Evidence of interventions for improving healthcare access for lesbian, gay, bisexual and transgender people in South Africa: A scoping review

Abstract

Background The lesbian, gay, bisexual and transgender (LGBT) populations have unique health risks including an increased risk of mental health problems, high usage of recreational drugs and alcohol, and high rates of infection with human immunodeficiency virus (HIV). Healthcare workers’ heteronormative attitudes compromise the quality of care to the LGBT population. Aim The objective of this study was to provide an overview of documented evidence on South Africa interventions aimed at improving healthcare access for LGBT individuals using a systematic scoping review. Setting This is a secondary literature review. Methods An electronic search was conducted using the following databases: EBSCOhost, PubMed, Cumulative Index to Nursing and Allied Health Literature, and Google Scholar. Abstract and full article data were screened using inclusion and exclusion criteria by two researchers. Data extracted from the eligible studies were analysed using thematic analysis. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool, version 2011. Results Seventeen articles of the initial 151 hits were selected for review and an additional five files were identified through bibliographical search. Most studies had small sample sizes and focused on sexual health, targeting gay men and men who have sex with men in urban areas. Lesbians and bisexual women were not prioritised. Discussion It emerged from the review that LGBT issues were not covered in the healthcare worker curriculum. Further it was noted that there is a paucity of data on the South African LGBT population, as sexual orientation does not form part of the routine data set. The findings of this review indicate gaps in the literature, practice guidelines and policies in LGBT healthcare in South Africa.

Ansiedade em minorias sexuais e de gênero: uma revisão integrativa

“…Uma pesquisa identificou que os profissionais de saúde não são capacitados para lidar com as questões de saúde da população em questão, o que faz com que sua prática seja pautada pela ausência de sensibilidade e de profissionalismo, refletindo na ausência das minorias sexuais e de gênero nos serviços de saúde e no aumento da vulnerabilidade ao adoecimento físico e mental 31 . Dessa forma, a iniciativa de profissionais que respeitem, que saibam lidar com essa demanda e que criem grupos de apoio para essa população pode aproximá-la dos serviços de saúde.…”

Queering global health: an urgent call for LGBT+ affirmative practices

“…The call for new contributors to share their expertise and experiences is overdue, given the widespread criminalisation of sexual and gender diversity across the world and the immediate intersection of this criminalisation with inequities in health care. [1][2][3][4] In this spirit, we responded to the invitation to foreground our work done in African LMICs, particularly South Africa, Cameroon, and Nigeria. Our work is rarely acknowledged as global due to socioeconomic power imbalances that predetermine whose work gets published in elite academic journals.…”

“…Their International Classification of Diseases listed transgender issues as mental disorders until 2019. 2 Only in 2013 did WHO produce its first ever report on the health of LGBT+ people, but caved into pressure from African and Middle Eastern countries to remove the report from its Executive Board meeting agenda. 26 Unfortunately, as described by Po-Han Lee, "many governments still regard sexual and gender minorities as 'irresponsible' in terms of the global burden of both the HIV epidemic and mental disorders, and such a bias, without reasonable grounds, is one of the greatest impediments that prevents LGBT health from being considered on the global social health agenda".…”

Reference intervals for biochemical analytes in transgender individuals on hormone therapy

“…6 In keeping with their marginalised status, some studies have addressed aspects of poor health-care for transgender subjects, whereas South African studies have highlighted the need for improving health-care for this group, particularly concerning awareness of appropriate hormone therapy. 7 Moreover, prejudices were exposed for this group and a correlation of quality of health-care and urbanisation exists, favouring relative urbanisation of persons wishing to undergo gender reassignment. [7][8][9] Reference intervals play a crucial role in clinical decision-making, as most test results are interpreted in relation to these intervals.…”