Talk about it. There are several health issues that every patient should discuss with their physician, and some that are related to sexual orientation or gender identity. It’s important that LGBT persons be able to discuss these issues with their health care providers. This necessitates first coming out to their provider, and elsewhere on this website you can find resources about how LGBT persons can safely do this. Here we discuss ten important health issues LGBT persons should discuss with their physician.
1. Health History and Sexual History
In order to provide the best possible health care to their patients, physicians need to know relevant information about their patients’ health history and sexual history. It’s important that LGBT patients be able to trust their physicians and that the confidentiality of their health and sexual histories be strictly protected.
2. HIV/AIDS and Sexually Transmitted Diseases
Although great strides have been made in educating the population at large and the LGBT community in particular about preventing HIV/AIDS and STDs, the last few years have seen a return to many unsafe sex practices. Physicians should discuss safe sex practices with their LGBT patients and support the maintenance of safe sex by providing literature, condoms, and dental dams.
3. Depression and Anxiety
Due to social stigmatization and discrimination related to sexual orientation or gender identity, LGBT persons are at a greater risk for depression and anxiety, and these issues may be more severe for those persons that remain closeted or do not have sufficient social supports. LGBT young adults may be more at risk for suicide as well. Physicians should be aware of culturally sensitive mental health providers that target the LGBT community so that they can make appropriate referrals.
4. Hepatitis Prevention
Men who have sex with men (MSM) are at a higher risk of sexual transmission of the viruses that cause hepatitis, a serious infection of the liver. Physicians should discuss immunizations for Hep A and B with their MSM and LGBT patients.
5. Cancer
All patients should discuss cancer screening and prevention with their physicians. Members of the LGBT community are for various reasons at higher risk of certain cancers than the general population as well. Women should discuss screening and prevention of breast and ovarian cancer with their physicians, and men should discuss testicular, prostate, and anal cancer and anal papilloma with their physicians. Transgender persons should discuss the cancer risks associated with hormone therapy as well.
6. Alcohol and Substance Abuse
Members of the LGBT community are at a higher risk for alcohol and substance abuse. Patients should discuss concerns about substance dependency with their physicians, and doctors should be aware of culturally sensitive prevention and treatment programs.
7. Hormone Therapy and Silicone Injections
Transgender persons should discuss the health risks associated with hormone therapy and silicone injections. Both estrogen and testosterone have potential risks, and hormone use should be appropriately monitored by the patient and physician. Silicone injections administered by non-medical persons may contain contaminants and cause scarring. Silicone should not be injected, and physicians should discuss this important issue with their transgender patients.
8. Domestic / Intimate Partner Violence
Domestic violence occurs at slightly higher rates in LGBT couples than heterosexual couples, but presents unique problems: LGBT persons are often more reluctant to report domestic violence. Physicians should provide safe spaces for their patients to discuss domestic violence and be aware of culturally sensitive organizations.
9. Cardiovascular Health
For various reasons, LGBT persons are at higher risk levels for heart disease. All patients should discuss ways to improve and maintain their cardiovascular health. Physicians should be sensitive to the fact that transgender people can be reluctant to discuss cardiovascular health for fear their doctors will recommend stopping hormone therapy.
10. Diet and Fitness
Everyone should discuss healthy diet and fitness practices with their physicians. Maintaining a healthy diet and fit lifestyle is key to a long and fulfilling life. LGBT persons are at a higher risk for eating disorders such as bulimia. Obesity also affects the LGBT community disproportionately, and this can lead to debilitating illnesses such as diabetes and heart disease.
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