Health and Medicine: LGBT Health

Baćak, Valerio, et al. “Incarceration as a health determinant for sexual orientation and gender 

minority persons.” American Journal of Public Health. Vol. 108, issue 8 (August 2018) 994-999.

​ The authors discuss how incarceration affects the health of sexual and gender minority (SGM) individuals. They find that there is a disproportionate amount of SGM individuals in jails and prisons and note the leading health risks for this vulnerable population.  They discuss ways to examine this population further, note the importance of health care access and quality, and recommend further study of the health of the SGM population during incarceration and afterward.

Caputi, Theodore L., et al. “Substance use among lesbian, gay, bisexual, and questioning adolescents in the United States, 2015.” American Journal of Public Health. Vol. 108, issue 8 (August 2018) 1031-1034.

​The objective of this study is to provide current national estimates of lesbian, gay, bisexual, and questioning (LGBQ) adolescents’ substance use risks -- data that is necessary to guide public health and policy strategies. Using data from the 2015 National Youth Risk Behavior Survey (YRBS), the study presents risk estimates for 15 types of substances and finds that LGBQ adolescents have significantly greater risk for substance abuse. The authors urge policymakers to invest in prevention and early intervention resources to address this risk among LGBQ adolescents.

Chelvakumar, Gayathri. "Updates on health and care utilization by TGNC youth." Pediatric News. (March 2018) 19.  

​Chelvakumar looks at a study published in the February 2018 issue of Pediatrics that presented data on the health and care utilization of transgender and gender-nonconforming (TGNC) youth. She notes a few key points of the study, including: the prevalence of TGNC youth is higher than previously reported, there are statistically significant differences in health status between TGNC youth and cisgender youth, and TGNC youth with a perceived gender expression incongruent with the sex assigned at birth were more likely to report poor health status. Suggestions made include, for example, that health care providers recognize there are health disparities in the TGNC population and that TGNC individuals may be vulnerable to discrimination, and for providers to promote access to gender-affirming care.

Dawson, Milly. "Treating LGBTQ patients: 4 ways to address their needs." Medical Economics. (November 10, 2018) 47-48.

​This article suggests several ways staff might address the needs of LGBTQ patients in the healthcare setting. The suggestions include, for example, how to address the patient by using the patient's preferred pronoun and by being self-aware/ knowing one’s own limitations

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​Dubin, Sam. “Working toward a ‘Status Neutral’ Future”. The New York Times Company (June 2019).

​Dr. Demetre Daskalakis, deputy commissioner for the Division of Disease Control of the New York City Department of Health and Mental Hygiene, is among those trying to rewrite the AIDS narrative.During his tenure, New York City has succeeded in lowering H.I.V. transmission rates, rolling out PrEP and rebranding the city's STD (for sexually transmitted disease) Clinics as Sexual Health Clinics. Dr. Daskalakis exemplifies the shifting paradigms around sexual and gender minority health. He has advocated a disease prevention strategy that attempts to remove the stigma associated with H.I.V. and AIDS.

​​Durso, Laura E. “Progress and challenges in sexual orientation and gender identity measurement in the first year of the Trump Administration” American Journal of Public Health. Vol. 108, issue 7 (July 2018) 894-95.

​This editorial addresses the progress and challenges associated with sexual orientation and gender identity during U.S. President Donald Trump's first term in office. It looks at data on LGBTQ populations as well as data from America's National Survey of Older Americans Act Participants (NSOAAP) and the Nation's 2020 Census and American Community Survey.

​Enos, Gary A. "LGBT youths report eating disorders at stunning rate: data shows more than half  of the surveyed population between age 13 and 24 has been diagnosed with an eating disorder." Addiction Professional. (Spring 2018) 42-43. ​

The unique stressors experienced by members of the LGBTQ population, such as harassment and coming out, can influence the levels of low self-esteem, depression, anxiety and unhealthy coping behaviors (e.g. substance abuse) an individual experiences. All of these factors can contribute to the development of eating disorders. This article looks at the results of a recent survey on eating disorders among young people in the LGBTQ population and brings up some concerns. Amit Paley, CEO of the Trevor Project, states that the findings "are alarming and highlight the need for further research to improve the lives of LGBTQ young people in this country." 

George, Rita and Mark A. Stokes. “A quantitative analysis of mental health among sexual and gender minority groups in ASD.” Journal of Autism & Developmental Disorders. Vol. 48, issue 6 (June 2018) 2052-2063.

