Tag Archives: healthcare

5 Ways Bisexual Women Can Pursue Better Healthcare

Many individuals in the LGBT community face significant issues with regard to health care. For example, bisexual women face a high risk of physical and mental health problems and have a higher likelihood of experiencing violence and addiction. Discrimination is often experienced within the healthcare system. The bisexual community is fighting this, to spread education and make quality healthcare more accessible.

There are some general guidelines that may be helpful for bisexual women who are looking for quality health care. Read on to learn the five ways bisexual women can take care of their health, even while facing exceptional challenges.

5 Ways Bisexual Women Can Pursue Better Healthcare

Be aware of risks
Bisexual women are more likely to experience addiction, smoke, have depression and have suicidal thoughts and/or attempts, compared to other groups. Bi woman are also at a higher risk for cancer than heterosexual women or lesbians and less likely to get screening. Amy André, a co-author of Bisexual Health: An Introduction said, “Research shows that bisexuals experience more discrimination, violence, and stigma than gays and lesbians.” She believes that the fact that bisexuals have the worst health is directly linked to the violence, stigma and discrimination.

Seek quality health care
Unfortunately, it’s not possible to assume that every doctor is able to cater to the unique needs of LGBT patients. It is easier in urban areas, but still more difficult to find a provider that doesn’t group bisexual patients with gay or straight women. There is a list of providers in the Gay and Lesbian Medical Association directory and the Bisexual-Aware Professionals Directory. Everyone deserves to be treated with respect and compassion.

Be your own advocate
You’ll need to be more assertive at times because some doctors will ask questions that are heteronormative. If you find that the doctor assumes you are a sexuality that you aren’t, you may need to answer broadly. You’ll want to make sure that you’re giving proper information about your past and current partners, and your sexuality. Some women will find it more difficult if they live in a small community with few doctors. Push yourself as far as you feel comfortable and remember that you can request certain types of screening for your physical and mental health.

Know your financial barriers
According to LGBT MAP’s Unfair Price study, bi women are more than twice as likely to live in poverty than the general population, and 29% of LGBT women have trouble finding affordable health care, compared to 19% of heterosexual women. Women in rural areas may experience even more difficulty. It’s of vital importance to have access to affordable health care. This could mean a visit to a free clinic, Planned Parenthood or a doctor’s office that takes your health insurance.

Get the word out
Form a support system and be supportive to others in a similar position. Doing this not only positively affects your chances of receiving affordable health care, it improves your health.

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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.

6 Major Reasons We Need to Rethink HIV Prevention

Many HIV prevention campaigns rely on appealing to our emotions, but are not taking a good look at the HIV research and information available. Read on to see why we should rethink HIV prevention.

60 Percent of young people with HIV do not know their status
According to the Centers for Disease Control (CDC), 60 percent of young individuals have no idea that they have HIV. Some men and women who are HIV negative think that it is too big of a risk to be with someone who discloses that they are HIV positive, yet they might go on to have sex with someone who believes they’re HIV negative, but hasn’t been tested to verify. Those undiagnosed carry a higher viral load than those who are aware of their status and on treatment.

91 percent of new HIV transmission happen by those who are not diagnosed or haven’t been treated
This statistic comes from a new study released by JAMA Internal Medicine. In 2009, there were more than 1.1 million people living with HIV; of these people 207,600 were undiagnosed and 519,414 knew they were HIV positive, but were not receiving medical care. In comparison to those who were undiagnosed, those who knew about their status, yet not receiving medical care were 19 percent less likely to transmit the virus.

6 Major Reasons We Need to Rethink HIV Prevention

Those who are HIV positive and receiving antiretroviral therapy (ART) who have achieved an undetectable viral load are 96 percent less likely to spread HIV
There hasn’t been a reported case of anyone living with the virus with an undetectable viral load who has transmitted the virus.

Truvada has been shown to reduce HIV transmission by 96 – 99 percent, when used daily
One new study also shows when PrEP is used as needed (a user taking Truvada 2-24 hours before sex and one pill 24 and 48 hours after) has shown to be 86 percent effective in preventing HIV. With all that’s available–TasP, PrEP and condom use, there seems to be much less of a reason to fear sex with someone with someone of opposite HIV status. Be open and honest with your partner.

Three out of 10 in the US have their virus under control
The care continuum, which is also known as the HIV treatment cascade, showed that even though 86 percent of people living with HIV were diagnosed, only 30 percent of them had  an undetectable viral load. The majority of those living with HIV know they have it, but are either too scared or unable to do what is needed to control it.

