Why the world of LGBTQ health doesn't fit under a single label

By Michael Merschel, American Heart Association 巴黎人

(Annetka/iStock via Getty Images)
(Annetka/iStock via Getty Images)

LGBTQ people may celebrate as one during Pride Month. 但专家表示,当话题是健康时,承认差异至关重要.

太频繁, LGBTQ people are considered one entity, "as if they all have the same issues, all have the same needs,博士说. 小卡尔·斯特里德.他是波士顿大学医学院的医学助理教授. "But that is not at all the case."

最新的 盖洛普民意测验 结合 人口普查数据 puts the number of LGBTQ adults living in the U.S. at around 18 million, 强调说. So it might be obvious that broad labels would not apply to all. 但压力, 她也是波士顿医疗中心变性医学和外科中心的研究负责人, LGBTQ的每个字母不仅标注了自己的社区和自己的健康需求, "there are unique needs within each individual letter of that as well."

“所以,不仅仅是跨性别者与女同性恋有不同的需求,甚至在跨性别群体内部也有不同的需求,他说.

Some health issues do affect everyone under the LGBTQ umbrella, said Tonia Poteat, 北卡罗来纳大学教堂山分校社会医学副教授. 其中许多问题都与面临歧视时的长期压力有关.

"We see that in terms of both mental health, like higher prevalence of depression and anxiety, but also in terms of physical health,她说.

根据 U.S. Office of Disease Prevention and Health Promotion, 对LGBTQ人群的歧视与精神疾病的高发病率有关, substance abuse and suicide. 和一个 2020 scientific statement from the American Heart Association, which Poteat and Streed helped write, 他说:“越来越多的证据表明,LGBTQ成年人的心血管健康状况比他们的顺性别异性恋同龄人更差."

But as the focus narrows, differences emerge, 强调说.

"There are differences in rates of hypertension, levels of cholesterol and diabetes across all these categories,他说, as well as differences in levels of physical activity.

The example of hypertension, or high blood pressure, shows just how much a problem can vary among groups. Preliminary research 去年在美国心脏协会科学会议上发表的一项研究发现,男同性恋者和双性恋者比异性恋者患高血压的风险更高, the problem was more common in gay men. Lesbian women and bisexual men, 与此同时, faced no additional risks beyond what their heterosexual peers had.

写在 the Lancet in 2021, 波蒂特和她的合著者说,来自加拿大的统计数据表明,双性恋女性的心理健康状况比女同性恋者差.

2020年美国心脏协会的科学声明强调,女同性恋女性比异性恋女性更有可能使用烟草, 男人和同性恋, 而跨性别女性和男同性恋者则承担着不成比例的艾滋病毒负担, which is associated with increased risk for heart disease, when compared with non-LGBTQ people.

But research that highlights such differences is sparse. Streed说,这可能导致医生之间缺乏了解和不知情的护理.

不了解LGBTQ需求的卫生保健专业人员甚至对基本的医疗需求都不敏感. A lesbian woman might be asked about birth control, 强调说, 或者一个跨性别者可能会被告知去做一个他们没有的解剖检查.

To Poteat, solutions could begin with a simple acknowledgment. "Everybody needs to be addressed as an individual,她说. 这就要求你对那个人的个人经历感到好奇, and also not coming with assumptions about who they are."

强调同意. 太频繁, 他说, 去看医生充满了各种经历,可能会疏远非直人, 健康的白人男性. 无知的医护人员会“假设我们认为病人应该是什么样子”, what bodies they should have, and what families they should be part of."

为了解决这个问题, 护理提供者和研究人员需要“忘记许多假设,认识到人类生活实际多样性的复杂性,并建立研究工具来识别和衡量这一点。,他说.

Poteat said people have the option to choose their care 供应商. She recommended GLMA.org是全国LGBTQ医疗保健专业人员协会的网站,该网站提供了一个 free list of 供应商 who testify to being LGBTQ friendly and knowledgeable. Trans people can look for 供应商 谁是世界变性人健康专业协会认证的.

“通过这些组织,可以找到那些至少在努力了解LGBTQ并做出回应的人,波提特说.

斯特里德说,人们应该感到舒适,并有权要求适当的护理. “这是他们的健康,他们正在寻求一个以关心为己职的职业的帮助. So if our profession falls short, it is our fault."

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美国心脏协会巴黎人报道心脏病、中风和相关健康问题. 并非所有美国心脏协会巴黎人报道中表达的观点都反映了美国心脏协会的官方立场. 语句, 结论, 发表在美国心脏协会科学期刊上或在美国心脏协会科学会议上发表的研究的准确性和可靠性仅代表研究作者的观点,并不一定反映美国心脏协会的官方指导, policies or positions.

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