Tag Archives: doctors

Many Transgender People are Completely Avoiding Doctors

It can be difficult for many individuals to have discussions about their sexual history with a physician. It’s not uncommon for people to consider it uncomfortable. But, for many transgender people, the conversation never happens because they do not seek out health care, according to Adrian Juarez, PhD, a public health nurse and assistant professor in the University at Buffalo School of Nursing.

A preliminary study (“Examining the Role of Social Networks on Venue-Based HIV Testing Access and Decision Making in an Urban, Transgendered Population”) that examined health-based decision making and access to HIV testing in urban, transgender populations, showed that many transgender individuals withheld from pursuing necessary care due to social stigma and lack of affordability.

Many Transgender People are Completely Avoiding Doctors

“There is evidence that health care providers do tend to be judgmental, and it’s unwelcoming,” says Juarez.  Of course, people are not going to visit health care providers if they fear that they’re going to face discrimination and stigma.

The results of the study are especially cause for concern because, according to a 2009 report from the National Institutes of Health (NIH), about one third of transgender people in the U.S. are HIV positive. And, transgender women of color are even more at risk of HIV infection. According to the NIH study, more than 56 percent of black transgender women are HIV positive.

Among other reasons, an inability to afford medical care is keeping transgender patients away from doctors. Transgender people are more than twice as likely to be homeless and four times more likely to experience extreme poverty (compared to the general population)…having a household income of less than $10,000 per year. This data comes from a 2011 report from the National Center for Transgender Equality. It’s not as if it’s easy for transgender people to get work, either. According to the National Center for Transgender Equality, out of more than 6,000 transgender people surveyed in the nation, 90 percent said they were subject to mistreatment, harassment, and discrimination at work.

If a transgender person does happen to visit a healthcare provider, some doctors are not informed on how to properly treat the  patients. Juarez says, “It puzzles me how doctors will still refer to trans individuals by their biological name. That’s their identity.”

The line between identifying and biological gender can be blurry in healthcare settings. For example, transgender men still need Pap smears and transgender women need prostate screenings, but some health care providers might not offer these tests in order to keep from making suggestions that go against the patient’s identified gender. There is an urgent need to address stigmatization and provide health care professionals education on how to appropriately and compassionately treat transgender patients.

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Nurses are the Key to Older LGBT Care

Nurses are the Key to Older LGBT Care

According to a study recently published in the Journal of Gerontological Nursing the aging LGBT community weighs in at a hefty 2 million individuals (Newswise.com). Oftentimes those in the community don’t have children or younger family members that they can count on to help them or take care of them in their older years. Others have been ostracized by their families.

According to the healthcare industry, nurses are the key to older LGBT care. Lead author of the study and associate professor of nursing at the University of Alabama at Birmingham School of Nursing, Rita Jablonski, said in a statement about their findings, “Nurses are in a prominent position to create health care environments that will meet the needs of this often misunderstood group of people. Nurses are the front line for care, and they can directly impact the quality of care older LGBT adults experience.” There is little if any literature and training available to nurses however to provide such care. Though we refer to this population as LGBT, each subset has its own particular health issues that need to be addressed specifically. Jablonski and her colleagues therefore put together some suggestions to make this group more comfortable and to be able to address their healthcare needs in a more effective way.

“Given lifetime experiences of negativity at best and violence at worst, older LGBT adults may not openly share their identity with health care providers. Older LGBT adults may have prior life experiences, including having been married or having children, that cause nurses to assume heterosexuality. Don’t make that mistake.” There are two waves of older LGBT. The first that is retiring now came to age in the fifties, the McCarthy Era. These are very secretive as they became young adults in a very oppressive age. The second which will begin retiring later are those of the sixties generation when different sexual orientations became acceptable. Homosexuality, for instance, was thought of as a mental disorder until the early 1970’s when the attitude of the country changed. Still, older LGBT are more private and wary of letting others in.

According to Jablonski since this population suffered so much discrimination it’s important for nurses to take questions in a uniform way and preface them with why they are asking. The nurse can say straight out, “To provide the best and most sensitive care for all of our patients, we ask questions that may seem different.” Questions about gender identity and sexual orientation should be addressed in a sensitive way. For instance, “On forms, a blank line can be included after the ‘male’ and ‘female’ choices to allow older adults to label their own gender,” Jablonski said. “Another option is to ask, ‘What is your gender?’ and leave a blank line to allow for an individual to complete the question as he or she believes appropriate.” Jablonski sums up this new research and the initiatives they are espousing by saying, “Older LGBT adults have encountered a lifetime of discrimination, violence and even persecution, and these experiences have left many suspicious of health care providers and systems. By adopting inclusive language and practices, nurses are in the best position to provide thoughtful and culturally appropriate care to these older adults.”