You can expect to live an additional 51 years if you’re newly diagnosed in your 20’s
That is, if you enter proper treatment. This is roughly the same number of years as a person without HIV would live. Many need only take one pill each day to manage HIV. Of course, there are mental and emotional health issues to treat as well.

Study Shows LGBT Women among Most at Risk for Poverty

A study conducted by The National LGBTQ Task Force, Movement Advance Project, and Center for American Progress, called Paying an Unfair Price: The Financial Penalty for LGBT Women in America, shows that LGBT women are presented with challenges that obstruct their economic well being in health coverage, jobs and getting legal recognition from their families. The study emphasizes the many obstacles that LGBT women in the US face, including exclusion from insurance coverage, wage differences and inflexible workplaces.

LGBT women (transgender in particular) risk employment discrimination
Sixteen percent of LGB individuals said they lost their job because of sexual orientation and 35 percent said they were harassed by their employers, as recently as 2008. Sixty-two percent of LGB people in the study said they heard jokes about lesbians and gays while at work. Out of the transgender women surveyed, 55 percent of them said they were turned down for employment due to their gender identity.

LGBT women are asked by healthcare providers to pay higher rates
They are twice as likely as non-LGBT women to not have a doctor who they visit on a consistent and regular basis. LGBT women with incomes at or below $47,000/yr tend not to have healthcare coverage. The fact that there are exclusions in care for transition-related issues, it’s incredibly expensive for needed services for trans women.

LGBT women are more likely not allowed to be legal parents of their children
They often lack protected family or medical leave at work, and face obstacles in obtaining safe, affordable health care for their families. This is due to the lack of marriage equality throughout the US.

Study Shows LGBT Women among Most at Risk for Poverty

LGBT women pay higher rent and longer rental applications
One study by H.U.D. showed that opposite-sex couples were favored over same-sex couples by 16 percent when they applied for the same rentals. Same-sex couples were given higher prices, longer application processes and less incentives about promotions.

LGBT women lack intimate partner violence protection
The study showed that bisexual women were less “out” in the workplace, which may cause them to stay in an abusive relationship because they fear being outed by their partner. It’s also possible that women who report domestic violence when they’re in same-sex relationships are not taken seriously because of gender stereotypes.

LGBT women/families may not be aware of their eligibility for government assistance
It’s challenging for same-sex couples to navigate state and federal benefit systems because of the legal jumble of relationship recognition for them.

Doctors Need to Initiate Communication with LGBTQ Patients

LGBTQ patients are faced with a variety of health obstacles.

Within the community are high rates of substance abuse and suicide. Men who have sex with men (MSM) make up the majority of new cases of HIV. In order to narrow and eventually close the health gaps between LGBTQ patients and those who are straight, doctors need to talk about sexual orientation and gender identity with their patients.

Dr. Harvey Makadon, director of the National LGBT Health Education Center at the Fenway Institute in Boston said that few physicians talk to patients about sexual behavior, desires and issues of identity.

It’s important for doctors to speak up about sexual orientation and gender identity with patients. It’s a huge part of one’s life and certain issues need to be addressed that affect both mental and physical health. Doctors are potentially missing some of the big issues. Those in the transgender community are of particular concern. Statistics in the community are unsettling. Transgender individuals suffer high rates of poverty, crime and STDs. Almost one-third of transgender women have HIV. According to Makadon, that’s a rate 49 percent higher than other adults of reproductive age.

Doctors Need to Initiate Communication with LGBTQ Patients

Physicians who are not afraid to treat transgender patients hold the key to preventing significant medical issues. It’s tricky because not all MSM identify as gay and some transgender people may have trouble defining gender clearly, particularly those who are younger and. It’s important for people to become comfortable and get to know LGBTQ people. It will allow individuals to feel at ease in seeking care.

Health issues may start early; children and teens struggle with sexuality. LGBTQ teens have a higher suicide rate than straight teens—two to three times higher, in fact. There are also issues with regard to lack of support systems, as many of them have faced parental rejection. This often leads to homelessness, which leads to risky behaviors that include drug and alcohol abuse and sex work. Transgender and gay minorities face rates of HIV infection that are even higher.

Makadon says, “Most people who I’ve had this discussion with say that the duty to care for everybody has to outweigh personal values. For people who continue to feel too conflicted, they probably shouldn’t continue to be in a caring profession. That may sound harsh, but I do think it’s a reality that if we do provide healthcare that we have to provide healthcare for everybody.

