Tag Archives: Lesbian Health Care

LGBT Rights Activists Welcome NHS Questioning Of Patients Over Sexuality

This week, it was announced that UK doctors will now ask patients about their sexual orientation.

In England, NHS patients will be asked about their sexuality under new guidelines designed to ensure lesbian, gay and bisexual (LGB) people aren’t discriminated against.

The new guidelines, which are expected to be implemented across England by 2019, recommend that doctors, nurses and other health professionals ask about sexual orientation during “every face to face contact with the patient, where no record of this data already exists.”

People who identity as LGB can face different health risks from people who identify as heterosexual.

According to the LGBT Foundation, it’s thought that LGB people are at significantly higher risk of mental health problems, suicidal thoughts and deliberate self-harm than heterosexual people.

Patients are free to decline to answer, and in these cases their sexuality will be listed as ‘Not Stated’.

An NHS spokesperson explained;

All health bodies and local authorities with responsibility for adult social care are required under the Equality Act to ensure that no patient is discriminated against. This information standard is designed to help NHS bodies be compliant with the law by collecting, only where relevant, personal details of patients such as race, sex and sexual orientation. They do not have to do it in every area, people do not have to answer the questions and it will have no impact on the care they receive.”

The new guidelines have been welcomed by LGBT charity Stonewall, who also urged NHS England to extend them to trans and non-binary patients.

We have been calling for sexual orientation to be considered as other protected characteristics for over a decade. This move will also help health services gather evidence on and understand the needs of LGB people. We’d also like to see NHS England introduce similar gender identity monitoring for trans and non-binary patients where appropriate. We look forward to working with NHS England on these issues in the future.”

America’s Healthcare System Is Discriminatory Against Queer Women, Experts Warn

A leading doctor has expressed concern for queer women seeking health care in the USA.

According to a new report, queer women have higher rates of substance abuse, psychological disorders and suicide attempts than heterosexual women, studies show.

Experts with the Mayo Clinic say these statistics are clearly connected to access to care for queer women and how they are treated.

They are also less likely to receive imperative treatments such as cervical cancer screenings and mammograms.

The research authors say that queer women would have better healthcare if clinicians were more accepting towards them and if they had better access to insurance.

Some ways to improve healthcare for queer women is to not assume a patient is heterosexual during their first appointment and to regularly assess anxiety, depression and substance abuse.

The essay focused on middle age queer women and what stressors they deal with in terms of their healthcare.

Dr Jordan E. Rullo and Dr Stephanie S. Faubion wrote in their essay:

Clinicians who have an understanding of lesbian women and their unique stressors, who provide a welcoming and inclusive environment, and who provide cross-cultural care are well positioned to reduce healthcare stigma and improve clinical outcomes.”

The authors said that LGBT people have health and sexual relationship patterns like those in the general population but ‘have higher rates of substance use, psychological disorders, and suicide attempts than their heterosexual counterparts.’

Queer women have a higher chance of smoking and obesity than heterosexual women, according to new studies the authors analyzed.

The authors also found that queer women are less likely to have had a recent mammogram or been screened for cervical cancer.

Dr. Lori R. Muskat, a psychology professor at Argosy University in Atlanta who was not an author on the opinion piece, said:

This paper is particularly important regarding lesbians who are now in middle age. Most of these women grew up and ‘came out’ when being a lesbian was even more taboo than it is now.”

Muskat also believes ‘culturally literate’ clinicians are more likely to offer an environment that is ’emotionally safer’ for middle-aged lesbians, ‘resulting in a freer reporting of symptoms and concerns.’

Dr Valerie Fein-Zachary of Beth Israel Deaconess Medical Center in Boston, also not an author on the paper, said:

By learning about the specific health issues of lesbian, bisexual and transgender women, we as providers can better counsel them – including about screening exams for breast, cervical/ovarian or prostate cancer, depending on their individual needs; and about risk-reduction strategies.”

She also suggests asking patients if they feel safe at home, at work, and in the community.

She identified several barriers to care:

Lack of access to insurance, lack of knowledgeable providers, lack of culturally competent providers, and lack of institutional acceptance – including hospitals denying LGBT people basic rights such as visitation by family members (non-blood relatives)… Lack of insurance coverage may hamper access to healthcare because most insurance still relies on employment or spousal insurance through employment.”

