Abstract
Nearly every lesbian, gay, bisexual and transgender (LGBT) patient in the U.S. accesses health care at non-LGBT affiliated medical facilities. This chapter is an introduction for the busy practitioner to the unique health needs of sexual and gender minorities. Many providers are comfortable asking the question “Do you have sex with men, women, or both?”, but it is sometimes difficult to know how to translate this information into improved clinical outcomes. The art of medicine goes well beyond data gathering. To that aim, this chapter discusses LGBT history, demographics, and medical terminology. Understanding LGBT history will help providers build therapeutic alliance and better understand the relationship between minority stress and health disparities. An exploration of demographics reveals the natural variation of sexual orientation, gender expression and gender identity across all racial, religious, and socioeconomic populations that you will serve, regardless of specialty. An exploration and deconstruction of the varied terminology used by and for LGBT patients can help even experienced health care providers improve their data gathering and communication skills. It is our hope that this chapter will not only help you improve the well-being of your patients, but excite you to seek out opportunities to serve these unique, diverse, resilient communities.
Keywords
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Obedin-Maliver J, et al. Lesbian, gay, bisexual, and transgender-related content in undergraduate medical education. JAMA. 2011;306(9):971–7.
Ng H, Sudano J. Health centers in the United States. Presented at American Public Health Association meeting, 2012.
Kaiser Family Foundation. HIV/AIDS in the lives of gay and bisexual men in the United States. 2014. http://kff.org/hivaids/report/hivaids-in-the-lives-of-gay-and-bisexual-men-in-the-united-states/. Accessed Sept 2014.
Cochran S, Keenan C, Schober C, Mays V. Estimates of alcohol use and clinical treatment needs among homosexually active men and women in the U.S. population. J Consult Clin Psychol. 2000;68:1062–71.
Gilman S, Cochran S, Mayx V, Hughes M, Ostrow D, Kessler R. Risk of psychiatric disorders among individuals reporting same-sex sexual partners in the National Comorbidity Survey. Am J Public Health. 2001;91:933–9.
Mays V, Yancey A, Cochran S, Weber M, Fielding J. Heterogeneity of health disparities among African American, Hispanic and Asian American women: unrecognized influences of sexual orientation. Am J Public Health. 2002;92:632–9.
Drabble L, Trocki K. Alcohol consumption, alcohol-related problems, and other substance use among lesbian and bisexual women. J Lesbian Stud. 2005;9:19–30.
Hughes T, Wilsnack S, Szalacha L, Johnson T, Bostwick W, Seymour R, et al. Age and racial/ethnic differences in drinking and drinking-related problems in a community sample of lesbian women. J Stud Alcohol. 2006;67:579–90.
Kripke M, Weiss G, Ramirez M, Dorey F, Ritt-Olson A, Iverson E, Ford W. Club drug use in Los Angeles among young men who have sex with men. 2007. Club drug use in Los Angeles among young men who have sex with men. Subst Use Misuse. 2007;42:1723–43.
Cochran S, Mays V. Physical health complaints among lesbian women, gay men, and bisexual and homosexually experienced heterosexual individuals: results from the California Quality of Life Survey. Am J Public Health. 2007;97:2048–55.
Lee GL, Griffin GK, Melvin CL. Tobacco use among sexual minorities in the USA: 1987 to May 2007: a systematic review. Tob Control. 2009;18:275–82.
Xavier J, Honnold J, Bradford J. The health, health-related needs, and lifecourse experiences of transgender Virginians. Virginia HIV Community Planning Committee and Virginia Department of Health. Richmond, VA: Virginia Department of Health; 2007. Available from: http://www.vdh.virginia.gov/epidemiology/DiseasePrevention/documents/pdf/THISFINALREPORTVol1.pdf.
Hughes TL. Chapter 9: Alcohol use and alcohol-related problems among lesbian women and gay men. Annu Rev Nurs Res. 2005;23:283–325.
Lyons T, Chandra G, Goldstein J. Stimulant use and HIV risk behavior: the influence of peer support. AIDS Educ Prev. 2006;18(5):461–73.
Mansergh G, Colfax GN, Marks G, et al. The circuit party men’s health survey: findings and implications for gay and bisexual men. Am J Public Health. 2001;91(6):953–8.
Garofalo R, Wolf RC, Wissow LS, et al. Sexual orientation and risk of suicide attempts among a representative sample of youth. Arch Pediatr Adolesc Med. 1999;153(5):487–93.
Conron KJ, Mimiaga MJ, Landers SJ. A population-based study of sexual orientation identity and gender differences in adult health. Am J Public Health. 2010;100(10):1953–60.
Kruks G. Gay and lesbian homeless/street youth: special issues and concerns. J Adolesc Health. 2010;12(7):515–8.
Van Leeuwen JM, Boyle S, Salomonsen-Sautel S, et al. Lesbian, gay, and bisexual homeless youth: an eight-city public health perspective. Child Welfare. 2006;85(2):151–70.
Cahill S, South K, Spade J. Outing age: public policy issues affecting gay, lesbian, bisexual and transgender elders. Washington, DC: National Gay and Lesbian Task Force; 2009.
Buchmueller T, Carpenter CS. Disparities in health insurance coverage, access, and outcomes for individuals in same-sex versus different-sex relationships, 2000–2007. Am J Public Health. 2010;100(3):489–95.
