LGBTQ HEALTH: WHO, WHAT,
WHERE AND WHY WE SHOULD CARE
-ABHINAV SRIVASTAVA
TANMAY JOSHI
VIDHI SACCHAN
OM DHOK
AMAAN AHMED
LAKSHYA PAREEK
OBJECTIVES
Introduce you to LGBTQ terminology
Discuss historical and contemporary health
concerns of the LGBTQ community
Discuss facilitators and barriers to health
Is your facility compliant?
DEFINITIONS LGBTQ
Gay, Lesbian
Exclusive physical and emotional attraction to members of one’s
own sex
Bisexual
Physical and emotional attraction to members of both sexes
Transgender (gender identity)
A person who feels his or her body is not the sex it should be,
regardless of transformational hormone or surgical status
Cis-Gender
A person whose gender identity matches their sex at birth
Transgender
(gender LGBTQ
identity)
MtF = Male-to-Female (she) transwoman
Born with male anatomy, female gender
FtM = Female-to-Male (he) transman
Born with female anatomy, male gender
Definitions LGBTQ
Intersex
The vogue term for hermaphrodite. People born with
the sexual characteristics of both sexes
Questioning
People who suspect they might be LGBT, but are not
yet certain
Queer
Inclusive term of the LGBTIQ community
Unique paradigm
PREVALENCE - 9 MILLION LGBT PEOPLE IN THE
U.S.
Homosexual (gay/lesbian is preferred
term)
3.4% self-identify as LGBT (Gates & Newport 2012)
1 in 5 - 20.8% of males in the U.S. reported
either homosexual behavior or homosexual
attraction since age 15 (Sell, Wells & Wypij, 1995)
17% of women and 6% of men have engaged in same-
sex behavior. However, 7% of women and 4% of men
identify as gay or bisexual (Copen et al. 2016).
EARLY SOCIAL TRANSITION
Child lives as gender that matches their
identity
Trial run - name, attire, social roles at school, in community
Reversible
Family decision whether to disclose to others or not
Approx. 25% of children who were assessed for gender
dysphoria grew up to be cis-gender gay vs. transgender.
CHILDREN AND YOUTH
EARLY medical and mental health
services
Family support is critical to positive health
outcomes
Puberty experienced congruent with gender (delay
until sure)
Reduces need for later medical interventions
Prevents unwanted sex characteristics (i.e.
breasts)
Decreases stress, anxiety, depression
IRREVERSIBLE HORMONE
EFFECTS
ESTROGEN TESTOSTERONE
Breast development Uterine atrophy
Nipple enlargement Facial and body hair
Loss of erection Deepened voice
Testicular atrophy Clitoral enlargement
? sterility ? sterility
FIRST DO NO HARM….
There is harm related to NOT intervening
Suicide ~ 44%
Depression
Anxiety
Homelessness
ETOH, drug use
Sex work
HIV
OVERREPRESENTED
HEALTH PROBLEMS
HIV/ AIDS
Trauma/ Victimization
Mental Health Concerns
Addictions
Is this because they’re LGBT? –or- because of
the context within which LGBT people must
exist?
HIV/ AIDS
A missing generation of gay men due to AIDS
HIV+ the norm in some areas
Homelessness/ poverty – survival sex
Street hormones (trans)
TRAUMA/ VICTIMIZATION
Parental abuse
Increased prevalence of verbal and physical abuse and
heightened suicidal ideation among those who disclosed their
s.o. to their families
Hate crimes
MENTAL HEALTH –
DEPRESSION & ANXIETY
Additional stress d/t image
management related to s.o./g.i.
LGBT children often grow up in a
society that says that they should not
exist and/or should not act on their
feelings.
These societal mores can be internalized =
internalized homophobia
MENTAL HEALTH - SUICIDE
LGB youth = 30%
attempted suicide (double
the hetero rate)
School bullying increased
the risk of suicide (Bouris et al,
2016)
CDC RECOMMENDATIONS FOR
SCHOOLS TO SUPPORT LGBTQ
HEALTH
1. Identify “safe spaces”
2. Prohibit harassment and bullying
3. Facilitate access to health & psych providers not on school
property who are LGBTQ affirming
4. Encourage professional development on safety for all
students
5. Provide health education curricula with inclusive terminology