 

Older Lesbians and Bi Women Suffer More Chronic Health Conditions Than Heterosexuals, Study Finds

According to a new study, Lesbian and bisexual older women are more likely than heterosexual older women to suffer chronic health conditions, experience sleep problems and drink excessively.

The study from the new University of Washington, found that in general, lesbian, gay and bisexual (LGB) older adults were found to be in poorer health than heterosexuals, specifically in terms of higher rates of cardiovascular disease, weakened immune system and low back or neck pain.

They also were at greater risk of some adverse health behaviours such as smoking and excessive drinking. At the same time, however, findings point to areas of resilience, with more LGB adults engaging in preventive health measures, such as obtaining HIV tests and blood pressure screening.

The study is the first to use national, population-based data to evaluate differences in health outcomes and behaviours among lesbian, gay and bisexual older adults. Using two-year survey data of 33,000 heterosexual and LGB adults ages 50 and older from a probability-based study of the U.S.

Centers for Disease Control and Prevention, researchers from the UW School of Social Work report noticeable health disparities between LGB and heterosexual adults.

The findings were published in the August issue of the American Journal of Public Health.

While this study did not delve into what causes the poorer health outcomes, UW social work professor Karen Fredriksen-Goldsen pointed to other research, including the landmark longitudinal study, Aging with Pride: National Health, Aging and Sexuality/Gender Study, that has identified associated factors.

“The strong predictors of poor health are discrimination and victimization,” said Fredriksen-Goldsen, the principal investigator on Aging with Pride, which surveyed 2,450 adults aged 50 to 100, studying the impact of historical, environmental, psychological, social, behavioral and biological factors on LGBT older adult health and well-being.

The new UW study relied on the 2013-14 National Health Interview Survey, which for the first time asked respondents about their sexual orientation. In the United States, approximately 2.7 million adults age 50 and older self-identify as lesbian, gay, bisexual or transgender. This number is expected to increase to more than 5 million by 2060.

Among the UW study’s findings:

  • Disability and mental distress are significantly more prevalent among lesbians or gay men than among their bisexual counterparts.
  • Strokes, heart attacks, asthma, arthritis and lower back or neck pain affected significantly greater percentages of lesbian and bisexual women than heterosexual women. For example, 53 percent of lesbians and bisexual women experienced lower back or neck pain, versus not quite 40 percent of heterosexuals.
  • Nearly 7 percent of gay and bisexual men, compared to 4.8 percent of heterosexual men, suffered chest pain related to heart disease.
  • More LGB people reported weakened immune systems: about 17 percent of women, and 15 percent of men, compared to 10 percent of heterosexual women, and 5 percent of heterosexual men.
  • Lesbian and bisexual women were up to two times as likely to engage in adverse health behaviors such as excessive drinking.
  • More than three-fourths of gay and bisexual men, and almost half of lesbians and bisexual women, had received an HIV test. In contrast, roughly one-fourth of heterosexuals had obtained a test.
  • Slightly more lesbian and bisexual women had health insurance than heterosexual women, a possible reflection of professional choices, financial independence or same-sex partner benefits.

But the health disparities among lesbian and bisexual women indicate a population that merits greater attention, Fredriksen-Goldsen said.

Most people think gay and bisexual men would have more adverse health effects, because of the HIV risk. Lesbian and bisexual women tend to be more invisible, less often considered when it comes to health interventions. This is a population that isn’t getting the attention it deserves.”

Bisexual men and women, meanwhile, may be marginalized not only in the general population, but also within gay and lesbian communities. As a result, bisexuals report feeling more isolated and experience greater stress, which, in turn, could lead to more adverse health conditions associated with stress as well as frequent risky health behaviors, Fredriksen-Goldsen said.

Like Aging with Pride, this new national study brings to light the need to target prevention efforts and health care services to improve health and the quality of life of LGB older adults, Fredriksen-Goldsen said.

The study was funded by the National Institute on Aging. Other authors were Hyun-Jun Kim, Chengshi Shiu and Amanda E.B. Bryan, all of the UW School of Social Work.

6 Mental Health Issues That Are More Common Than People Realise.

The National Institute of Mental Health (NIMH) estimates that 18 percent of adults in the United States experience some form of mental illness.

