Alex Blaze

Why are LGBT people less healthy?

Filed By Alex Blaze | July 06, 2009 5:30 PM | comments

Filed in: Living, Marriage Equality
Tags: health care reform, health insurance reform, kids, LGBT, LGBT homeless, LGBT youth, lgbt youth, queer youth, street, trans youth

Empire State Pride Agenda has put out an interesting study of 3500 LGBT people who live in New York State and their access to health care. LGBT people generally receive less health care, and it's not just because of a lack of marriage or DP benefits. The number one reason is homelessness:

At the national level, researchers have estimated that LGBT people lag behind on seven of the ten targets set by the U.S. government to improve health nationally, called Healthy People 2010. In New York City, we know that LGBT lag behind on at least six of NYC's health goals, called Take Care New York. However, most states do not measure sexual orientation on their health surveys, and none have consistently measured gender identity.[...]

For example, fourteen percent of all LGBT people, including one-third of transgender New Yorkers, are or have been homeless at one time--and we know that people who are homeless also lack other basic services. As one service provider who works with youth told us, "Housing is health care." Youth and adults who are homeless frequently cannot access health services at all. Youth who are transgender are particularly vulnerable.

We blog every now and then about stories about LGBT people getting kicked out of religious and gendered homelessness services, a problem that exacerbates homelessness brought on both job discrimination and rejection by families of origin. But don't expect any action nationally on this issue, since homelessness is still one of the issues Congress finds easiest to put off - not only are homeless people unlikely to donate to political campaigns, they are also unlikely to vote. And the rest of us feel better just ignoring them.

The study explains more about the connection between health care and homelessness (pdf):

Key informants who participated in focus groups recognized the importance of housing to health and human services. One staff member of an urban program for LGBT homeless youth said, "For us, [the most pressing health and human service need] is housing...housing is healthcare. Once we've housed people who are unstably housed, their lifestyle changes. If they are engaging in unprotected sex, involved in street work...once they become steadily housed, they are more open to protecting themselves and using condoms. Once they become housed, they become more adherent to medical treatment. When they are on the street, they are not adherent to their medical regimens with HIV, etc. They feel more in control, and they have somewhere to live. It's more comforting and allows them to deal with other stuff." Another provider, a physician who works with LGBT youth of color said, "As a physician, I'd go out on a limb and say [the most pressing issue is] it's stable housing for LGBT youth, particularly trans youth."

Youth are particularly at risk for homelessness, and this study finds the same bizarre fact that that study in Vancouver that made headlines earlier this year did, LGB youth are more likely than heterosexual youth to get pregnant:

In New York City, LGB youth are more likely to have been pregnant or made someone pregnant, to have missed school or been injured in a physical fight, to have been physically hurt by an intimate partner or forced to have sex.

The Needs Assessment survey included 13% of respondents between the ages of 18 and 24. Because the survey could not ask questions of people under 18, the survey results on youth are limited to those who were in this young adult category.
Young adults aged 18-24 were more than six times as likely to report that they are currently homeless than were older adults in this sample. Several key informants who participated in focus groups or interviews suggested that homelessness for LGBT youth is one of the most pressing health and human services issues. A staff member at an LGBT health center explained that homelessness and poverty have specific negative consequences for LGBT youth, saying, "Homelessness [is something] we see a lot among young clients we work with. One of the things we hear recently in terms of the economy is that based on the difficulty getting part-time jobs, people looking for summer jobs, it looks like there may be more young people turning to sex work this year, this spring and this summer, than have in the past...How do we support them in a way that doesn't encounter violence and protects their health?"

The report cites other issues that result in us having worse health than the population at large: higher than average rates of substance abuse, social isolation and loneliness, and finding culturally competent medical care top the list.

Health care access is fundamentally a question of poverty and how wealth is distributed. And while it's important to demand that the White House and Congress move on providing health care benefits to same-sex partners of federal employees, addressing basic issues like housing right in our own backyards would probably do more to increase access to health care than expanding the scope of the copulative relationships we reward with health care access.


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Being a marginalized minority is hazardous to your health. Medical studies on African-Americans have proven that, and it's not surprising to me that the same medical issues and finding are starting to show up in the GLBT population.

