Dataset Information

Discrimination in the United States: Experiences of lesbian, gay, bisexual, transgender, and queer Americans.

ABSTRACT: OBJECTIVE:To examine reported experiences of discrimination against lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults in the United States, which broadly contribute to poor health outcomes. DATA SOURCE AND STUDY DESIGN:Data came from a national, probability-based telephone survey of US adults, including 489 LGBTQ adults (282 non-Hispanic whites and 201 racial/ethnic minorities), conducted January-April 2017. METHODS:We calculated the percentages of LGBTQ adults reporting experiences of discrimination in health care and several other domains related to their sexual orientation and, for transgender adults, gender identity. We report these results overall, by race/ethnicity, and among transgender adults only. We used multivariable models to estimate adjusted odds of discrimination between racial/ethnic minority and white LGBTQ respondents. PRINCIPAL FINDINGS:Experiences of interpersonal discrimination were common for LGBTQ adults, including slurs (57 percent), microaggressions (53 percent), sexual harassment (51 percent), violence (51 percent), and harassment regarding bathroom use (34 percent). More than one in six LGBTQ adults also reported avoiding health care due to anticipated discrimination (18 percent), including 22 percent of transgender adults, while 16 percent of LGBTQ adults reported discrimination in health care encounters. LGBTQ racial/ethnic minorities had statistically significantly higher odds than whites in reporting discrimination based on their LGBTQ identity when applying for jobs, when trying to vote or participate in politics, and interacting with the legal system CONCLUSIONS: Discrimination is widely experienced by LGBTQ adults across health care and other domains, especially among racial/ethnic minorities. Policy and programmatic efforts are needed to reduce these negative experiences and their health impact on sexual and/or gender minority adults, particularly those who experience compounded forms of discrimination.

SUBMITTER: Casey LS

PROVIDER: S-EPMC6864400 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Discrimination in the United States: Experiences of lesbian, gay, bisexual, transgender, and queer Americans.

Casey Logan S LS Reisner Sari L SL Findling Mary G MG Blendon Robert J RJ Benson John M JM Sayde Justin M JM Miller Carolyn C

Health services research 20191028

<h4>Objective</h4>To examine reported experiences of discrimination against lesbian, gay, bisexual, transgender, and queer (LGBTQ) adults in the United States, which broadly contribute to poor health outcomes.<h4>Data source and study design</h4>Data came from a national, probability-based telephone survey of US adults, including 489 LGBTQ adults (282 non-Hispanic whites and 201 racial/ethnic minorities), conducted January-April 2017.<h4>Methods</h4>We calculated the percentages of LGBTQ adults ...[more]

PMID: 31659745

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Project description:BackgroundLesbian, gay, bisexual, transgender, and queer (LGBTQ) populations face multiple health disparities including barriers to healthcare. Few studies have examined healthcare trainees' perceptions of their preparedness to care for LGBTQ populations and none have compared perceptions of training across medicine, dental medicine, and nursing. We aimed to understand variations across disciplines in LGBTQ health by assessing medical, dental, and nursing students' perceptions of preparedness across three domains: comfort levels, attitudes, and formal training.MethodsWe developed a 12-item survey with an interprofessional panel of LGBTQ students from the schools of medicine, dental medicine, and nursing at a top-tier private university in the United States. Any student enrolled full time in any of the three schools were eligible to respond. We performed descriptive statistical analyses and examined patterns in responses using Kruskal-Wallis tests and an ordered logistic regression model.Results1,010 students from the Schools of Medicine, Dental Medicine, and Nursing responded to the survey for an overall response rate of 43%. While 70-74% of all student respondents felt comfortable treating LGBTQ patients, fewer than 50% agreed that their formal training had prepared them to do so. Overall, 71-81% of students reported interest in receiving formal LGBTQ health education, though dental students were significantly less likely than medical students to report this interest (OR 0.53, p<0.01). Respondents who identified as LGBQ were significantly less likely than heterosexual students to agree that training was effective (OR 0.55, p<0.01) and that their instructors were competent in LGBTQ health (OR 0.56, p<0.01).ConclusionDespite high comfort levels and positive attitudes towards LGBTQ health, most student respondents did not report adequate formal preparation. There were some significant differences between disciplines, but significant gaps in training exist across disciplines. Health professional schools should develop formal content on LGBTQ health and utilize this content as an opportunity for interprofessional training.

