The Health of Lesbian, Gay, Bisexual, and Transgender People Building a Foundation for Better Understanding (2011) / Chapter Skim
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The 17-member Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities comprised experts in the fields of mental health, biostatistics, clinical medicine, adolescent health and development, aging, parenting, behavioral sciences, HIV research, demography, racial and ethnic disparities, and health services. The committee was asked to • conduct a review and prepare a report assessing the state of the sci ence on the health status of lesbian, gay, bisexual, and transgender populations; identify research gaps and opportunities; and outline a research agenda that will assist NIH in enhancing its research efforts in this area.
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For instance, laws prohibiting marriage between same-sex individuals often affect the access of lesbians, gay men, and bisexual people to employersponsored health insurance. Other barriers to care include the limited availability of providers with adequate training to treat transgender patients in a culturally competent manner and LGBT patients' previous negative experiences with the health care system.
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Even though the extent to which findings based on such samples accurately characterize these populations is unknown, these samples have yielded valuable information for expanding the field of LGBT research and identifying possible gaps in health services. In addition to providing general descriptive data for LGBT populations and their subgroups, nonprobability samples have served to reveal the existence of certain phenomena, to suggest relationships among variables, to identify possible differences among groups, and to generate hypotheses and formulate ideas that can be advanced for systematic study in the future.
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Respectful involvement refers to the involvement of LGBT individuals and those who represent the larger LGBT community in the research process, from design through data collection to dissemination. HEALTH STATUS OVER THE LIFE COURSE Drawing on the life-course framework, the committee examined the health status of LGBT populations in three life stages: childhood and adolescence, early/middle adulthood, and later adulthood.
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• Lesbians and bisexual women may use preventive health services less frequently than heterosexual women. • Lesbians and bisexual women may be at greater risk of obesity and have higher rates of breast cancer than heterosexual women.
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The committee believes that building the evidence base on LGBT health issues will not only benefit LGBT individuals but also provide new research on topics that affect heterosexual and non-gender-variant individuals as well. Given the large number of areas in LGBT health in which research is needed, the committee formulated a research agenda that reflects those areas of highest priority.
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Research Areas Research in the following areas is essential for building a solid evidence base in LGBT health: • Demographic research -- More demographic data on lesbian, gay, bisexual, and transgender people across the life course are needed, as are data on LGBT subpopulations.
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The positive view of this situation is that there are many research opportunities related to LGBT health. The research agenda proposed by the committee was drawn from the many research opportunities that currently exist.
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Collecting these detailed patient-level data, with adequate privacy and security protection as is needed for all data collected in electronic health records, could assist in identifying and addressing LGBT health disparities. At present, possible discomfort on the part of health care workers with asking questions about sexual orientation and gender identity, a lack of knowledge by providers of how to elicit this information, and some hesitancy on the part of patients to disclose this information may be barriers to the collection of meaningful data on sexual orientation and gender identity.
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A comprehensive research training approach should be created to strengthen LGBT health research at NIH. To encourage more research on LGBT health issues, NIH should expand its intramural and extramural training programs, focusing on three audiences: researchers who are working with or considering working with LGBT populations, researchers who may not be aware of LGBT health issues, and NIH staff.
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