An HIV Cure is Still a Long Way Away

Though HIV treatment today is better than at any time in the past, challenges remain.

We have antiretroviral therapy (ART) today which can help HIV patients lead a normal life. But this requires lifelong care. What’s more ARTs are expensive and compliance with the drug remains an issue for many patients. Besides medications that can control the virus, the case of the “Berlin Man” or Timothy Brown encourages researchers. In 2007 Brown went for leukemia treatment. He received a transplant of hematopoietic stem cells. These are all the cells associated with blood. But the donor these cells came from had a rare genetic disorder, which proved to make Mr. Brown HIV resistant. To date there is no sign of HIV in Brown’s body. He no longer has to take antiretroviral drugs. Despite this, there are still many challenges in curing HIV.  In fact, the task is more complex than researchers first imagined.

An HIV Cure is Still a Long Way Away

Though scientists are able to halt the virus’s replication, it continues to be able to hide out in the body, in what are known as HIV reservoirs. It can attach its DNA to a cell’s genome, and continue on in long living cells, such as CD4+T cells found within the immune system. One recent study suggests that the HIV virus can be kicked out of their hiding places and neutralized. Another study found a way to snip HIV’s DNA out of a cell’s genome.

A recent John Hopkins University study found that these latent reservoirs are 60 times more prevalent than previously thought.  ARTs are not only a method of controlling the virus but also preventing it. Many health experts say ARTs should be more widespread to prevent the virus, particularly amongst at-risk populations. Now that researchers understand the challenges they face more clearing in locating HIV reservoirs, extracting the virus and it’s DNA, they can now develop better methods and someday a cure.

Death Rate for African-Americans with HIV Declined Significantly

For African-Americans living with HIV, the mortality rate took an impressive nosedive between 2009 and 2012 according to the CDC.

In a recent report, the agency revealed that the mortality rate fell somewhere between 21-28% depending upon how it is calculated, while the number of actual deaths for blacks dropped 18%. Still, the mortality rate and number of deaths remains elevated over other races, the CDC finds. Though only 14% of the population, African-Americans account for 50% of all new HIV cases.

Among certain subgroups such as black men who have sex with men (MSM) the number of cases has actually risen. Still, the drop in death rate and mortality rate made greater strides for black people, more than any other race.  Data from the U.S. Census was cross-referenced with the National HIV Surveillance System in order to arrive at these results.

Death Rate for African-Americans with HIV Declined Significantly

Two rates were calculated from this data, the rate of those living with HIV per 1,000 and per 100,000. It is estimated that 8,165 African-Americans lost their lives to HIV in 2012, compared with 5,426 whites and 2,586 Hispanics. African-Americans were 48% of the total. They were 1.5 times more likely to die of HIV than whites and 3.2 times more likely than Hispanics. Still, deaths among African-Americans between 2008 and 2012 dropped 18% according to the report. Among all of those living with HIV, a 28% decline was observed. For African-Americans, mortality rates fell from 28.4 per 1,000 in 2008 to 20.5 per 1,000 in 2012. Those who were older and living with HIV had a higher death rate.

Transmission method had considerable influence, as those who contracted HIV through intravenous drug use had the highest mortality rate. This is because they are more likely to have other serious health problems that increase their risk. MSM had the lowest mortality rate from HIV. Researchers note that the way the study was conducted, looking at all deaths associated with HIV, rather than HIV-only related deaths, it is impossible for them to determine any differentiation in care among the races.

Researchers wrote that overall the situation has improved for all of those living with HIV and differences between races has narrowed.  Moreover, minority focused treatment and care programs may see further declines.

Eating Disorders a Significant Problem in the LGBT Community

Numerous findings from the National Eating Disorders Association (NEDA) have been gathered about eating disorders in the LGBT population.

Unfortunately, eating disorders are a problem with individuals in general. In the US, 20 million women are affected and 10 million men. In the LGBT community, a reported 15 percent of gay and bisexual men reported having some type of eating disorder in their life compared to 4.6 percent of heterosexual men. A survey showed that gay men were seven times more likely to binge and 12 times more likely to purge than heterosexual men. In the LGBT adolescent group, gay and bisexual individuals were much more likely to have gone on a fast, vomited or purged in another way, than heterosexuals reported.