​As noted by the authors, individuals with autism spectrum disorder (ASD) experience increased mental health difficulties, and individuals of sexual and gender minority groups experience poorer mental health than those of the heteronormative population. According to recent research, individuals with autism report increased non-heterosexuality and gender-dysphoric traits. This study aims to assess whether being a member of a sexual minority group or gender minority group reduces the mental health status of someone with ASD.

Johnson, Kevin K. "Special issues in LGBTQ geriatric psychiatry." Psychiatric Times. (May     2018) 22-23, 27.

​Johnson discusses a number of healthcare issues faced by the ageing LGBTQ population, a diverse group with unique healthcare needs. He suggests ways that clinicians can approach older LGBTQ patients in order to provide them with the best care. Johnson notes the importance of looking at historical context. For example, those born before 1945 came of age in a time when same-sex behavior was highly stigmatized and often illegal. He also looks at disparities and minority stress experienced by older LGBTQ individuals, many who have faced legal and economic discrimination and higher rates of disability and health problems than the general population. However, adds Johnson, many LGBTQ elders have developed coping skills and other factors important to successful ageing: community supports, positive self-identity, socioeconomic resources, access to health care, etc.  

Landers, Stewart, and Farzana Kapadia. “50 Years After Stonewall, the LGBTQ Health Movement Embodies Empowerment, Expertise, and Energy”. American Journal of Public Health (June 2019). 849  

​The author argues that the Stonewall Riots of 1969 did not precipitate the following HIV epidemic in the U.S. due to increased promiscuous sexual behavior by gay men. Topics include the U.S. healthcare system's lack of preparedness     and unwillingness to meet the needs of the LGBTQ population, the emphasis on social justice and health equity through activism during the AIDS era, and the impact of social conditions and inequity on the health and well-being of LGBTQ people, women, and people of color.

Larkin, Marilyn.  “Enhancing health, wellness and community for older LGBT adults.” The Journal on Active Aging. (July/August 2018) 38-40, 42, 46-49.

​Older LGBT adults face similar issues to other aging adults: isolation, housing affordability, ageism, etc. According to research, older LGBT adults have additional concerns that affect their health and wellness, such as a higher prevalence of mental health problems, disability and disease. This article discusses initiatives being made to build the community, health and wellness of older LGBT adults. It looks at an intergenerational complex in California and a LGBT- welcoming development in New York, and notes how each facility strives to combat the feelings of loneliness and exclusion and boost connectedness among LGBT people. 

​​​Littman, Lisa. “Rapid-onset gender dysphoria in adolescents and young adults: a study of parental reports. PLoS ONE (Public Library of Science). Vol. 13, issue 8 (August 16, 2018) e0202330.​

Gender dysphoria (GD) is defined as an individual's persistent discomfort with one’s biological sex/assigned gender. Two types of gender dysphoria include early-onset, where symptoms begin in early childhood, and late-onset (or adolescent onset) where the symptoms begin after puberty. Rapid-onset gender dysphoria (ROGD) is a type of late-onset gender dysphoria where symptoms begin suddenly in an adolescent/young adult who did not meet the criteria for the disorder in childhood. By examining parental reports, this study describes ROGD, looks at factors in the condition’s development, points out a number of issues with diagnosis and treatment, and advises further research to better understand its implications and scope.

McDowell, Michal, Jaclyn M. White Hughto and Sari L. Reisner. “Risk and protective factors for mental health morbidity in a community sample of female-to-male trans-masculine adults”. BMC Psychiatry. 19.1 (Jan. 9, 2019).

Montano, Gerald T. "All children deserve support for their gender identities." Pediatric News. Vol. 52, Issue 10 (October 1, 2018) 19. ​

Montano looks at a few key points that Jesse Singal made in "When Children Say They’re Trans," in the July/August (2018) edition of The Atlantic. (This article appears in the July/August 2018 print edition with the headline “Your Child Says She’s Trans. She Wants Hormones and Surgery. She’s 13.”) These key points include “desistance,” when individuals no longer feel that their gender identities are different from their physical appearance, and “detransitioning,” when people undergo social or physical transitions and later reverse them. Montano discusses Singal’s concerns that children who have had irreversible medical treatments to confirm their gender identity will change their minds. He questions Singal’s call for a cautious approach for treating children identifying as transgender and recommends instead that parents and clinicians support the child in affirming gender identity.