Many people are aware that mental health issues such as anxiety and depression are quite common, however not many people, unless they are sufferers, fully understand the symptoms or the causes.

There is still a stigma attached to it which is not helped by people’s lack of awareness and stereotyping in the media.


Postpartum Depression

This is also referred to as postnatal depression and can occur after a woman has given birth. It effects up to one in seven women and apparently around 4% of fathers are also affected by it as well. Women can often be very tearful, lethargic and at times not bond with her new baby.


Adult ADHD

The full name for this is attention Deficit Hyperactivity Disorder and is more commonly found in children. Many grow out of the condition as they become adults but around 60% of children carry the condition with them into adulthood. Symptoms include problems with impulsivity control and heightened anxiety levels.


Social Phobia

The NIMH states that social phobia effects up to 7% of adults in the United States. The sufferer feels intense panic in social situations and some will avoid being with other people totally.


PTSD

This is known as Post Traumatic Stress Disorder and can occur because of any event in a sufferer’s life that has caused a huge amount of stress. Over 3.5% of Americans suffer from this and symptoms include anxiety, depression, tremors and a feeling of worthlessness.


Specific Phobias

Specific phobia is when a sufferer has an extreme fear of specific objects or situations. It is one of the most common psychological disorders effecting around 9% of the population. Sufferers experience extreme reactions to their phobia such as shaking, anxiety and panic and hyperventilation when they come into contact with whatever they are phobic about.


Schizophrenia

Many people think schizophrenia is rare but it actually effects around 1% of the World population which makes it far more common than people realise. Schizophrenia is a psychiatric disorder and sufferers can have auditory and visual hallucinations, paranoia and extreme anxiety.

It’s important as a society we try to understand conditions such as these, especially as they are so common. This is the only way to take away the stigma and ensure sufferers feel more comfortable talking about their condition to others.

Cuba’s Gay Pride Calls for Same-Sex Marriage to Become Legal

Last weekend, more than 1,000 LGBT Cubans marched through the streets of Havana to protest against discrimination

The event was organised by President Raul Castro’s daughter, Mariela Castro.

Cuban LGBT 01

Although same-sex marriage remains illegal, dozens of couples took part in symbolic gay weddings presided over by religious leaders from Cuba and the US.

The wedding ceremonies at the Eighth Annual March against Homophobia and Transphobia were a form of protest at the fact that gay marriage and same sex unions are still illegal in Cuba.

Cuban LGBT organisations hope gay marriage will become legal before their march takes place next year.

Also read: Lesbian and Bisexual Women Receiving Unequal Treatment from Cuban Health Services

Of all the areas in which Cuba has changed since Fidel Castro left power, the steps towards improved gay and lesbian rights on the island are some of the most significant, says the BBC’s Will Grant in Havana.

Mariela Castro, who is head of Cuba’s Sexual Health Institute spoke, out saying.

Same sex marriage is already legal in Argentina and Uruguay and in Mexico City. And we’ve always celebrated their achievements. So we’re not interested in being the first. For us, it’s just about achieving it in the first place.”

Two years ago, Cuban law banned workplace discrimination based on sexual orientation.

 

Lesbian and Bisexual Women Receiving Unequal Treatment from Cuban Health Services

In addition to other forms of discrimination, lesbian and bisexual women in Cuba face unequal treatment from public health services. Their specific sexual and reproductive health needs are ignored, and they are invisible in prevention and treatment campaigns for women.

Many lesbian and bisexual women are afraid of gynaecological instruments and procedures which they experience as particularly distasteful given their sexual orientation. Many are unaware of their risks of contracting sexually transmitted infections (STI) and postpone attending gynaecology appointments in order to avoid questions about their love life, activists and health experts told IPS.

Dayanis Tamayo, a 36-year-old education specialist who lives in Santiago de Cuba, 862 kilometres from Havana, feels that health professionals are judgmental when they discover that her partner is a woman. They make lesbophobic comments and give her disapproving looks.

“Sometimes I get by unnoticed because I don’t fit the stereotype of a butch lesbian, but otherwise I always feel judged.”

Dayanis Tamayo

Recent studies back up Tamayo’s statement, pointing to prejudice against lesbian and bisexual women among the country’s health personnel, and ignorance about their particular sexual health needs.

