Health – Page 2 – news.lgbti.org

Getting Hold of Transsexual Hormone Replacement Therapy

Transsexual hormone replacement therapy helps those who feel they were born in the wrong body transition to what they feel is their proper sex. Many transgender feel discrimination for not having an easily distinguished gender. Hormone therapy helps them easily blend in and not become a target for discrimination.

Those who live near a metropolitan area should be able to gain access to hormone replacement therapy rather easily. First, make sure you are mentally prepared to take the theerapy. If you are severely dysphoric, you may need to seek the help of a certified mental health professional; preferably one that you trust and has experience assisting with someone in your situation. If you are on a constrained budget, try looking into LGBTI advocacy groups in your area that may be able to offer help. Also consider universities in your vicinity, as many offer psychological services on a sliding scale.

Doubting one’s transsexuality may cause psychological issues when hormone therapy begins to change your body. Always consult a physician about hormone therapy before you begin but throughout the process. You need to be carefully monitored to make sure no abnormalities occur. Think of all the questions you have, do thorough research and be sure to ask your doctor. Remember to advocate for your health when you don’t think you are being heard or your questions are not being answered.

Avoid healthcare providers that go by the Harry Benjamin Standards of Care guidelines drafted by the World Professional Association for Transgender Health (WPATH), or what was originally known as the Harry Benjamin International Gender Dysphoria Association (HBIGDA). Therapist intervention levels are high with these guidelines and without meeting these standards, they may block your access to hormone therapy. There are many doctors out there who require these Standards of Care before even approaching your case.

There is another set of guidelines that will give you easier access to hormone therapy with little to no therapist’s intervention. Instead look for doctors and clinics who stick to the Tom Waddell Standards; like a physician in the free clinics in San Francisco. Dr. Tom Waddel personally penned these standards from his own experiences with the transgendered. While you may have to attend group meetings, the standards he implements are very straight forward.

It can be difficult finding a particular clinic’s standards. The best advice is to ask others in the transgender community. Find out which doctor or doctors they used and who they recommend. You can also check the internet for clinics in your area that provide hormone therapy. Just remember to get official help, as too little or too many hormones in the body can cause many serious health problems.

Bisexual Women Have Higher Rates of Depression

Studies that survey the psychological health of lesbian, bisexual, and gay individuals have for years indicated that members of the LGB community struggle more with mental health issues such as depression, suicidality, alcoholism, and cigarette smoking.

Experts on psychological health accept that gay and bisexual individuals are not more impulsive than heterosexuals are. The reason for the high incidence of mental illness in LGB people is that simply having a sexual identity that is considered idiosyncratic places abnormal pressures on LGB people.

Gay and bisexual people may feel less of a sense of community, and the pressure to conform to gender roles may also contribute to the higher incidence of depression. Most surveys that have been done on psychological well-being and “outness” in the LGB community has shown that women, and in particular bisexual women, are more likely to have thoughts of suicide or chronic depression. The preponderance of the data suggests that women that have “come out of the closet” are actually less distressed and much less likely to struggle with thoughts of suicide than women that choose to keep their sexual orientation a secret. But the reasons for why bisexual women are far more likely than those of homosexual orientation to struggle with depression are unclear.

According to an article in the Desert Sun, bisexual women suffer from anxiety and depression at rates of 58.7% and 57.8%, which is more than 10% higher than the prevalence of these psychological issues reported by lesbians. The explanation for these numbers is that bisexual women feel less social support, but the article states that surveys of LGB members in California show that 75.3% of individuals surveyed feel that they have the necessary support. So what is responsible for the high rates of depression in bisexuals? It is not hard to fathom that bisexual women face stigmatization more often.

Gender roles are hard to escape, and while our society is becoming more understanding of homosexual relationships it is still difficult for women to express sexuality the way that men do.

Women are under more pressure to be chaste even in today’s world where media and popular culture frequently glorify gratuitous sex. Rather than liberate non-heterosexuals, our cultural ideals probably contribute more to confusion regarding the identity of bisexual women who are often mistaken for being promiscuous. Victimization by partners and peers is also a likely factor in the rate of depression in bisexual women, although there is little to indicate that bisexual women experience victimization more often than other members of the LGB community.