Eating Disorders a Significant Problem in the LGBT Community

According to the research, lesbian women appeared to be the most satisfied with their bodies overall, but they, along with bisexual females, were at more of a binge-eating risk than heterosexual women, at approximately twice the rate. Lesbian and bisexual girls were also shown to have higher rates of laxative use and purging, or vomiting than heterosexual girls. No matter their sex, those identifying as LGBTQ were more likely to have disordered eating habits or an eating disorder than their heterosexual peers. It was not unusual for LGBT teens to have disordered eating habits when they were as young as 12.

There are some issues that may explain this big difference in eating disorders in the LGBT population, with teens in particular, including:

  • Internalization of negative thoughts and messages about gender identity or expression, or sexual orientation
  • Fears about rejection and coming out
  • Having previous traumatic experiences related to sexual orientation
  • Past experiences with discrimination or bullying

There are a lot of myths and misconceptions associated with eating disorders. For example, many people don’t think they affect men or they believe eating disorders to be lifestyle choices, not illnesses. It’s important to spread awareness of the actual truth.  There is help available and everyone should feel safe seeking treatment.

Pediatrician Refuses to Treat Newborn of Lesbian Couple

Dr. Vesna Roi of Eastlake Pediatrics in Roseville, Michigan refused to treat the newborn child of Krista and Jami Contreras after “much prayer”, even after initially agreeing to do so. The lesbian couple in Michigan says Roi refused to care for their child due to their sexual orientation.

According to the Detroit Free Press, Krista and Jami brought their 6-day-old in to see the doctor for a check-up when another doctor informed them that Roi would not see them.  This doctor offered to care for their child.  According to the couple, the second doctor also informed them that Roi did not pay a visit to the clinic that day because she didn’t want to see them.

The baby’s biological mother, Krista, said, “I was completely dumbfounded.”  She told the paper, “We just looked at each other and said, ‘Did we hear that correctly?’”

Pediatrician Refuses to Treat Newborn of Lesbian Couple

Roi wrote a letter to the couple, which is posted online by the Free Press.  She apologized for not letting them know in person and said the child, Bay, would have to be seen by another doctor in the clinic.  She also wrote: “After much prayer following your prenatal, I felt that I would not be able to develop the personal patient doctor relationship that I normally do with my patients”.

This may seem way out there, but what Roi said and did is not illegal.  Michigan is not one of the 22 states that have laws that prohibit doctors from discrimination based on sexual orientation. But, the American Medical Association’s code of ethics does say that doctors should not refuse care based on race, gender, or sexual orientation.  Doctors are allowed to refuse specific treatments if they somehow are not in alignment with the doctor’s personal, moral or religious beliefs.

According to Roi’s website, she hasn’t been part of the AMA since 2001, but she does belong to the American Academy of Pediatrics which also encourages non-discrimination.

LGBT Health Disparities and Cancer

We don’t know a sufficient amount about cancer in the LGBT population.

There are specific prevention and treatment programs that have been designed for groups based on statistics. Such data comes from certain geographic, racial and ethnic groups. Lesbian, gay, bisexual and transgender people need to know exactly how prevalent cancer is among their groups because they currently don’t.

Even without official data, it’s pretty safe to say that LGBT people are disproportionately affected by cancer. There is plenty of research to confirm LGBT people have a specific “cluster of risk factors” that would give them greater incidence of cancer and diagnosis in a later stage. It is estimated that there are currently over 1 million LGBT cancer survivors in the US. This disproportionate amount of risk factors and burden of disease is referred to as “health disparities”.

Although there aren’t any biological or physiological differences between heterosexual and LGBT people, disparities exist due to a combination of economic and social factors and behaviors. These can frequently be linked to the stresses that come with living as a gender and/or sexual minority in the US.

LGBT Health Disparities and Cancer

One study of health disparities of lesbian, gay, and bisexual women found that bisexual women and lesbians were more likely than heterosexual women to:

  • Generally be in worse physical and mental health
  • Have asthma
  • Have diabetes
  • Be overweight
  • Smoke
  • Consume too much alcohol

This study showed that these women were at a higher risk for breast cancer and other cancers associated with alcohol abuse, obesity and smoking.

Health disparities in the LGBT community are not limited to cancer incidences. The quality of life for cancer survivors in the LGBT population is profoundly different from heterosexuals with regard to sexuality, relationships in general, and interactions with medical professionals. For example, gay and heterosexual men are affected much differently when it comes to changes in sexual function due to prostate cancer treatment. Unfortunately, few health care professionals will bother asking gay men about their sex lives or even know how to respond if the patient inquires about the issue. It is important that those in the LGBT community receive competent, compassionate medical treatment, with unique problems considered and addressed.