Question

Find a web-based information site that provides information on mental health problems

experienced by LGBTQ populations in the USA, and around the globe.

Cite 2.

3. Suggest 2 ways nurses can take the lead in ensuring that quality care is provided for LGBTQ

individuals.

Answer 1

Everyone has a sexual orientation and gender identity. Sexual orientation is who you are romantically or physically attracted to. Gender identity is the internal sense of being male, female, both or neither, which is separate from your biological sex. People who have a different sexual orientation or gender identity from most people fall under the umbrella term LGBTQ+. It is really important to know that identifying as LGBTQ+ is NOT a mental illness or disorder.

Although being LGBTQ+ is absolutely not a mental ^xillness, many LGBTQ+ people experience mental health struggles. The bisexual and transgender communities have the highest rates of mental health concerns within the LGBTQ+ population. Younger members of the LGBTQ+ community struggle the most with mental health concerns of all the age groups.

Most LGBTQ+ individuals are incredibly resilient and will thrive in the face of adversity, with the help of supportive families, communities, and peers. One study even found that LGBTQ+ people used mental health services at 2.5 times higher rates than their “straight” counterparts. However, they are also at particular risk for experiencing shame, fear, discrimination, and adverse and traumatic events.

Also, many people who identify as LGBTQ+ are part of second (and sometimes third or more) community that is marginalized. Examples of these groups are BIPOC (Black, Indigenous, or People of Color), people with a physical disability, people practicing a religion different than their neighbors, and people with low socioeconomic status. These people have complex experiences that cannot be easily addressed in one area of their life.

There are many negative stereotypes about being LGBTQ+ which makes many uncomfortable letting people know this important part of their identity. When people do openly express this part of themselves, they face the potential of rejection from peers, colleagues, and friends can exacerbate feelings of loneliness.

Demographics/Societal Issues

Among U.S. adults, 4.5 percent identify as lesbian, bisexual, or transgender.

LGBT identification is lower as age increases; 8.2 percent of Millennials (born between 1980 and 1999) identify as LGBT, compared to 3.5 percent of Generation X individuals (born between 1965 and 1979).

Women are more likely to identify as LGBT than men (5.1 percent compared to 3.9 percent).

Research suggests that LGBTQ+ individuals face health disparities linked to societal stigma, discrimination, and denial of their civil and human rights. Discrimination against LGBTQ+ persons has been associated with high rates of psychiatric disorders, substance abuse, and suicide.

Personal, family, and social acceptance of sexual orientation and gender identity affects the mental health and personal safety of LGBT individuals.

Attitudes

A majority of LGBTQ+ people say that they or an LGBTQ+ friend or family member have been threatened or non-sexually harassed (57 percent), been sexually harassed (51 percent), or experienced violence (51 percent) because of their sexuality or gender identity.

Fifty-nine percent of LGBTQ+ people feel that they have fewer employment opportunities and 50 percent believe they are paid less than non-LGBTQ+ people.

Thirty-eight percent of transgender people say they have experienced slurs and 28 percent have experienced insensitive or offensive comments because of their gender identity or sexual orientation.

Twenty-two percent of transgender individuals say they have avoided doctors or health care our of concern they would be discriminated against.

Prevalence

LGBTQ+ teens are six times more likely to experience symptoms of depression than non-LGBTQ+ identifying teens.

LGBTQ+ youth are more than twice as likely to feel suicidal and over four times as likely to attempt suicide compared to heterosexual youth.

Forty-eight percent of transgender adults report that they have considered suicide in the last year, compared to 4 percent of the overall US population.

Access/Insurance

In a survey of LGBTQ+ people, more than half of all respondents reported that they have faced cases of providers denying care, using harsh language, or blaming the patient’s sexual orientation or gender identity as the cause for an illness. Fear of discrimination may lead some people to conceal their sexual orientation or gender identity from providers or avoid seeking care altogether.

In 2011, the Joint Commission, an independent non-profit national organization that accredits and certifies more than 20,000 health care organizations and programs in the U.S., began to require that hospitals prohibit discrimination based on sexual orientation, gender identity, and gender expression in order to be accredited.

Treatment Issues

Approximately 8 percent of LGBTQ+ individuals and nearly 27 percent of transgender individuals report being denied needed health care outright.

In mental health care, stigma, lack of cultural sensitivity, and unconscious and conscious reluctance to address sexuality may hamper effectiveness of care.

Evidence suggests that implicit preferences for heterosexual people versus lesbian apepervasive among heterosexual health care providers.

Nursing care****"

1. Expand your own LGBTQ-care knowledge

To understand the needs of LGBTQ patients, nurses must expand their own knowledge on the subjects of sexual orientation (SO), and gender identity (GI), and how both areas are included in healthcare.