Cuban psychiatrist Ada Alfonso presented a report on “Salud, malestares y derechos sexuales de las lesbianas” (Lesbians’ sexual health, illnesses and rights) at the 2014 Cuban Day Against Homophobia. She said that when they go to see the doctor, these women are asked more about their sexual experiences than about their reason for seeking treatment.

If we look at women’s health through the lenses of inequality, the gap between lesbians and heterosexuals in regard to health services has a lesbophobic subtext hidden behind the discourse on ‘social needs’.”

Ada Alfonso

Also Read: Dark Side of Cuban LGBT History

In her view, social pressure on women who are not heterosexual, amounting to homophobia, causes various forms of psychological and sexual malaise.

Alfonso interviewed women in several of the island’s provinces. She found that ethical deficiencies in the system are leading women to postpone clinical tests until they can see a doctor who has been recommended, or a health professional sharing their own sexual orientation.

The women are particularly averse to gynaecological tests because of the instruments used and invasive procedures such as pelvic and vaginal examinations.

Cuba

Gynaecology outpatient consultations total 925,549 a year, for a population of 4.7 million women aged over 15, according to the National Office of Statistics.

Personnel working in preventive screening services for cervical and uterine cancer told Alfonso that lesbian women tend to come forward for testing too late for any therapeutic action to be taken.

We generally think that since we do not have sex with men, we are exempt from those risks, because the information campaigns in the media only portray heterosexual couples. Although I do know that it is important, I find it psychologically difficult to face this test because I feel so exposed, assaulted even, and I personally do not like penetration.”

All Cubans enjoy health coverage by a local family clinic, which is responsible for reminding women when it is time for their next Pap test. However, many women put it off.

In 2013, a total of 765,822 Cuban women aged over 25 had a Pap test done, a take-up rate of 195.8 per 1,000 according to the most recent figures from the Cuban Annual Health Statistics.

All treatment in the Cuban health system is free of charge and is delivered without institutionalised discrimination. But prejudice against non heterosexual people continues to grow.

According to José Martínez, medical training in Cuba is too narrowly focused on a biological approach and makes hardly any reference to psychosocial determinants of health.

“Health personnel are part of society, and society rejects lesbians. When a lesbian woman goes to see a gynaecologist, the doctor will probably assume that she is at lower risk (of cervical or uterine cancer) because penetration is not involved in her relationship, because this is what they have been taught.”

José Martínez

Yenis Milanés, who has a degree in hygiene and epidemiology, told IPS that “medical students are not required to take a single course on sexuality” during their training.

Women who have intimate relations with women tend to have a low perception of their own risk, and seldom take protective measures during sex, Milanés and Martínez said.

They both collaborated in a 2013 study of 30 lesbian and bisexual women in the province of Granma, which found these women thought they were unlikely to acquire sexually transmitted infections.

Another study in 2014 by Martínez and Milanés confirmed that sexual and reproductive health programmes in Cuba generally do not include information about the risks of contracting STI and HIV/AIDS that specifically addresses lesbian women’s issues.

Lesbians receive less information about STI prevention than other population groups and they have fewer welcoming institutional spaces where they can socialise and discuss their problems, said the report, to which IPS had access.

The research study debunks the myth that engaging in lesbian sex avoids all infection risks, although these are indeed much lower than for other sexual behaviours.

Depending on the sexual practices of a same-sex lesbian couple, unprotected contact with exchange of vaginal secretions and menstrual blood can lead to infection with the HIV/AIDS and Herpes simplex viruses, bacterial vaginosis, gonorrhoea, syphilis, vaginal parasites and other diseases.

Women represented 18.5 percent of the 2,156 new HIV-positive cases diagnosed in Cuba in 2013, bringing the total number of people living with the virus to 16,400, according to the Ministry of Public Health.

Training health professionals to be sensitive to sexual diversity has been a long-established demand by groups of lesbian women supported by CENESEX in the provinces of Camagüey, Ciego de Ávila, Cienfuegos, Granma, La Habana, Santiago de Cuba, Trinidad and Villa Clara.

Through community activism, these groups are struggling for their rights to responsible enjoyment of sexual health, including equality of treatment in the health services and access to assisted reproduction technology.