Add to the fact that GLBT peeps are more likely to be smokers than the straight population.

http://www.bilerico.com/2009/03/smokin.php

Robert Ganshorn Robert Ganshorn | July 6, 2009 8:57 PM

Let us not forget drinking either. All those booze pride floats have to come from some place other than passionate concern for our health.

BTW when I first read the title I was wondering if it related to those who read Bilerico or those who comment... ;)

The study mentioned that specifically as another factor:

Research suggests that some LGBT people smoke, drink or use other drugs to cope with the stigma and violence they experience. Smoking, which may lead to lung cancer and other health problems, is elevated among LGBT people (Gruskin & Gordon, 2007; Tang et al., 2004). Alcohol abuse is more common among lesbian and bisexual women than heterosexual women (Burgard et al., 2005) and some studies also find this is true for men (King et al., 2008). Finally, illegal drug use and dependence are more common among LGBT people than non-LGBT people (King et al., 2008).

The same groups at most risk for depression—youth, transgender people and Black and Hispanic people—were those least able to access mental health and support group services.

In New York City, the Community Health Survey shows that adult LGB people are more likely to smoke and binge drink, and the Youth Risk Behavior Survey shows that LGB youth are more likely to smoke, drink and binge drink.

As one substance abuse counselor who works at an LGBT-specific health center explained, substance abuse issues vary within the LGB community, saying, “We’ve become very sophisticated in trying to figure out the interdependency of queer behavior, HIV, substance abuse. . .. There’s more development and sophistication around identifying…high risk behavior for men. For lesbians, we haven’t figured out the bridges.”

bigolpoofter | July 6, 2009 9:24 PM

Recent studies published about fatalism and adverse health outcomes for teens somehow skirted the Queer stuff that was part of my experience. Give a Queer boy the message he's eternally damned, add a life-threatening condition c. 1980 and a few run-ins with brain surgeons, and one wonders how and why he became HIV-positive before turning 18?!

Homelessness among Queer teens was in our faces back in the day, unmistakable in any big city: how did we lose sight of the problem? Oh, yeah, equality.

I've taken to saying that rather than spend another $40 million on a California ballot initiative for same-sex marriage we should put that money where it is really needed, such as devoting resources to homeless LGBT teenagers. I had no idea how right I was (unfortunately). Thanks for passing along this research.

Rick Sours | July 7, 2009 9:08 AM

Thanks Nancy...

My Partner and I agree completely, what this 40 million dollars could do if put into areas which really needed it.

I am a therapist, and I find my younger patients are much more likely not to label their sexual identities and to wander from having sex with one gender to another. However, as the article points out, the more queer-acting/appearing young people are more likely also to be homeless, and unable to access health services such as birth control, hence more likely to get pregnant.

A Dionne Stallworth | July 6, 2009 11:24 PM

And people wonder why I am so angered at the straight and gay driven obsession of same-sex marriage? Is everyone really that clueless? I said it on my FB page: "The inmates are running the asylum!"

Why in the world would you possibly use the adjective "bizarre" about the data showing that "LGB youth are more likely to have been pregnant or made someone pregnant." It makes it seem as thought while people give PC lip service to the concept, that really people do not
actually believe that bisexual people (that would be the "B" in LGBT) actually exist.

Bisexual people have among the worst healthcare and mental health services in the greater LGBT Community because in addition to fighting the general societal stigma against Queer People, we must also fight the rampant, practically institutionalized, biphobia within the greater Lesbian/Gay Community too.

Robert Ganshorn Robert Ganshorn | July 7, 2009 10:22 AM

I am glad for your rant, but miss the point. I think homelessness is the greatest health risk. It is your choice as to whom and what you reveal about yourself. If you can, be out, if you must survive any way you can. A lie to the devil is irrelevant.

I suppose a better adjective would be "counterintuitive." Because the study showed that the rates of teen pregnancy, for both bisexual and lesbian-identified youth, were higher than average. I would assume that bisexual youth's pregnancy rate would be, at most, the same as straight youth's and that lesbians' pregnancy rate would be much lower.

Yes, "counterintuitive" is a MUCH better adjective because it is not so loaded with negative meanings.