Project description:Amid incremental progress in establishing an enabling legal and policy environment for lesbian, gay, bisexual, transgender and queer-identified people, and people with intersex variations (LGBTQI+) in India, evidence gaps on LGBTQI+ health are of increasing concern. To that end, we conducted a scoping review to map and synthesize the current evidence base, identify research gaps, and provide recommendations for future research. We conducted a scoping review using the Joanna Briggs Institute methodology. We systematically searched 14 databases to identify peer-reviewed journal articles published in English language between January 1, 2010 and November 20, 2021, that reported empirical qualitative, quantitative or mixed methods data on LGBTQI+ people's health in India. Out of 3,003 results in total, we identified 177 eligible articles; 62% used quantitative, 31% qualitative, and 7% mixed methods. The majority (55%) focused on gay and other men who have sex with men (MSM), 16% transgender women, and 14% both of these populations; 4% focused on lesbian and bisexual women, and 2% on transmasculine people. Overall, studies reported high prevalence of HIV and sexually transmitted infections; multilevel risk factors for HIV; high levels of mental health burden linked to stigma, discrimination, and violence victimization; and non-availability of gender-affirmative medical care in government hospitals. Few longitudinal studies and intervention studies were identified. Findings suggest that LGBTQI+ health research in India needs to move beyond the predominant focus on HIV, and gay men/MSM and transgender women, to include mental health and non-communicable diseases, and individuals across the LGBTQI+ spectrum. Future research should build on largely descriptive studies to include explanatory and intervention studies, beyond urban to rural sites, and examine healthcare and service needs among LGBTQI+ people across the life course. Increased Indian government funding for LGBTQI+ health research, including dedicated support and training for early career researchers, is crucial to building a comprehensive and sustainable evidence base to inform targeted health policies and programs moving forward.

Project description:BackgroundRecognizing the unique health needs of sexual and gender minorities (i.e., lesbian, gay, bisexual, transgender, queer/questioning individuals) is critical to providing competent and comprehensive healthcare.ObjectiveTo assess resident knowledge of healthcare issues uniquely affecting sexual and gender minorities as well as the role of online case-based didactics to measure and improve knowledge in the diagnosis and treatment of these patients.DesignA multicenter online education intervention from December 2016 to April 2018.ParticipantsThe study population consisted of 833 PGY1-3 residents at 120 internal medicine residency programs in the USA who completed 1018 tests.InterventionsA 1-h online module addressing sexual and gender minority (SGM) health. The test evaluated each resident in four categories: (1) terminology relevant to SGM patients; (2) health disparities and preventive care issues affecting SGM patients; (3) substance use and mental health issues unique to SGM patients; and (4) common sexually transmitted illnesses affecting SGM populations.Main measuresParticipants completed a pre-test assessing SGM health knowledge. A didactic module reviewing diagnosis and management of these diseases was then completed, followed by a post-test.Key resultsAmong 1018 resident respondents, there was no difference between post-graduate year pre-test performance (PGY-1 52%, PGY-2 50%, PGY-3 51%; p?=?0.532) or post-test performance (PGY-1 80%, PGY-2 82%, PGY-3 82%; p?=?0.285). Pre-test and post-test performance of an online didactic module was the same across test categories and patient populations for PGY-1 vs. PGY-2 vs. PGY-3. Residents demonstrated an improvement between pre- and post-test knowledge.ConclusionsBaseline knowledge of health issues of sexual and gender minorities, as assessed by pre-test performance, did not change during residency training. An online didactic module introduced trainees to critical issues regarding the care of these vulnerable populations until such curricula are required in training. Health disparities in LGBTQ communities may improve with improved physician training on clinical care of LGBTQ patients and families.

Project description:BackgroundLGBT community organizations in the United States have been providing health services since at least the 1970s. However, available explanations for the origins of LGBT health services do not sufficiently explain why health in particular has been so closely and consistently linked to LGBT activism. Little is also known regarding how LGBT health services may have evolved over time with the growing scientific understanding of LGBT health needs.MethodsThis study begins with a review of the early intersections of sexuality and health that led to an LGBT health movement in the United States, as well as the evolution of LGBT health services over time. Informed by this, an asset map displaying the location and types of services provided by "LGBT community health centers" today in relation to the population density of LGBT people was explored. An online search of LGBT community health centers was conducted between September-December, 2015. Organizational details, including physical addresses and the services provided, were confirmed via an online database of federally-registered non-profit organizations and organizational websites. The locations and types of services provided were analyzed and presented alongside county-level census data of same-sex households using geographic information system (GIS) software ArcGIS for Desktop.FindingsLGBT community health centers are concentrated within urban hubs and coastal states, and are more likely to be present in areas with a high density of same-sex couples. LGBT community health centers do not operate in 13 states. The most common health services provided are wellness programs, HIV/STI services, and counseling services.ConclusionsLGBT community health centers have adapted over time to meet the needs of LGBT people. However, significant gaps in service remain in the United States, and LGBT community health centers may require significant transformations going forward in order to continue serving LGBT people.

Dataset Information

Discrimination in the United States: Experiences of lesbian, gay, bisexual, transgender, and queer Americans.

Publications

Discrimination in the United States: Experiences of lesbian, gay, bisexual, transgender, and queer Americans.

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