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Customized, Comprehensive Care for the LGBTQ+ Community Contributed by Erik Stanley Haugland, MD
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n recent years the healthcare industry has done an increasingly better job of creating strong, effective experiences for diverse population segments. However, many challenges still remain when it comes to providing primary care for individuals within the LGBTQ+ population. LGBTQ+ individuals often face a host of social and economic barriers that keep them from seeking primary care and obtaining important health screenings. These barriers can range from a lack of consistent insurance coverage, to higher rates of unemployment, to less cultural competence among providers, to outright bias and discrimination. Concerning Statistics Regarding the Health of the LGBTQ+ Population
Data compiled by the US Office of Disease Prevention and Health Promotion provides some startling facts concerning the health of LGBTQ+ individuals such as: • The LGBTQ+ population has the highest rate of tobacco use in the US. • Transgender individuals are much less likely to have health insurance. • Lesbians and bisexual females are more likely to be overweight or obese. These factors and a host of others contribute to poor health outcomes for many LGBTQ+ individuals, including higher rates of heart disease, diabetes, STDs including HIV/AIDS and substance abuse. The current pandemic is also causing greater health issues for senior members of this population. Recent studies from the Human Rights Campaign Foundation 16
September/October 2020
place for comprehensive health care. So, they are required to visit separate specialty gender clinics to ensure they get all the care they need. This can make receiving quality care more problematic given their unique health needs. The Importance of Primary Care
and Sage report that older LGBTQ+ adults are particularly vulnerable to becoming seriously ill from COVID-19. To explain the reasons for this greater risk, experts have pointed to additional stressors for the LGBTQ+ population that can lead to chronic conditions later in life, including a much higher rate of tobacco use, as noted earlier. In addition to experiencing more risk in terms of their physical health, the LGBTQ+ population also faces a higher rate of mental health issues. Older LGBTQ+ individuals are often isolated and more fearful of stigma, while LGBTQ+ youths contemplate suicide at three times the rate of their peers, according to the CDC. This is particularly frightening given that suicide is often reported as the second or third leading cause of death among young people in the US. For transgender customers, health care can be even more complex. Most transgender individuals do not have one
The LGBTQ+ community tends to avoid primary care, as they often feel stigmatized and don’t want to experience uncomfortable conversations. And yet as they face higher rates of tobacco use, high blood pressure, obesity and other chronic conditions, it is arguably even more important for LGBTQ+ individuals to have access to a primary care provider for overall health assessments and to recommend routine screenings. In addition, those doctors need to understand the unique needs and additional guidelines for preventative health for the LGBTQ+ population including: • Men who have sex with men (MSM) within this population have a risk of anal cancer that is 80 times that of their heterosexual peers. As a result, they may need to have routine anal pap smears every one to three years. • Transgender women may need more routine cancer screenings and could require both a prostate check and a mammogram on a regular basis. • Testosterone treatments may cause higher levels of cholesterol, hypertension and coronary artery disease, indicating a need for more routine screenings. • Estrogen treatments increase the risk of high cholesterol and cardiovascular
MetroDoctors
The Journal of the Twin Cities Medical Society
