with COVID-19 vaccination, and compare sexual behavior before and since vaccination. Mean age was 47.3 years (SD 14.0). At least one-dose vaccination coverage had reached 57.2%, and 61.3% reported that the majority of their friends intended to be vaccinated. Vaccinated men reported a mean of 1.11 (SD 2.10) weekly non-relationship sex partners before vaccination and 1.62 (SD 3.42) partners following vaccination. GBM demonstrated high confidence in COVID-19 vaccines. Their sexual activity increased following vaccination suggesting that greater sexual freedom may be a specific motivation for vaccine uptake among some men.
Topics: Australia; Bisexuality; COVID-19; COVID-19 Vaccines; HIV Infections; Homosexuality, Male; Humans; Male; Middle Aged; Sexual Behavior; Sexual Partners; Sexual and Gender Minorities
PubMed: 35132480
DOI: 10.1007/s10461-022-03611-x -
International Journal of Environmental... Nov 2021Considerable research has been undertaken regarding the mental health inequalities experienced by lesbian, gay, bisexual, transgender and intersex (LGBTI+) youth as a... (Review)
Review
Considerable research has been undertaken regarding the mental health inequalities experienced by lesbian, gay, bisexual, transgender and intersex (LGBTI+) youth as a consequence of societal and individual prejudice, stigma and discrimination. Far less research has focussed on protective factors that promote wellbeing for this population. A scoping review was conducted using a six-stage methodological framework, and is reported in accordance with the PRISMA-ScR statement. This explored the extent, range and nature of the peer-reviewed, published, academic literature on what is known about the protective factors that promote LGBTI+ youth wellbeing. Six databases were systematically searched applying Population-Concept-Context key inclusion criteria, complemented by contact with authors to identify additional sources, reference checks and hand searches. Ninety-six individual research records were identified and analysed, drawing from Honneth's Recognition Theory. Interpersonal relations with parents ( = 40), peers ( = 32) and providers ( = 22) were associated with indicators of enhanced wellbeing, as were LGBTI+ community relations ( = 32). Importantly, online ( = 10), faith ( = 10) and cultural ( = 5) communities were potentially protective. Content and thematic analysis highlighted the importance of Gay-Straight Alliances (GSAs) ( = 23) offering powerful protective opportunities through intersecting interpersonal, community and legal forms of recognition. GSAs enhance allyship by peers and providers ( = 21), facilitate access to LGBTI+ community networks ( = 11) and co-exist alongside inclusive policies ( = 12), curricular ( = 5) and extracurricular activities ( = 1). This scoping review underscores the need to move beyond the predominant focus on risk factors for LGBTI+ youth, which subsequently inform protectionist approaches. It concludes with an appeal to develop mechanisms to apply recognitive justice to policy, practice and, importantly, future research directions. This emphasises the salience of enhanced understandings of inclusion, which is rights-based, universally available and of potential benefit to all.
Topics: Adolescent; Bisexuality; Female; Homosexuality, Female; Humans; Protective Factors; Sexual and Gender Minorities; Transgender Persons
PubMed: 34770199
DOI: 10.3390/ijerph182111682