Obviously there are a variety of reasons for the statistics showing that "LGB youth are more likely to have been pregnant or made someone pregnant." Some of this can be attributed to the rough life many LGBT Youth live where girls are more likely to get pregnant sometimes against their will. Also many tweens/teens & young adults may experiment sexually before gaining an understanding of their actual orientation. However a LARGE portion can also be attributed to the fact that many Queer Kids are in fact quite fluid in their sexuality, (just like Queer Adults!) no matter what words they choose to use to self-identify and how much society pushs them to confine themselves to certain narrow PC "boxes". A fact of life that makes most mainstream LGBT/Progressive Health and Youth organizations very uncomfortable and that they do their best to overlook.

There are studies that those who are interested can refer to, including the 2007 joint BiNet USA/Task Force Bisexual Health study (http://bit.ly/iCjhC). Additionally the upcoming Bi Health Summit being held in Chicago this August (http://bit.ly/z3Z1j) will undoubtedly be an occasion where new data on all of this is presented.

Yes, "counterintuitive" is a MUCH better adjective because it is not so loaded with negative meanings.

Obviously there are a variety of reasons for the statistics showing that "LGB youth are more likely to have been pregnant or made someone pregnant." Some of this can be attributed to the rough life many LGBT Youth live where girls are more likely to get pregnant sometimes against their will. Also many tweens/teens & young adults may experiment sexually before gaining an understanding of their actual orientation. However a LARGE portion can also be attributed to the fact that many Queer Kids are in fact quite fluid in their sexuality, (just like Queer Adults!) no matter what words they choose to use to self-identify and how much society pushs them to confine themselves to certain narrow PC "boxes". A fact of life that makes most mainstream LGBT/Progressive Health and Youth organizations very uncomfortable and that they do their best to overlook.

There are studies that those who are interested can refer to, including the 2007 joint BiNet USA/Task Force Bisexual Health study (http://bit.ly/iCjhC). Additionally the upcoming Bi Health Summit being held in Chicago this August (http://bit.ly/z3Z1j) will undoubtedly be an occasion where new data on all of this is presented.

My anecdotal observation is that many LGBTQ persons struggle with self-esteem issues, often related to their LGBTQ status. In bad cases this may mean family rejections, job discrimination, self-defeating compulsive behaviors, feelings that we are not worth or can not really have long-lasting relationships (because society tells us so), etc. People who have so much negative stuff going on about themselves are not likely to take good care of themselves, may smoke, drink and drug, risky sex "since I know I'm going to die young anyway." Haven't we all heard numerous people say that?
THis is why I personally think that the marriage issue and repeal of "Don't ask don't tell" are so hugely important. They have gotten our agenda on every front page in America, gotten everyone talking about our agenda for the first time in history, and on various levels know that the LGBTQ agenda has to be taken seriously. Even if you are not in the military or are not interested in marriage for yourself, I think that the ubiquity of these issues- on every talk show, Oprah, fully out in the open, has helped the LGBTQ communities immensely by removing some , maybe alot, or the shame, guilt rejection, and other negative feelings that seem to be pervasive among us. In the short and long runs, this has to be good for all of us. Yes, there are many other issues, and very important ones, but they will never capture the imagination and attention of straight America as do marriage and Don't Ask, Don't tell, since most Americans identify with marriage and or military service.As our own self-images and our image in straight society improves, I bet our physical and mental health will also improve.

It makes me feel sad when people talk about fighting for issues as though it has to be either-or; as though we all have to fight for one issue at a time. Obviously L and G and B and T and human nature is that we are going to fight hardest for what gets in our own personal way the most; but at this point in time I don't think it is helpful to demonize each other for doing that. In New York there is right now a bill for Marriage Equality, a bill against hate crimes against trans folk, and a bill against bullying of all LGBT students in schools. It was as easy for me to write letters supporting all three as it would have been to write letters supporting just one, and obviously my friends who went to Albany lobbying day lobbied hardest for the one which affected them the most, but also lobbied for the other two.

Research shows that the best way to dispell prejudice is for people to know people in the stereotyped group who do not fit the stereotypes. As people get to know that queer people have long term, stable relationships, pay their taxes, are good neighbors, work hard, care about and are visible parts of their communities, and yes, join the PTA, are class cookie moms and dads, little bit by little bit the prejudice will fade away. I know trans people feel like these things are dreams for them, but right now, Proctor & Gamble has a trans-friendly hiring policy, and more and more corporations are sure to follow suit. L & G & B & T can all fight for what we need most, and spare some time for what everybody needs, as there is a lot of common ground.