“Sexual orientation and gender identity” (SOGI) is a term used by the BC Human Rights Code to describe an area of prohibited discrimination. It is an inclusive term that encompasses all individuals regardless of where they identify on the sexual orientation or gender identity spectrums, including lesbian, gay, bisexual, transgender, queer, two-spirit, heterosexual, and cisgender. (The ARC Foundation. 2016)
SO/GI is an initiative to improve access to health services of quality for LGBTI patients and collect data. According to authorities such as the Institute of Medicine and The Joint Commission, collecting sexual orientation and gender identity (SO/GI) data in health care settings is essential to providing high-quality, patient-centered care to LGBT individuals, as well as an important part of efforts to better understand and address LGBT population health disparities.
Because most clinical records systems do not support the collection of structured SO/GI data, however, LGBT people are often invisible in care settings. This invisibility masks disparities and impedes the provision of important health care services for LGBT individuals, such as appropriate preventive screenings; assessments of risk for HIV and other sexually transmitted infections; and effective interventions for mental and behavioral health concerns, particularly those that may be related to experiences of anti-LGBT stigma and discrimination.
Moreover, like all patients, LGBT people have many concerns related to aspects of everyday life such as relationships, family planning, and issues of aging that occur in different stages of the life cycle. Providing patients with opportunities to share information about their sexual orientation and gender identity in a welcoming environment facilitates important conversations with clinicians who are in a position to significantly promote these patients’ optimal health and wellbeing.
It is important that clinical staff be trained in how to provide culturally competent and affirming care to LGBT patients, and how to ask about sexual orientation and gender identity in an efficient, effective, and respectful manner as part of that process. (The Fenway Institute, 2015)
There are no LGBT-specific diseases or illnesses. However, LGBT people are more likely to experience certain health issues compared to people who are not LGBT. These health issues are often related to the stigma and discrimination LGBT people experience in their daily lives—at school or work, in public places, or in health care settings. These experiences can be the cause of health issues requiring medical attention.
For example, LGBT youth may experience bullying from schoolmates and, as a result, become socially isolated and turn to substance abuse. At other times, LGBT people’s previous negative experiences getting care can interfere with their access to the health care they need. If they feel uncomfortable due to negative experiences with staff, they may stop going to a clinic or medical facility even if they are in the middle of necessary treatment. Being a member of a group that experiences discrimination can cause high levels of stress (sometimes called “minority stress”), which can lead to a broad range of health problems, some of which are listed below. By learning to avoid discrimination, stigmatization, and simple mistakes due to inexperience, front-line health care workers can help LGBT people avoid the “double whammy” of experiencing these health problems in their daily lives, and then being discouraged from seeking the care they need.
A few examples of these health problems include:
- LGBT youth are 2 to 3 times more likely to attempt suicide, and are more likely to be homeless (it is estimated that between 20% and 40% of all homeless youth are LGBT). LGBT youth are also at higher risk for becoming infected with HIV and other sexually transmitted diseases (STDs). They are also more likely to be bullied.
- Gay men and other men who have sex with men (MSM) are at higher risk of HIV and STDs, especially within communities of color.
- LGBT populations are much more likely to smoke than others; they also have higher rates of alcohol use, other drug use, depression, and anxiety.
- Lesbians are less likely to get preventive services for cancer, such as mammograms and Pap tests.
- Bisexuals have higher rates of behavioral health issues compared to lesbians and gay men.
- Transgender individuals experience a high prevalence of HIV and STDs, victimization, and suicide attempts. They are also less likely to have health insurance than heterosexual or LGB individuals due to rejection by their families or discrimination when seeking employment.
- Elderly LGBT individuals face additional barriers to health care because of isolation, diminished family supports, and reduced availability of social services. Some report discrimination from their peers when living in communal elderly housing. (The Fenway Institute, 2015)
Contemporary health disparities based on sexual orientation and gender identity are rooted in and re ect the historical stigmatization of LGBT people. Most LGBT people encounter stigma from an early age, and this experience shapes how they perceive and interact with all aspects of society, including health-related institutions. Likewise, heterosexual people (including many health care professionals) have been socialized in a society that stigma- tizes sexual and gender minorities, and this context inevitably affects their knowledge and perceptions of LGBT people. And institutions and systems that affect the health of LGBT people have evolved within a society that has historically stigmatized those populations, and this has important implica- tions for their ability to address the needs of sexual and gender minorities. (Institute of Medicine, 2011)
According to a survey conducted by vpnMentor 73% of LGBTQs have been harassed online due to sexual orientation or gender identity. This guide aims to give the tools to protect ourselves online.
The making of a LGBT medical directory is to be used as a symbol and as a tool of communication and education between actors (patients, medical professionals and everybody else). The route to build the directory is filled with challenges that will guide the tasks along the implementation process.
The problem: Lack of adequate trainning to provide differentiated care to LGBTI population.
According to Gerry Mackie and Francesca Moneti, there are many reasons why population groups engage in behaviors that are harmful, these behaviors may determine their access to health and other services. There may also be social motivations that explain why a behavior is common in a group. Beliefs about what others do, and what others think one should do, often guide a person´s actions in her social setting. When one does what others do it can be because one thinks they know best what to do. When one does what one believes others think one should do, it can be because one is motivated to secure the esteem and acceptance of others in the group or to avoid their disesteem and rejection, or by one´s belief that it is legitimate to comply with their expectations. If a harmful practice is social in nature, programs that concentrate on education of the individual, or increase in the availability of alternatives, or provision of external incentives, may not be sufficient. A program may need to support the clarification, and sometimes the revision of social expectations of people throughout the entire community of interest.
The actions of an individual range from the highly independent, to the dependent, to the highly interdependent. Development thinking has tended to understand individual actions of programmatic interest as being independent, or as being one-way dependent, as in the diffusion of innovation. However, there are human actions where what one does depends on what others do at the same time that what others do depend on what one does (many-way interdependence).
- Incentives: Compromise based on performance.
- Educational Content and communication.
- Service Evaluation: Follow-up.
The ultimate goal of the strategy is to adopt both in doctors and patients beneficial practices to uninstall harmful behaviors. The medical directory will be consulted on-line or in printed versions. In order to be listed on the directory, doctors will have to go through all three components, this will channel a commercial opportunity for overlooked markets.
The strategy doesn´t have to start necessarily at schools, it can be tailored scenarios such as conference cycles, seminars, workshops, webinars, meetings, video, talks, social network, it can be anything to reach specific audiences, we can take great advantage of digital channels, products and services.
All content on this website (c) Gloria Rodríguez 2018