Critical Issues in Pratice with LGBT Patients
Why is it Important to Have Guidelines of Practice Specific to Lesbian, Gay, Bisexual and Two-Spirit People's Health
Research demonstrates positive relationships between lesbian, gay,
bisexual, & two-spirit (LGBT) individuals and health care
professionals are vital in aiding the development of successful health
care usage by the LGBT community. This positive relationship also
promotes the health and well being of the individuals accessing
services as well as the LGBT community. Even with this research,
health care professionals remain relatively in the dark regarding
health and well being of the LGBT community and have very little
knowledge on developing suitable and pertinent services for them.
Unfortunately, there are numerous obstacles standing in the way of
providing positive health care experiences from health care providers
for the LGBT community. Historically, the LGBT population have faced
oppression and have been ostracized by the medical community in terms
of being defined as "mentally ill" and/or of being manipulated by
health care professionals. This negativity has created an untrusting
attitude of health care professionals and the health care system as
whole. In recent times, instead of blatant segregation of the LGBT
community, health care providers have came to ignore the differences
in LGBT individuals, thus paying no attention to their particular
needs.
Besides the discrimination and oppression LGBT individuals face
surrounding health care, there are very few resources related to
health issues specific to the LGBT community. Historically,
information pertaining to LGBT individuals was gathered only as a
means to create programs aimed at the prevention and "cure" of same
sex attractions. Of course, this information is useless to health care
providers who are seeking information regarding the support of LGBT
clients. Recently LGBT activists have started research on LGBT
healthcare, however; the majority of this information is available
only in LGBT health centres, not in medical journals.
Health care professionals often wish to provide the best practice for
all clients but when it comes to the LGBT community this is often
unattainable. To combat the lack of knowledge and awareness
surrounding good practice with LGBT clients, the McGill school of
Social Work has developed a module which is aimed to improve
professional practice and relationships between health care
professionals and the LGBT community.
What does the Module Cover?
The goals of the course are to increase awareness of health issues of
LGBT individuals, identify ways to adapt practice to fit LGBT clients
and finally, to suggest ways to improve treatment options Themes
which are prevalent through-out the training session are as follows:
- Health and psychosocial issues LGBT people face and how they are being addressed at the current time
- Existing met and unmet needs for health services to the LGBT community
- Ways in which services would best address the unmet needs
- Role of health care providers in addressing individual as well as community needs
- Critical examination of traditional practice in relation to the needs of LGBT people
- The health care provider's current understanding of what best practice means in relation to LGBT clients
What Does Each Session Entail?
Session 1 Introduction to Gay, Lesbian, Bisexual and Two Spirit People and Communities
This session focuses on defining concepts required to understand health issues surrounding LGBT clients. For a detailed look at these concepts, please refer to the terminology section of our website. Attention is also given to a brief history of attitudes towards homosexuality in Canada, as well as diverse living situations in relation to attitudes on identifying as LGBT.
Session 2: The Impact of Coming out on Health and Health Care Access
Health care professionals often misjudge the number of LGBT clients
they have because LGBT clients are often hesitant to disclose their
sexual orientation. Their reluctance to divulge is based on the fear
of encountering homophobic attitudes. This fear often results in
people who identify as LGBT delaying their medical care. This session
examines the coming out process, different ways of coming out and how
this relates to health.
To "be out" refers to becoming public about identifying as lesbian,
gay, bisexual or two spirited. Because attraction to the opposite sex
is considered normal, LGBT individuals find themselves continuously
deciding if they should disclose their sexual orientation or not. When
coming out, LGBT individuals risk being exposed to homophobic
attitudes and open hostility towards their lifestyle.
Benefits of coming out for health:
- Improved self-esteem and self acceptance
- Reduced risk of physical and mental health problems, substance abuse and addictions, suicide, and high risk behaviours
- Forging relationships based on honesty
- Increased likelihood of finding community belonging and friends
- Increased personal advocacy
- Appropriate and timely use of health services
Session 3: Gay, Lesbian, Bisexual and Two Spirit People through the Life Cycle
Each person of the LGBT community is unique and have different
experiences and backgrounds which shape who they are. However, each
person belonging to the LGBT community shares the commonality of
dealing with oppression and discrimination. This session discusses
LGBT in different life stages bringing to light different coping
strategies used and ways to adjust to life cycle stages and changes
while dealing with discrimination at the same time.
Life stages discussed are:
- LGBT Youth
- Mental Health of LGBT Individuals
- Gay and Lesbian and Parenting
- Elderly LGBT individuals
Session 4: Special Issues in Health
Issues surrounding hiding sexual orientation such as stress, poor self
esteem and segregation lead to higher risks for mental and physical
health difficulties. This session brings forth specific health
concerns facing LGBT individuals and discusses physical and mental
issues facing the LGBT communities which health care providers should
be aware of. Some main points from this module are outlined below.
Gay Men's Health
- Focuses primarily on HIV and the stereotypes and misconceptions surrounding HIV/AIDS and gay men
- Highlights specific stages in the coming out process where gay men are at the most risk for health problems
- Focuses on the lack of screening and testing surrounding STI's and breast cancer
- Studies showing LGBT people as having higher rates of addictions issues must be read with caution as there are inconsistencies within the study such as design, sampling biases and discrepancies of terminology used
- LGBT people are at a higher risk for depression and suicide which are thought to be related to the stigmatization and shame connected to living with discrimination and oppression
Session 5: Adapting Practice
This final session uses information which was gathered throughout the
module to demonstrate ways in which health care providers can increase
awareness, improve communication and advocate for change. The goal of
this session is to provide health care professionals with tools and
information to develop the best practice possible when working with
LGBT individuals.
There are many benefits and risks of improving practice. Benefits for
the LGBT community include better health, improved satisfaction with
care and increased self esteem, to name a few. Health care providers
have the pleasure of providing relevant services which improves trust
in health care providers by the LGBT community. Unfortunately
homophobia still exists and there are many people who will not support
the idea of an affirmative clinic. Because of this, it is imperative
health care professionals are equipped to deal with harsh negativity
from not only their colleagues and friends, but other clients as well.