The fear of seeming indecisive or abnormal in a society where women are encouraged to provide stability at home and the ineptitude of our culture to grasp how a woman can have male and female partners without being promiscuous or “risky” is more to blame.

Bisexual women must seek ways of strengthening their identity and liberating themselves from the cultural misconstructions of female sexuality. The stigma that is felt by the LGB community is an ongoing quandary, and like all members of the LGB community bisexual women should acknowledge that their distress is a natural and warranted reaction to the pressure they are under to change.

2015

Sexual Agreements & Substance Abuse among Gay Couples

Researchers have been trying to understand how gay male couples’ relationships, including their sexual agreements, affect their risk of getting HIV.

According to studies, gay men and other men who have sex with men are disproportionately affected by HIV. They account for nearly two-thirds of HIV cases among men in the U.S. Also, between one-third and two-thirds of men who have sex with men acquire HIV while in a same-sex relationship, according to a recent article published in AIDS and Behavior.

According to “A Cause for Concern: Male Couples’ Sexual Agreements and Their Use of Substances with Sex,” studies have found that gay men who use illegal substances, like ecstasy, and controlled substances, like alcohol, are at an increased risk for acquiring HIV. Some of these men are also more likely to engage in high-risk sexual behavior with men who have sex with men, such as unprotected anal intercourse, and some have used substances during sex. Many of these men consider some substances “sex drugs,” it said, because they either prolong or enhance the sexual experience.

The study’s researchers decided to also figure out how sexual agreements are associated with gay male couples who use substances with sex. They define a sexual agreement as “an explicit understanding between two partners about which sexual and other behaviors are permitted to occur within, and if relevant, outside of their relationship.”

The researchers recruited U.S. men who have sex with men using a Facebook advertisement. They looked for men who were either in a relationship, married or engaged, and they narrowed their focus to 275 HIV negative concordant couples who participated in an online survey.

The study found that 87 percent of the couples practiced high-risk behavior, and about one-third had sex outside of their relationship. Fifty-nine percent consented to a sexual agreement. A majority who agreed said it was closed, but a little over a third said it was an open agreement. A small percent were not okay with the agreement at all.

The findings also indicated that the couples having an established sexual agreement were more likely to use a variety of substances with sex particularly within their relationships. Couples who had broken their agreement were more likely to engage in the use of marijuana or amyl nitrates when having sex.

Researchers believe more studies need to look into these relationships and agreements further. Also, HIV prevention efforts, which have focused on individual gay men and communities, need to focus prevention intervention among gay male couples, especially those who use substances with sex.

Dr. M. Mirza, LGBT Health Wellness – 2014

Alarming Facts About Meth In The Gay Community

Crystal meth has become an epidemic in the gay community, especially in larger cities where “party and play” (PnP) is a well known scene. While party and play can include any type of drug use combined with sexual activity, it usually refers to crystal meth. Following are some unfortunate facts regarding crystal meth use in the gay community:

Meth abuse is widespread

There are higher levels of drug abuse and addiction reported from gay men than heterosexual men. Crystal meth has become an all too common dangerous problem in the gay community within the last 20 years. In certain areas, arrests that have involved crystal meth have doubled, and higher rates have taken place in gay neighborhoods.

Meth is used in combination with other drugs

Many combine meth with other drugs. One trend that wreaks havoc on the body is “speedballing”, which is the mixture of drugs that have opposite effects (sedatives with uppers). The most popular speedball concoctions involve meth and Viagra or GHB. More recent data shows that combining crystal meth and viagra can speed up HIV production in the brain.

Meth and sex parties are growing in popularity

The increasing popularity of parties, which often include drugs, exists with a lot of help from social media sites such as Tinder and Grindr. These parties are regular in many parts of the US. Those who host the get-togethers might even advertise that there will be free meth provided and anonymous sex. This leads to many of the folks attending engaging in unprotected sex.

Meth is extremely dangerous for gay, HIV positive men

Of course, meth is dangerous for everyone, but is particularly harmful in the gay community. There is concern due to indications provided by data that crystal meth can greatly reduce the effects of HIV medication and/or create the “HIV SuperVirus”, which is a virulent strain of HIV.

New HIV infections are rising among young gay men

Gay men between the ages of 17 and 29 are reported to be the highest users of meth and the highest risk level is to those in the western states, under 40 and gay. These risks include that of acquiring HIV and crystal meth addiction. Even if one is HIV negative, use of crystal meth could potentially lead to them contracting HIV more quickly.

