Health
Health concerns related to gender identity/expression and sexual orientation.
“Everyone has the right of access to preventive healthcare and the right to benefit from medical treatment under the conditions established by national law and practices”
Charter of Fundamental Rights of the EU, adopted in Nice, December 2000
What is HEALTH?
Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
All population groups neither share the same health status, nor have equal access to quality health care and related services.
LGBT people in particular as they experience in their everyday life a multiplicity of different forms of harassment and obstacles often are victims of unequal treatment referring to health cares.
What is LGBT health?
At present there is little medical or behavioural research for the development of a comprehensive lesbian, gay, bisexual, transgender (LGBT) health model. Cultural, economic, racial, age-related, and sexual diversity within the LGBT community dictate a broad range of health needs.
A practical LGBT health model addresses the concerns of the general population as well as the physical and psychological issues that affect the LGBT community.
Health concerns of particular relevance to the LGBT community include:
- Data protection
- Mental health
- Access to information
- Access to services
- Access to HIV/AIDS care by LGBT community including education about sexual behaviour, knowledge of HIV transmission and prevention, perceived risk of AIDS, and safer sex behaviour.
Cultural Factors affecting LGBT people's health
Cultural factors that have a psychological impact on the LGBT community and lead to inadequate physical and mental health care include the following:
- Concealment of sexual orientation and gender identity from care provider with the consequent incomplete medical history, diagnosis, and care of the LGBT patient.
- Delayed medical care and reluctance to seek preventive care
- Lack of support from family, schools, church, government
- Limited employer insurance coverage for same-sex partners
- Same sex parenting
- Underdeveloped child-custody laws
- Insufficient support for same-sex partners using alternative insemination
Societal prejudice, discrimination, and intolerance causing depression, anxiety, suicide (Recent Studies [1] highlight that stigmatization influences mental health in homosexual men. These data suggest that life events that are related to both stigmatization and life change and related emotional distress are significant predictors of psychology dysfunction.)
- Sexism and heterosexism (oppression of nonheterosexual identities)
- Transgender expression in dominant culture
- Ostracism from family, gay community, and general population
- Violence against LGBT community [2]
Doctor-Patient relationship: what are the issues?
Knowing when and why to seek health care and getting adequate care from a sensitive provider can be a challenge for anyone. Lesbian, gay, bisexual and transgender (LGBT) people may experience added difficulty.
Unfortunately, many healthcare providers don't know all they should about the unique health concerns of LGBT people.
Recent studies show that many physicians, clinicians, and therapists view LGBT people and their lifestyles as strange or irrelevant. Many providers claim that they do not feel comfortable treating LGBT people, and others see them as problematic, confusing, and dismissible. Many LGBT people recognize these perspectives and usually they became reluctant to seek medical care. The most common reasons for this unwillingness are:
- Delaying a visit to a medical provider or not visiting at all because of the fear of one’s sexual orientation or gender identity being revealed.
- Less than full trust in doctor’s ability to keep information confidential.
- Inability to talk about sexual orientation and/or gender identity, even when understood to be crucial to proper treatment.
- Belief that doctors are not sensitive to people of different sexual orientation or gender identity.
- Being known to or perceived to be of a different sexual orientation, or having to reveal one’s sexual orientation or gender identity
Increased risk for certain diseases combined with inadequate health care puts LGBT people at a disadvantage and endanger their health.
Research has indicated that fear of discrimination and stigma cause many GLBT individuals to postpone or decline seeking medical care. Others, once in care, sometimes withhold from their providers personal information, which may be critical to their well-being.
Many LGBT people are reluctant to seek care, because they fear insensitivity, dismissal, and discrimination from the medical community.
Eliminating barriers to care requires both an educated and empowered consumer base and a skilled, culturally competent, sensitive and welcoming provider community that is openly supportive of gay, lesbian, bisexual and transgender people and their families.