Montano, Gerald. "Preexposure prophylaxis among LGBT youth." Pediatric News. (January 2018) 19.

​The combination drug emtricitabine/tenofovir (also known as Truvada) is used as a pre-exposure prophylaxis (PrEP) against HIV (the human immunodeficiency virus). While many in the LGBT community have benefited from this HIV prevention treatment, questions of effectiveness and safety have kept providers from prescribing it to LGBT adolescents. Although it has risks, Montano urges providers to consider using PrEP with LGBT adolescents because significant barriers exist in preventing HIV in this high-risk population. Furthermore, he adds that there is growing evidence that PrEP is safe and effective at preventing HIV.

“New Findings from University of Utah Update Understanding of Cancer

This article states the results of a new study that identify the unique needs of lesbian, gay, bisexual, and transgender (LGBT) cancer patients and caregivers, and review recommendations supporting more effective and inclusive palliative and end-of-life care. Published research and clinical guidelines."  

[Palliative and End-of-life Care for Lesbian, Gay, Bisexual, and Transgender (Lgbt) Cancer Patients and Their Caregivers”. Obesity, Fitness and Wellness Week (April 2019) p 3243

"Researchers at Sylvester Comprehensive Cancer Center Report New Data on Cancer (Developing a Wef-based LGBT Cultural Competency Training for Oncologists: the Colors Training).” Obesity, Fitness & Wellness Week, (June 2019). 6382

​To increase cultural awareness among oncologists an meeting was conducted resulting in a practical and efficient web-based resource for LGBT cultural competency training for oncologists.

Oakes, Kari. “Breast cancer surveillance a must for transgender patients.” Family Practice News Volume 48, Issue 7 (April 15, 2018) 7.

​According to a Dutch national study, both transgender men and transgender women had an increased risk of breast cancer compared with a male, but not a female, reference population. This article points out that breast cancer can still occur after mastectomy in transgender men, and notes how at-risk individuals may fall through the cracks when electronic health records have a binary system.  

​Singal, Jesse. “Your child says she’s trans. She wants hormones and surgery. She’s 13.” Atlantic. Vol. 322, Issue 1 (July/August 2018) cover, 88-107.

​This article looks at gender dysphoria in children and at a number of issues in the decision making process of gender transitions. The author points out that while the new protocol of social and physical transition is helpful for many young people experiencing gender dysphoria, caution needs to be taken because for some, gender dysphoria is temporary while some effects of transitioning are permanent. Other topics discussed include the importance of support and acceptance of young people with gender dysphoria, the effects of puberty on decision making, and the occurrence of desisting (when people stop experiencing gender dysphoria without having fully transitioned socially or physically) and detransitioning (when people undergo social or physical transitions and later reverse them). Also discussed is the need for thorough mental health assessments that are critical to achieving positive outcomes, even though some find such assessments traumatizing. This is especially important for those seeking physical interventions. 

​Streed Jr., Carl G, et al. “Changing Medical Practice, Not Patients- Putting an end to Conversion Therapy”. New England Journal of Medicine (Aug 2019). 500

​​The article focuses on the conversion therapy that is rooted in the notion that any non-heterosexual sexual orientation is a pathology in need of a cure. It mentions that American Medical Association have publicly denounced that conversion therapy and documented the substantial harm associated with it. It mentions about offering supportive therapies and provide accurate information and resources for all LGBTQ patients and their families.

Worcester, Nancy, and Marianne Whatley. “Rx for Change: Transgender Gender-Affirming Hormone Treatment”. Women’s Health Activist, (July 2019). 

​This article discusses the dangers of purchasing hormones and the multiple barriers to medical care for transgender people. Some resort to finding their own hormone sources. The prevalence of medically unmonitored hormone use is as high as 60% among trans females in the U.S. and Canada. Online hormone incredibly easy--but potentially harmful. One study found 96% of online drug-sellers exist outside regulations, often selling unapproved drugs; drugs containing the wrong active ingredient or wrong amount of the active ingredient; or drugs containing dangerous ingredients. Trans people who lack insurance may seek crowd-funding to support hormone purchases, (16) which is generally unsuccessful for medical needs, and particularly so for transgender health care.

Zimlich, Rachael. “LGBT teens and suicide risk: How you can help: A new report highlights the increased risk of suicide for lesbian, gay, bisexual, transgender (LGBT) adolescents versus their heterosexual peers”. Contemporary Pediatrics (Mar. 2019) p34+.