IV use is increasing among gay men

Research shows that there is a significant rise in IV meth use seen in gay men. The Antidote, which is LGBTI support service in the UK, reports that use has quadrupled between 2011 and 2013. Users are given an extreme rush and high with an IV trend that is known as “slamming”, which sometimes lasts for several days at sex parties.

Sex can seem boring after quitting meth

It’s is extra difficult for gay men to quit meth due to the effects it has on dopamine in the brain, leading to intense euphoric feelings and heightened sexual arousal.

Removing Health Stereotypes Within The Trans Community

A recent study published in the journal of LGBT Health (Mary Ann Liebert, Inc., 2014), reported findings that reveal health disparities among the transgender community within the U.S. These studies involved comparing transgender participants to non-transgender, otherwise known as cisgender, participants.

The common assumption is that the transgender community suffers from more cases of sexually transmitted diseases, along with other physical and mental health problems, than their cisgender counterparts. What has been missing, however, is an adequate comparison of transgender and cisgender participants from similar cultural and geographical backgrounds, thus eliminating those influencing factors.

This study provided important information regarding the overall health and wellness of the transgender community and helped combat the stereotype that those within this community are more likely to have STDs. Coming from the same geographical and cultural backgrounds, the transgender and cisgender communities had an equal amount of sexual transmitted diseases. The common factor among individuals with a higher presence of sexual and mental health issues, therefore, was the urban culture they came from; with economic status and cultural background being the most reoccurring commonality.

Research studies such as this help disprove findings based on limited comparisons and narrow views that don’t take other important factors into consideration. It’s hoped that with time better research methods will help the health stigma placed on the transgender community be demolished.

Dr. M. Mirza, LGBT Health Wellness – April 2014

LGBT Health in Natural Disasters and other Emergencies

Whenever there is a public emergency or a natural disaster, health centers generally become a nerve center of activity. However, when disaster is pending, health centers should take measures to ensure that they can provide the necessary assistance and resources to the area’s most vulnerable populations, including the LGBT community (LGBT Health Education. org). Specific issues health centers should be concerned about include: higher rates of homelessness, particularly for LGBT youth, making them difficult to locate in an emergency situation; LGBT seniors often live alone and don’t have children, making access to them and ensuring that they receive the right safety information in an emergency far more difficult; LGBT relationships aren’t recognized everywhere, complicating healthcare and first response issues; those in the transgender community are often placed in a different shelter from the gender which they identify; and some in the LGBT community may find it hard to trust first responders and medical professionals due to discrimination in the past. Bathrooms can be a problem for the transgendered as well. If and when possible, centers should provide gender neutral restrooms in order to save the LGBT population from embarrassment. Those in the community should also be prepared to stand up and advocate for themselves and one another in times of disaster and crisis.

With the help of LGBT community leaders, advocacy groups and others in the community, health centers should develop proper policies and procedures to deal with these distinct LGBT issues.

The staff at these medical centers should also be trained in LGBT-specific issues. Staff should be made to recognize couples without asking for documentation of their relationship status. Staff should be trained to recognize and use the preferred gender identity and name of a person who is transgender. Working with transgender people and same sex families to make their trauma and transition as smooth as possible should be a training topic for staff as well when managing an emergency situation. Everyone working for the health care center should know the policies, procedures and best practices when dealing with the LGBT community in times of crisis. Those who are on HIV antiviral medications who have been cut off from their treatments during an emergency should have enough medication to last throughout the interim period. Emergency healthcare support and services should also be set up and policies and procedures for dealing with discriminatory acts, violence and other hate crimes against those in the LGBT community. In emergency situations it is generally the most vulnerable that are hurt the most.

Having the front line, vis-à-vis the healthcare community, on top of things will help protect the LGBT community and make sure they survive and do well during natural disasters and other emergencies.

Dr. M. Mirza, LGBT Health Wellness – May. 2014

Many Transgender People Are Completely Avoiding Doctors

It can be difficult for many individuals to have discussions about their sexual history with a physician. It’s not uncommon for people to consider it uncomfortable. But, for many transgender people, the conversation never happens because they do not seek out health care, according to Adrian Juarez, PhD, a public health nurse and assistant professor in the University at Buffalo School of Nursing.