2. Be aware of key LGBTQ definitions

The LGBT Center has a helpful and in-depth guide that breaks down definitions and terms that are used when addressing the LGBTQ community, as well as how those terms may be applied in the clinical sense. Some of the terms you can familiarize yourself with include those referring to gender identity. Gender identity includes transgendered individuals, when a person identifies as a different gender than their biological parts at birth. Gender identity also includes individuals who identify as genderfluid and or have gender expansive identities.

3. Deepen your LGBTQ knowledge

Deepening your knowledge base will enrich your understanding of sexuality in general, and increase your nimbleness in identifying potential health risks for patients seeking your care.

Keep your knowledge up-to-date with ongoing training, reading, and learning from others who are skilled in communicating with and caring for these patient.

4. Create a welcoming environment for LGBTQ patients

LGBTQ individuals have a long history of discrimination at the individual and institutional levels, including the healthcare system. They may “scan” an environment to determine if it is a safe place to reveal personal information. Some things an individual may watch for and take note of during their time in your reception or waiting room area:

Availability of unisex restrooms

Health education literature with diverse images and inclusive language, including information about LGBTQ health

Posters announcing days of observance such as World AIDS Day, Pride, and National Transgender Day of Remembrance

5. Use inclusive language

As a healthcare professional providing care for all, it’s important that you use inclusive language. Language matters when discussing and approaching LGBTQ-centered care. Here are some examples of how you can include inclusive language on both intake forms and in speaking with your patients:

For marital status, the form might read, “relationship status: married, partnered, or other,” as well as, of course, any gender identification spaced to include an option outside of male or female.

When asking patients to provide their names, it’s also helpful to include an additional space indicating “Preferred Name,” as a transgender individual may not wish to be called by a name that reflects their gender identity. And including “preferred pronoun” on a form shows understanding that someone may not identify as they appea

6. Use gender-neutral language

Approach each interaction with open-mindedness and a nonjudgmental attitude. For instance, you can use language that changes “nursing mother” to “currently nursing,” indicating that not all who lactate identify as mothers or women, or “menstruating person” instead of “menstruating woman.”

Pronouns are also incredibly important, and starting with a general “they” can be helpful if it’s not clear which pronoun your patient prefers. When in doubt about how to best address a patient, don’t be afraid to simply ask. Asking your patient how they would like to be addressed is a sign of respect and signifies that you are aware that not all individuals identify with she/he pronouns.

7. Ask open-ended questions

For example, asking, “Is there anything else that would help me ensure you get the most out of this visit?” can help patients share relevant health information.

Do not overwhelm patients with questions unrelated to the reason for their visit, or to enhance your own knowledge about transgender health. If caring for LGBTQ patients is new to you, it may also be helpful to practice your responses to questions in advance, such as “Thank you for being open with me; this will help me provide better care for you.” Role-playing your response can increase your own comfort with these situations.

8. Reflect the patient’s language

Avoid applying labels, as some people do not self-identify with any particular descriptive label, and may have sex with partners of more than one sex or gender. Do not presume.

9. Be aware of mental and physical health risks for LGBTQ patients

Be aware of the unique social pressures and health risks of LBGTQ patients. Societal phobias, violence, and hate crimes – and the fear of them -- are all too real. Along with the potential for being ostracized by family and other social groups, this can contribute to chronic anxiety and depression. Additionally, LGBTQ individuals who are members of minority populations often face a double burden of discrimination.

It’s also important to build your awareness of the specific physical health problems LGBTQ individuals face. For instance, some specific healthcare risks in the LGBTQ community as compared to the non-LGBT population, and especially for youth, include

Higher risk of substance abuse

Higher risk of STDs

Higher risk of cancers

Higher risk of cardiovascular diseases

Higher risk of bullying

Higher risk of mental health issues, such as anxiety, depression, and suicide

Familiarize yourself, whenever possible, with the specific risks of the population that you will be caring for so you can appropriately screen for any associated health conditions and offer resources as appropriate.

10. Convey respect

Always remember that the LGBTQ patient in front of you has taken a courageous step to be in your office and disclose some of the most personal information about their lives. Having as positive and affirming an experience as possible will make it more likely the individual will seek future care in a timely manner.

Becoming aware of resources specifically designed for LGBTQ individuals and making referrals as appropriate will convey that you care enough to become informed about their particular needs. The quality of your interaction can truly make a difference in someone’s health -- and life.

LGBTQ-Centered Care

More healthcare facilities across the nation are also turning their focus specifically to welcome LGBTQ patients, and train healthcare professionals on LGBTQ-focused care.