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Reply to 2 discussion posts – 2) Over the past few decades, clinicians, public

Reply to 2 discussion posts –
2) Over the past few decades, clinicians, public health researchers, and officials have become increasingly aware that lesbian, gay, bisexual, and transgender (LGBT) persons constitute sexual and gender minorities who have unique health care needs.
What are some of the barriers that LGBT populations encounter?
Reluctance by some LGBT patients to disclose sexual or gender identity when receiving medical care
Insufficient numbers of providers competent in dealing with LGBT issues as part of the provision of medical care
Structural barriers that impede access to health insurance and limit visiting and medical decision-making rights for LGBT people and their partners
A lack of culturally appropriate prevention services.
How do we improve public health policy and the quality and number of public health programs for LGBT populations?
For clinicians and service providers, they need to be sensitive to the potential stressors of coming out and the process of forming a positive identity as an LGBT person and should be prepared to answer questions and make referrals. They can also work on programs that specialize in the care of LGBT populations and can advocate for policies that diminish the stigma LGBT people encounter. There need to be more LGBT-specific prevention services to deal with violence victimization, substance abuse, mental health concerns, and other health care needs. Improvements in access to medical care and effective prevention services for LGBT patients could concomitantly improve the health care delivery for other vulnerable populations.
How do we create a healthier environment for sexual and gender minority patients?
We need welcoming clinical and program environments that promote good communication and allow individuals to feel comfortable discussing matters of their sexual identity, behavior, attractions, and any conflicts they may be experiencing. We also need to train providers and other staff to speak with patients and clients in a nonjudgmental, gender-appropriate, and professional way. These techniques should be taught during professional education and staff training in healthcare and service facilities and should be reinforced with nondiscrimination policies in clinical and program settings, intake forms that ask about gender identities and same-sex partners, and visual cues in waiting and examination rooms that signal acceptance, such as brochures that discuss LGBT health risks and promotion. Clinicians’ efforts should be synergistic with those of public health departments, which could do more to ensure that their programs are culturally competent for this group.
My thoughts:
Being a part of the LGBT community, I definitely understand this problem from a patient’s perspective. As the textbook stated, it is true that my queer friends and I experience a higher amount of mental issues compared to my heterosexual friends. For the majority, such mental problems stem from an identity crisis, fear of being unaccepted, verbally and physically abused. When I read the chapter, I also learned that apart from mental problems, queer folks are at higher risk for other illness as well. As concerning as it is, I am very glad that this has been brought to my attention. There seem to be specific problems for each sexuality. For example, the high rate of recreational drug use is associated with a higher rate of unsafe sexual practices and HIV and other sexually transmitted infections. Lesbians are more likely than women of other sexual orientations to be overweight and obese, while transgender patients may have enhanced cardiovascular risks because of exogenous hormone use. This makes me think that having sexuality belongs to the minority and having to deal with that fact impact people’s lifestyles profoundly in many ways, which resulted in their health problems. From my own experience, as a queer person, when I seek medical assistance, I often feel excluded and misunderstood. Therefore, I usually look up medical solutions on the Internet or figure out a way on my own, which can be dangerous. It is quite sad to see I am not the only person who experience this. I believe that as a community, we need to be more aware of the situation and make sure that our health facilities are more LGBT-friendly as well as have enough knowledge to handle LGBT-related health problems.
Question 1: Do you feel certain groups of patients are getting different care?
I do feel that certain groups are receiving a different level of care. Just as mentioned in the chapter, I think it is much more subtle rather than blatant. I believe this because I think if it were blatant, racist medical professionals wouldn’t retrain their job for long. Different care has two meanings. One of them is the lack of accommodation for certain cultures or groups. The other is rooted in racial and ethnic prejudice. I think this is why some medical professionals are targeted for bias and racism. One of the examples used in chapter 9 encapsulates this perfectly. The scenario reads “counseling African American and Latino patients with diabetes to lower carbohydrate intake by cutting rice from their diets may be a part of one person’s culture but not another” (Public Health and Social Justice, 135). Some of these treatments or counseling are with the best intentions but may come off as racist. The bias in this example could be connected to the advice given. These suggestions would better suit a “white” diet or lifestyle. A way to fix this would be to have better education about different cultures. Specifically, the lifestyle choices and traditions.
After watching the documentary, I feel more informed about some of the medical atrocities committed by the United States. Human experimentation is not a new topic when discussing possible medicinal advancements. Of course, this experiment was not justified in the slightest. It would’ve been a different story if there was a section in the agreement that explicitly stated that patients participating in this study would have proper treatment withheld from them. If that were the case, I don’t think this study would have gathered as many participants as it did without their informed consent. I believe that this town in Alabama was targeted because it was primarily a low-income area. They knew this because they provided an incentive to keep participating in the experiment. Rather than proper financial compensation, “they offered hot meals to those that returned annually” (Tuskegee Syphilis Experiment Documentary). I don’t think this will ever happen again due to the current scrutiny the United States has on medical studies. Perhaps some variation would provide medical treatment throughout the study. The odds of a similar experiment being conducted, I believe, are unlikely.

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