A preliminary study (“Examining the Role of Social Networks on Venue-Based HIV Testing Access and Decision Making in an Urban, Transgendered Population”) that examined health-based decision making and access to HIV testing in urban, transgender populations, showed that many transgender individuals withheld from pursuing necessary care due to social stigma and lack of affordability.

“There is evidence that health care providers do tend to be judgmental, and it’s unwelcoming,” says Juarez. Of course, people are not going to visit health care providers if they fear that they’re going to face discrimination and stigma.

The results of the study are especially cause for concern because, according to a 2009 report from the National Institutes of Health (NIH), about one third of transgender people in the U.S. are HIV positive. And, transgender women of color are even more at risk of HIV infection. According to the NIH study, more than 56 percent of black transgender women are HIV positive.

Among other reasons, an inability to afford medical care is keeping transgender patients away from doctors. Transgender people are more than twice as likely to be homeless and four times more likely to experience extreme poverty (compared to the general population)…having a household income of less than $10,000 per year. This data comes from a 2011 report from the National Center for Transgender Equality. It’s not as if it’s easy for transgender people to get work, either. According to the National Center for Transgender Equality, out of more than 6,000 transgender people surveyed in the nation, 90 percent said they were subject to mistreatment, harassment, and discrimination at work.

If a transgender person does happen to visit a healthcare provider, some doctors are not informed on how to properly treat the patients. Juarez says, “It puzzles me how doctors will still refer to trans individuals by their biological name. That’s their identity.”

The line between identifying and biological gender can be blurry in healthcare settings. For example, transgender men still need Pap smears and transgender women need prostate screenings, but some health care providers might not offer these tests in order to keep from making suggestions that go against the patient’s identified gender. There is an urgent need to address stigmatization and provide health care professionals education on how to appropriately and compassionately treat transgender patients.

7 Ways To Improve Healthcare For The Transgender Patient

Many healthcare workers lack the training to deal with the unique issues the transgender community faces. While others disapprove of the lifestyle of the LGBT community for one reason or another. This can compromise the patients’ care.

That’s according to a study in LGBT Health that discusses the issues the transgender patient faces and measures that can be taken by providers to improve care.

The transgender population struggles with social stigmas and rejection, and this experience has compounded in some medical settings, according to the study. The lack of cultural competency and knowledgeable physicians interferes with the patients’ ability to receive compassionate, knowledgeable and nonjudgmental healthcare. Awkward doctor-patient interactions occur because many physicians lack training in transgender healthcare issues, such as how to approach the gender identity of the patient.

This is a problem because more than 7,000 transgender patients postpone medical care due to the discrimination they face, according to the National Transgender Discrimination Survey. This group is at an increased risk for HIV infection and its related illnesses like depression, anxiety, suicide and substance abuse.

Healthcare facilities and workers at these organizations can take steps to improving transgender care by conducting an education campaign.

Here are some ideas on how to start:

Schedule a series of lectures from healthcare workers with specific training in transgender healthcare.
Hold consumer panels with transgender individuals.
Conduct cultural-sensitivity trainings.
Make resources about transgender healthcare available to workers whether online or via printed materials.
Post LGBT-friendly signs and welcome information at the facility and on the organization’s websites.
Signal in your publications that your physicians are comfortable with transgender patients and knowledgeable about their unique care.
Review office documents and update them accordingly to respectfully address the complex issue of gender identity, such as providing gender-neutral or transgender-inclusive terminology.

The cultural sensitivity provided at your healthcare facility can minimize barriers so transgender patients receive the care that they need. The study believes it will help prevent further health complications, build rapport within the transgender community and diminish healthcare delays.

Dr. M. Mirza, LGBT Health Wellness – 2014

Cervical Cancer Risk for Lesbians

The risk factors for developing cervical cancer are the same for all women regardless of gender identity and sexual orientation (LGBT Health Education .org). That said, bisexual women and lesbians are ten times less likely to get tested for cervical cancer.

Regular screenings, however, have been shown to be the best way to catch it early when treatment options and outcomes are the best. Lesbians are less likely to get preventative healthcare out of all women and lesbians and bisexuals are less likely to have health insurance that heterosexual women. Originally, cervical cancer was the most deadly form of cancer for women. Today, with early screening, it is one of the most preventable.

