Health Care Access Among Individuals Involved in Same-Sex Relationships

Heck, Julia E.; Sell, Randall L.; Gorin, Sherri Sheinfeld

doi:10.2105/ajph.2005.062661

Cited by 195 publications

(156 citation statements)

References 32 publications

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“…This inequality is evident in terms of access to the healthcare system and use of preventive health services [3,4]. As such, patients who identify as lesbian, gay, bisexual or transgender (LGBT) are at an increased risk for cancer, mental health disorders, substance abuse, and sexually transmitted infections [2,5,6].…”

Section: Introductionmentioning

confidence: 99%

Medical students’ perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study

Nama

MacPherson

Sampson

et al. 2017

Medical Education Online

108

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Background: Historically, medical students who are lesbian, gay, bisexual or transgendered (LGBT) report higher rates of social stress, depression, and anxiety, while LGBT patients have reported discrimination and poorer access to healthcare. Objective: The objectives of this study were: (1) to assess if medical students have perceived discrimination in their learning environment and; (2) to determine self-reported comfort level for caring for LGBT patients. Design: Medical students at the University of Ottawa (N = 671) were contacted via email and invited to complete a confidential web-based survey. Results: Response rate was 15.4% (103/671). This included 66 cis-gender heterosexuals (64.1%) and 37 LGBT students (35.9%). Anti-LGBT discrimination had been witnessed by 14.6% and heterosexism by 31.1% of respondents. Anti-LGBT discrimination most often originated from fellow medical students. Respondents who self-identified as LGBT were more likely to have perceived heterosexism (favoring opposite-sex relationships) (OR = 8.2, p < 0.001) or anti-LGBT discrimination (OR = 6.6, p = 0.002). While half of LGBT students shared their status with all classmates (51.4%), they were more likely to conceal this from staff physicians (OR = 27.2, p = 0.002). Almost half of medical students (41.7%) reported anti-LGBT jokes, rumors, and/or bullying by fellow medical students and/or other members of the healthcare team. Still, most respondents indicated that they felt comfortable with and capable of providing medical care to LGBT patients (≥83.5%), and were interested in further education around LGBT health issues (84.5%). Conclusion: Anti-LGBT discrimination and heterosexism are noted by medical students, indicating a suboptimal learning environment for LGBT students. Nonetheless, students report a high level of comfort and confidence providing health care to LGBT patients.

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Section: Introductionmentioning

confidence: 99%

Medical students’ perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study

Nama

MacPherson

Sampson

et al. 2017

Medical Education Online

108

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show abstract

“…[22][23][24][25][38][39][40][41] Furthermore, individuals in same-sex relationships report significantly more barriers to healthcare access than individuals in opposite-sex relationships. 42 Based on data from other countries, these disparities might be attributable to minority stress, healthcare discrimination, and lack of LGBT-specific medical expertise. 22,25,40,[43][44][45][46][47][48][49][50] By targeting mental health concerns through psychosocial interventions, physical health risk behaviors are concomitantly addressed.…”

Section: Introductionmentioning

confidence: 99%

Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context

Leluţiu-Weinberger

Pachankis

2017

LGBT Health

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Purpose: Lesbian, gay, bisexual, and transgender (LGBT) individuals in Romania encounter pervasive stigma and discrimination and there is a high need for LGBT-competent mental health professionals (MHPs). We tested the impact of a pilot LGBT-affirmative training for MHPs in Romania on these professionals' LGBT-relevant attitudes, knowledge, and perception of clinical skills. Methods: We conducted a 2-day training for MHPs in Bucharest. Fifty-four attended and 33 provided training evaluation data at baseline and follow-up. Results: The majority of trainees were female (90%) and heterosexual (73%) with a mean age of 36.4 (SD = 7.7). From baseline to follow-up, trainees demonstrated a significant increase in perceived LGBT-relevant clinical skills (P < 0.001) and perceived knowledge (P < 0.05).LGBT-affirmative practice attitudes (P < 0.05) and comfort in addressing the mental health of LGBT individuals (P < 0.01) increased significantly, and homonegative and transnegative attitudes decreased significantly (P < 0.01). Negative attitudes toward LGBT individuals were low at both baseline and follow-up. The majority of trainees reported being highly interested in the training (84%), which they reported had prepared them to interact with and care for LGBT individuals (74%). Conclusion: This pilot training appeared to be effective in increasing perceived LGBT competence among participating MHPs. This type of training model needs to be tested further in a randomized controlled trial with longer follow-up periods to assess intervention durability and implementation of clinical skills. Future trainings can be incorporated into existing curricula. National accreditation bodies might consider encouraging such training as part of standard educational requirements.

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“…The greatest health risk for people who identify as LGB is that they avoid health care in the first place. This lack of regular health care leads to less opportunities to conduct screening, act upon preventative care, and educate one's patients (Harrison & Silenzio, 1996;Heck, Sell, & Gorin, 2006;Krehely, 2009). Heteronormative communication in the practitioner-patient setting can lead to an avoidance of health care and thus some of the health disparities that are present.…”

mentioning

confidence: 99%

Heteronormativity and practitioner–patient interaction

Utamsingh

Richman

Martin

et al. 2015

Health Communication

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Heteronormativity is the presumption of heterosexuality as the default sexual orientation and can result in discrimination against the lesbian, gay, and bisexual (LGB) population. This study serves as one of the first experimental studies to examine heteronormative perceptions in communication and their effects on practitioner-patient relationships.LGB participants were randomly assigned to read either heteronormative or non-heteronormative vignettes of a doctor-patient interaction. They then indicated how much health-relevant information they would disclose to the doctor in the vignette and their level of trust in the doctor. In the heteronormative condition, participants were less likely to disclose healthrelevant information to the doctor in the vignette and were less trustful of the doctor as compared to those in the non-heteronormative condition. These results have important health implications, as lack of disclosure and trust may prevent people from getting needed care and prevent doctors from giving the best health advice possible. The results of this study provide further evidence that there is a need for more education for all health care professionals to feel comfortable while respectfully communicating with and treating patients who do not identify as heterosexual in order to ensure the best health care experience.

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Health Care Access Among Individuals Involved in Same-Sex Relationships

Abstract: In this study involving a nationwide probability sample, we found some important differences in access to health care between individuals in same-sex and opposite-sex relationships, particularly women.

Cited by 195 publications

References 32 publications

Medical students’ perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study

Medical students’ perception of lesbian, gay, bisexual, and transgender (LGBT) discrimination in their learning environment and their self-reported comfort level for caring for LGBT patients: a survey study

Acceptability and Preliminary Efficacy of a Lesbian, Gay, Bisexual, and Transgender-Affirmative Mental Health Practice Training in a Highly Stigmatizing National Context

Heteronormativity and practitioner–patient interaction

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