That's why LGBT patients need to educate themselves in order to make sure they get sensitive and competent care. [3] And why urgent is the need to educate about the health needs of LGBT people some members of the medical and counselling profession in order to create a welcoming environment for LGBT patients.
ILGA-Europework to support and LGBT people’s health concerns:
Health concerns related to LGBT people rights is one of the main issues ILGA-Europe is working towards throughout different kinds of actions [4].
Particularly ILGA-Europe focus its efforts on the need to promote information about the main concern issues related to LGBT people health and to provide EQUAL TREATMENT in receiving healthcare (health care equality) and in accessing to the health care system to prevent illness, disability, and premature death;
Our main objective is to promote targeted, value and research based information to strengthen civil and political awareness on these subjects, to set priorities to suggest recommendations of actions to be taken at EU and national levels.
Useful links:
- What does Europe mean for our health? EPHA presentation to ILGA AGM http://www.epha.org/a/879
[1]The relationship between life events and mental health in homosexual men
Ross MW.; PMID: 2212041 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Display&dopt=pubmed_pubmed&from_uid=1529044&tool=ExternalSearch
[2] Source: http://www.lgbthealthchannel.com/healthcare.shtml
[3] http://www.lgbthealthchannel.com/healthcare.shtml
[4] http://www.ilga-europe.org/europe/campaigns_projects/health_project
Council of Europe resolution on “child and teenage suicide”
ILGA leaflet on breast and cervical cancer prevention for women who love women
Do women who love women have a greater risk of developing breast or cervical cancer?Being lesbian or bisexual does not have a direct influence on the frequency of breast cancer or cervical cancer. However, there are certain risk factors that are unique to women who love women – which explains the importance of informing them of the risks.
Because the problem is particularly unrecognised by the public most concerned, ILGA has decided to disseminate a leaflet in English and Spanish on breast and cervical cancer prevention.
The French and Dutch versions were initially coordinated by ILGA with the Belgian Foundation against Cancer and with the help of Belgian lesbian groups.
Accessing Health: the Context and the Challenges for LGBT People in Central and Eastern Europe (April 2006)
This research project is the first of its size and scope has to be carried out among LGBT communities in Bosnia and Herzegovina, Hungary, Macedonia, Moldova and Romania. As such, the initiative is of groundbreaking importance and the data collected will serve to inform ongoing advocacy and policy work. The report presents the findings on health and access to the health care system by the LGBT communities in five Central and Eastern European countries, as well as draws conclusions and makes recommendations to the relevant stakeholders, including international organisations. It also introduces a methodology and lessons learnt, which could be used for further research.
Lesbian and Bisexual Women's Health Report (ILGA, 2006)
Written Contribution from ILGA-Europe, Green Paper – Improving the mental health of the population: Towards a strategy on mental health for the European Union (COM (2005) 484), May 2006
Discrimination, social exclusion and mental ill-health are interconnected in more than one way. While people with mental illness may face discrimination due to stigma attached to mental health problems, discrimination on a variety of grounds can be also at the root of mental health problems.
Lesbian, gay, bisexual and transgender (LGBT) people do face many forms of discrimination and exclusion which may negatively impact their mental health. While LGBT people are not inherently any more prone to mental or emotional distress than anyone else, research shows that the discrimination they experience on grounds of their sexual orientation and/or gender identity is a significant determinant of their mental health.
In this context, ILGA-Europe welcomes the proposal to launch a debate on the need for an EU strategy on mental health and would like to contribute to the consultation by highlighting the importance of discrimination as a determinant of mental health. This contribution is intended to stress the connection between discrimination and mental health through a brief overview of the impact of discrimination on grounds of sexual orientation and/or gender identity on the mental health of LGBT people. This paper also provides a response to the questions raised by the Commission in the green paper from the perspective of promoting equality for, and combating discrimination against LGBT people.
ILGA-Europe welcomes the opportunity to contribute to this green paper consultation process, and looks forward to an ongoing debate in this important policy area with all the relevant stakeholders.