Since we know now that bisexual and lesbian women are the least likely to be screened, an outreach program is underway to get cervical cancer under control, and these two groups have been designated as priority populations. In addition, black women suffer the highest mortality rates from cervical cancer, while the highest age-adjusted rates are suffered by Hispanic women. Survival rate from cervical cancer within the first five years of being diagnosed is 67.9%, but if it is found early on, the survival rate is 90.7%. That’s why it’s so important to reach out to these populations and motivate them to get regular screenings.

Smoking, immunosuppression often related to HIV, and human papilloma virus (HPV) infection are major risk factors for cervical cancer. Many in the LGBT community such as lesbian women, bisexual women and transgender men who still have a cervix have higher chances of having or developing these other conditions, and so have an increased risk of developing cervical cancer. What makes matters worse, since they are much less likely to be insured, they are less likely to seek out preventative care.

Obesity is another risk factor which is also higher among lesbians. Not as much data is available on bisexual women, though some studies show that they may have lower insurance rates and higher smoking rates, making them also more susceptible. One study found that 2.2% of bisexual women develop cervical cancer as opposed to 1.3% of heterosexual women. Hispanic and black bisexual and lesbian women should be particularly targeted for an outreach program.

Although we are seeing more and more types of studies being done concerning LGBT health, more still has to be done. We see that race and age data is often collected while sexual orientation data often slips through the cracks of the healthcare system. There has been a pivot recently. LGBT health is becoming more of a priority in communities across the country and certainly on the national front. We should see this data being collected more and issues such as this coming to the forefront, as well as policies and procedures to better address the health disparities suffered by the LGBT community.

Cervical Cancer Risk for Lesbians and WSW
Dr. M. Mirza, LGBT Health Wellness – 2015

Gay Black Men’s Pressure to Conform Leads to Higher HIV Risk

Familial and cultural pressure to conform to expected masculine behaviors leads gay black men to engage in riskier behavior, therefore increasing their risk of contracting HIV. This is according to a report out of the John’s Hopkins Children’s Center and published in Science Daily. This community of men feel distress and social isolation, according to the report, which may contribute to their decision to take part in such behaviors. The “compensatory” behavior according to researchers leads to riskier behavior and contributes to the higher infection rate among gay black men.

Gay and bisexual black men attributed to 4,800 new HIV cases in 2010, more than two times that of other male groups, says the CDC. Thirty five young, male participants took part in this study, recently published in the American Journal of Public Health. Openly gay and bisexual men took part in this study, as did young men who have sexual relations with men but don’t self-identify as gay or bi-sexual, also known as MSM. Adolescent medicine expert at the John’s Hopkins Children’s Center and the study’s lead author, Errol Fields, M.D., Ph.D., said of this study, “HIV risk is the sum total of many factors, but social and family stress is a well-known driver of all types of risk-taking behaviors, and our findings clearly support the notion this also holds true when it comes to HIV risk.”

There is a very traditional view of masculinity with strong anti-gay sentiment in the community where the participants grew up. These participants needed to prove their masculinity, hide homosexuality, and conform to social pressures. This makes them far less likely to take part in monogamous relationships and more likely to take part in unprotected sex. Black gay men also sought affirmation through sex which they weren’t getting from a close loved one in their life. Some also said that having unprotected sex showed trust and love for one’s partner. Since the community they were from expected them to act aggressive and free of any feminine behaviors, they were forced to either conform or be ostracized. Drug use, drinking, fighting and other such risky behavior was taken part in so as to prove their masculinity and fit in.

According to Dr. Fields, “The findings of our study reveal a clear clash between internal sexual identity and external expectations at a critical developmental stage,” As a result, “This clash creates loneliness and low self-esteem and appears to drive these boys and men to risky behaviors, sexual and otherwise.” These young men were also constantly worried that they would be found out. If they were found out they would lose their friends and family, so they needed their secret to be safe. “It’s a true catch-22 for these youngsters,” said Fields. “On one hand, they are dealing with the chronic anxiety of hiding their homosexuality, but on the other they face the prospect of becoming social pariahs if they come out as gay or bisexual.”

Dr. M. Mirza – 2014
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