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Define and describe for lesbian, bisexual and transgender individuals.
Gender and sexuality concepts.
Social and political context.
Social determinants of health affecting lesbian, bisexual and transgender individuals.
Barriers to health care.
Health care disparities.
LGBT stands for Lesbian, Gay, Bisexual, and Transgender. The LGBTQ+ acronym includes other identities. The following is an overview of the concepts and issues faced by this community.
Sex: Refers to the biological and physiological characteristics that define male, female, and intersex bodies. These characteristics include chromosomes, hormones, and reproductive organs.
Gender Identity: An individual's internal sense of being male, female, or something else entirely. It is not necessarily the same as the sex assigned at birth.
Cisgender: A person whose gender identity aligns with their sex assigned at birth.
Transgender: A person whose gender identity differs from the sex they were assigned at birth.
Gender Expression: How a person publicly expresses or presents their gender. This can be through clothing, hairstyle, voice, or behavior.
Sexual Orientation: A person's romantic, emotional, and/or physical attraction to others.
Lesbian: A woman who is primarily attracted to other women.
Bisexual: A person who is attracted to both men and women.
Gay: A man who is primarily attracted to other men.
The social and political landscape for LGBTQ+ individuals has evolved significantly. In many Western countries, there has been a push for equal rights, including marriage equality, non-discrimination laws, and hate crime legislation. The Obergefell v. Hodges Supreme Court case in 2015 legalized same-sex marriage nationwide in the United States. However, political debates continue over issues such as transgender rights, particularly regarding access to healthcare, bathrooms, and participation in sports.
Despite progress, LGBTQ+ individuals still face significant stigma, discrimination, and violence in many parts of the world. In some countries, being gay or transgender is still criminalized, with punishments including imprisonment or even death.
Social determinants of health (SDOH) are the conditions in the environments where people are born, live, learn, work, and age that affect a wide range of health and quality-of-life outcomes. For LGBTQ+ individuals, these include:
Economic Stability: Higher rates of unemployment and poverty due to discrimination in hiring and unequal pay.
Education Access: Harassment and bullying in schools can lead to poor academic performance and higher dropout rates.
Healthcare Access and Quality: Lack of insurance, fear of discrimination from healthcare providers, and a lack of culturally competent care.
Neighborhood and Built Environment: Living in communities with higher rates of violence, lack of safe housing, and social isolation.
Social and Community Context: Experiences of family rejection, stigma, and social isolation lead to mental health issues like depression and suicide.
LGBTQ+ individuals often face unique barriers to accessing healthcare:
Lack of Culturally Competent Providers: Many healthcare professionals lack adequate training on the specific health needs of this community, leading to misdiagnosis or inappropriate care.
Stigma and Discrimination: Patients may fear judgment or discrimination from medical staff, causing them to postpone or avoid seeking care.
Lack of Insurance and Financial Barriers: Due to employment discrimination and poverty, LGBTQ+ individuals may have higher rates of being uninsured.
Negative Past Experiences: Previous negative encounters with healthcare providers, such as being misgendered or having their identity dismissed, can create a lasting distrust of the medical system.
These barriers contribute to significant healthcare disparities:
Mental Health: Higher rates of depression, anxiety, substance abuse, and suicidal ideation, often stemming from discrimination and social stigma.
HIV/AIDS: Gay and bisexual men, and transgender women, are disproportionately affected by HIV/AIDS.
Cancer: Lesbians and bisexual women have higher rates of obesity, which increases the risk of certain cancers. Additionally, they are less likely to receive routine screenings like mammograms and Pap smears due to healthcare barriers.
Substance Abuse: Higher rates of smoking, alcohol, and drug use compared to the general population.
Chronic Diseases: Transgender individuals may face unique health challenges related to hormone therapy, such as increased risk of blood clots or cardiovascular issues, which require specialized medical monitoring.