Dilley JA, Simmons KW, Boysun MJ, et al. Demonstrating the importance and feasibility of including sexual orientation in public health surveys: health disparities in the Pacific Northwest. Am J Public Health. 2010;100(3):460–7.
Struble CB, Lindley LL, Montgomery K, et al. Overweight and obesity in lesbian and bisexual college women. J Am Coll Health. 2010;59(1):51–6.
Centers for Disease Control and Prevention (CDC). HIV and AIDS among gay and bisexual men. Atlanta: CDC; Sept 2010. Available from:http://www.cdc.gov/nchhstp/newsroom/docs/2012/CDC-MSM-0612-508.pdf.
Herbst JH, Jacobs ED, Finlayson TJ, et al. Estimating HIV prevalence and risk behaviors of transgender persons in the United States: a systematic review. AIDS Behav. 2008;12:1–17.
Whitbeck LB, Chen X, Hoyt DR, et al. Mental disorder, subsistence strategies, and victimization among gay, lesbian, and bisexual homeless and runaway adolescents. J Sex Res. 2004;41(4):329–42.
Diaz RM, Ayala G, Bein E, et al. The impact of homophobia, poverty, and racism on the mental health of gay and bisexual Latino men: findings from three US cities. Am J Public Health. 2001;91(6):141–6.
Kenagy GP. Transgender health: findings from two needs assessment studies in Philadelphia. Health Soc Work. 2005;30(1):19–26.
National Gay and Lesbian Taskforce. National transgender discrimination survey: preliminary findings. Washington, DC: National Gay and Lesbian Taskforce; Nov 2009. Available from: http://www.thetaskforce.org/downloads/reports/fact_sheets/transsurvey_prelim_findings.pdf.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Publishing; 2013.
Gates G, Ost J. Estimating the size of the gay and lesbian population. The gay and lesbian atlas. Washington, DC: Urban Institute Press; 2004. p. 17–21.
Gates G. How many people are lesbian, gay, bisexual, and transgender? A Report of the Williams Institute. Los Angeles, CA: Williams Institute, UCLA School of Law; 2011.
Olyslager F, Conway L. On the calculation of the prevalence of transsexualism. Paper presented at WPATH 20th international symposium, Chicago, USA, 2007.
Gates G. LGBT adult immigrants in the United States. Los Angeles, CA: Williams Institute at UCLA Law School; 2013.
Grant J, et al. Injustice at every turn: a report of the national transgender discrimination survey. Washington, DC: National Gay and Lesbian Task Force and National Center for Transgender Equality; 2011.
Consortium on the Management of Disorders of Sex Development. Clinical guidelines for the management of DSD in childhood. Intersex Society of North America. 2006.
Fausto-Sterling A, et al. How sexually dimorphic are we? Review and synthesis. Am J Hum Biol. 2000;12:151–66.
Centers for Disease Control and Prevention. Sexual identity, sex of sexual contacts, and health risk behaviors among students in grades 9–12 in selected sites—youth risk behavior surveillance, United States, 2001–2009. MMWR Surveill Summ. 2011;60(7):1–133. Early Release.
Gates G, Konnoth C. Same-sex couples and immigration in the United States. Los Angeles, CA: Williams Institute, UCLA School of Law; 2012.
Feldman M. Aversion therapy for sexual deviations: a critical review. Psychol Bull. 1966;65:65–79.
Levine M. The impact of AIDS on the homosexual clone community in New York City. Paper presented at 5th international conference on AIDS, Montreal, 1989.
Levine MP, et al. In changing times: gay men and lesbian women encounter HIV/AIDS. Chicago, IL: University of Chicago Press; 1997.
Hereck G. AIDS and stigma. Am Behav Sci. 1999;42:1106–16.
Herbenick D, Reece M, Schick V, Sanders SA, Dodge B, Fortenberry JD. Sexual behavior in the United States: results from a national probability sample of men and women aged 14–94. J Sex Med. 2010;7 Suppl 5:255–65.
Koh AS. Use of preventive health behaviors by lesbian, bisexual and heterosexual women: questionnaire survey. West J Med. 2000;172(6):379–84.
Koh AS, Ross LK. Mental health issues: a comparison of lesbian, bisexual and heterosexual women. J Homosex. 2006;51(1):33–57.
Wilsnack SC, et al. Drinking and drinking-related problems among heterosexual and sexual minority women. J Stud Alcohol Drugs. 2008;69(1):129–39.
American Lung Association. Smoking out a deadly threat: tobacco use in the LGBT community. 2010.
Diamant AL, et al. Health behaviors, health status and access to and use of health care: a population-based study of lesbian, bisexual and heterosexual women. Arch Fam Med. 2000;9(10):1043–51.
Grant J, Mottet L, Tanis J, Herman J, Harrison J, Keisling M. National Transgender Discrimination Survey: findings of a study by the National Center for Transgender Equality and the National Gay and Lesbian Task Force. National Center for Transgender Equality; 2010.
Institute of Medicine. The health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding. Washington, DC: National Academies Press; 2011.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Blechinger, D.R. (2016). Understanding the LGBT Communities. In: Eckstrand, K., Ehrenfeld, J. (eds) Lesbian, Gay, Bisexual, and Transgender Healthcare. Springer, Cham. https://doi.org/10.1007/978-3-319-19752-4_1
Download citation
DOI: https://doi.org/10.1007/978-3-319-19752-4_1
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-19751-7
Online ISBN: 978-3-319-19752-4
eBook Packages: MedicineMedicine (R0)