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Define and describe for lesbian, bisexual and transgender individuals.
Gender and sexuality concepts.
Social and political context.
Social determinants of health affecting lesbian, bisexual and transgender individuals.
Barriers to health care.
Health care disparities.
The social and political context for lesbian, bisexual, and transgender (LBT) individuals has historically been marked by discrimination and marginalization. Before the late 20th century, homosexuality and gender non-conformity were widely stigmatized and pathologized as mental illnesses. The Stonewall Riots of 1969 are often cited as a turning point, sparking the modern LGBTQ+ rights movement.
Politically, the fight for equal rights has led to significant milestones like the legalization of same-sex marriage in the US in 2015 and the increasing recognition of transgender rights. However, many states and countries still lack comprehensive non-discrimination laws, and anti-LGBTQ+ rhetoric and legislation persist, particularly targeting transgender individuals. This political and social environment directly affects the health and well-being of LBT people.
Social determinants of health (SDOH) are the non-medical factors that influence health outcomes. For LBT individuals, these include:
Socioeconomic Status: Discrimination in hiring, housing, and education can lead to lower income and employment instability, which in turn limits access to quality healthcare.
Physical Environment: LBT individuals may face housing insecurity and homelessness due to family rejection or discrimination, leading to higher rates of poor health.
Social and Community Context: Stigma, discrimination, and violence from family and community members can lead to social isolation, mental health issues, and a lack of support systems.
Education: LBT students may experience bullying and harassment, leading to higher dropout rates and lower educational attainment, which impacts future employment and health literacy.
LBT individuals face significant barriers to healthcare, which contribute to stark health disparities.
Barriers:
Lack of Insurance: Due to employment discrimination and poverty, LBT individuals are more likely to be uninsured or underinsured.
Provider Bias: Many healthcare providers lack training in LGBTQ+ health and may hold unconscious biases, leading to disrespectful treatment or refusal of care.
Fear of Discrimination: LBT individuals may fear being "outed" or discriminated against by healthcare providers, causing them to avoid seeking necessary care or being dishonest about their behaviors.
Structural Barriers: Healthcare forms often do not include options for non-binary gender identities or same-sex partners, making LBT people feel invisible and misunderstood.
Health Disparities:
These barriers contribute to a range of health disparities.
Mental Health: LBT individuals have higher rates of depression, anxiety, suicide attempts, and substance abuse due to minority stress—the chronic stress experienced by members of marginalized groups.
Lesbian: A woman who is primarily emotionally, romantically, and/or sexually attracted to other women. The term is a sexual orientation.
Bisexual: A person who is emotionally, romantically, and/or sexually attracted to more than one gender. This is also a sexual orientation and is often misunderstood as attraction to only two genders (men and women), but it includes attraction to people of any gender.
Transgender: A person whose gender identity differs from the sex they were assigned at birth. For example, a person who was assigned male at birth but identifies and lives as a woman is a transgender woman. This term refers to a person's gender identity, which is distinct from their sexual orientation.