The Health of Lesbian, Gay, Bisexual, and Transgender People Building a Foundation for Better Understanding (2011) / Chapter Skim
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1 Introduction
1 Introduction
Pages 11-24
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From page 11... ...
refers to a broad coalition of groups that are diverse with respect to gender, sexual orientation, race/ethnicity, and socioeconomic status. Thus while this report focuses on the community that is encapsulated by the acronym LGBT, the committee wishes to highlight the importance of recognizing that the various populations represented by "L," "G," "B," and "T" are distinct groups, each with its own special health-related concerns and needs.
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From page 12... ...
As one might expect, there are health differences between transgender and nontransgender people, as well as between transgender females and transgender males. Whereas "LGBT" is appropriate and useful for describing the combined populations of lesbian, gay, bisexual, and transgender people, it also can obscure the many differences that distinguish these sexual- and gender-minority groups.
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From page 13... ...
Commonalities Among LGBT Populations What do lesbians, gay men, bisexual women and men, and transgender people have in common that makes them, as a combined population, an appropriate focus for this report? In the committee's view, the main commonality across these diverse groups is their members' historically marginalized social status relative to society's cultural norm of the exclusively heterosexual individual who conforms to traditional gender roles and expectations.
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From page 14... ...
Fearing discrimination and prejudice, for example, many lesbian, gay, bisexual, and transgender people refrain from disclosing their sexual orientation or gender identity to researchers and health care providers. Regardless of their own sexual orientation or gender identity, moreover, researchers risk being marginalized or discredited simply because they have chosen to study LGBT issues (Kempner, 2008)
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From page 15... ...
The racial and ethnic communities to which one belongs affect self-identification, the process of coming out, available support, the extent to which one identifies with the LGBT community, affirmation of gender-variant expression, and other factors that ultimately influence health out comes. Members of racial and ethnic minority groups may have profoundly different experiences than non-Hispanic white LGBT individuals.
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From page 16... ...
Although intersexuality constitutes an additional type of "otherness" that is stigmatized and overlaps in some respects with LGBT identities and health issues, the committee decided it would not be appropriate to include intersexuality in the study scope. The majority of individuals affected by disorders of sex development do not face challenges related to sexual orientation and gender identity, although homosexuality, gender role nonconformity, and gender dysphoria (defined as discomfort with the gender assigned to one at birth [see Chapter 2]
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From page 17... ...
Additionally, the committee will consider research training needs to foster the advancement of knowledge about LGBT health and identify impediments that hinder such advancement. Areas of interest to the committee might include but are not limited to • the state of knowledge regarding LGBT health, health risks and protective factors, health disparities, and access to and utilization of health care; • the developmental process from childhood across the life course, in the context of family and social networks; the impact of family and social acceptance of sexual orientation, gender identity, and expression on health and well-being; and the experience of families with LGBT parents; • the effects of age cohort, race, ethnicity, socioeconomic status, and geography (particularly urban vs.
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From page 18... ...
Given that chapters, academic books, and technical reports typically are not subjected to the same peerreview standards as journal articles, the committee gave the greatest credence to such sources that reported research employing rigorous methods, were authored by well-established researchers, and were generally consistent with scholarly consensus on the current state of knowledge. With respect to articles describing current health issues in the LGBT community, the committee attempted to limit its review to these articles published since 1999.
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From page 19... ...
However, it always referred back to the original citations to evaluate the evidence. Conceptual Frameworks In understanding the health of LGBT populations, multiple frameworks can be used to examine how multiple identities and structural arrangements intersect to influence health care access, health status, and health outcomes.
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From page 20... ...
From the perspective of LGBT populations, these four dimensions have particular salience because together they provide a framework for considering a range of issues that shape these individuals' experiences and their health disparities. The committee relied on this framework and on recognized differences in age cohorts, such as those discussed earlier, in presenting information about the health status of LGBT populations.
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From page 21... ...
The committee's use of this framework is reflected in the discussion of stigma as a common experience for LGBT populations and, in the context of this study, one that affects health. In addition to the minority stress model, the committee believed it was important to consider the multiple social identities of LGBT individuals, including their identities as members of various racial/ethnic groups, and the intersections of these identities with dimensions of inequality such as poverty.
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From page 22... ...
The committee found this framework useful in thinking about the effects of environment on an individual's health, as well as ways in which to structure health interventions. Each of the above four frameworks provides conceptual tools that can help increase our understanding of health status, health needs, and health disparities in LGBT populations.
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From page 23... ...
Chapters 4, 5, and 6 review, respectively, what is known about the current health status of LGBT populations through the life course, divided into childhood/adolescence, early/middle adulthood, and later adulthood. Each of these chapters addresses the following by age cohort: the development of sexual orientation and gender identity, mental and physical health status, risk and protective factors, health services, and contextual influences affecting LGBT health.
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From page 24... ...
2003a. Minority stress and mental health in gay men.
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