Module 12 Related Health Issues

1
Module 12Related Health Issues

• A Providers Introduction to Substance Abuse for
  Lesbian, Gay, Bisexual, and Transgender
  Individuals
• First Edition

2
Related Health Issues

• Learning Objectives
• Understand health issues for LGBT persons
• Be able to list barriers to adequate health care
• Be able to recognize and assess mental health
  issues
• Understand the effect of interpersonal violence
  in the LGBT community

Power Point Slide 12-1, n21
3
True Or False

• LGBT people are the victims of the most violent
  hate crimes in America.

• TRUE
• Hate crimes based on sexual orientation are
  probably among the most underreported crimes.
• Hate crimes against sexual minorities are
  generally more violent than other hate crimes.

Power Point Slide 12-2, n22
4
True Or False

• FALSE
• Lesbians may be at increased risk for HPV
  infection and, hence, cervical cancer, depending
  on their sexual practices.
• Lesbians typically see healthcare providers less
  frequently than do heterosexual women, and, thus,
  may not undergo sufficient screening.

• Lesbians are at lower risk for breast and
  cervical cancer than heterosexual women.

Power Point Slide 12-3, n23
5
True Or False

• TRUE
• Hepatitis A and B can be transmitted through
  sexual contact.
• Hepatitis B and C can be transmitted through
  sexual contact and/or sharing needles.

• Gay men are at higher risk
• for hepatitis A and B, and, in some cases,
  hepatitis C.

Power Point Slide 12-4, n24
6
True Or False

• There is a relatively low prevalence of HIV
  infection among male-to-female transgender
  persons.

• FALSE
• In recent San Francisco study HIV prevalence
  among MTF persons was 35 and 65 among
  African-American MTFs.
• Other recent studies of transgender health risks
  in urban areas around the country show similar
  results.

Power Point Slide 12-5, n25
7
True Or False

• Gay men tend to smoke less than heterosexual
  men.

• FALSE
• Recent and representative studies among gay men
  have indicated strikingly higher rates of smoking
  among gay men than in the general male
  population.

Power Point Slide 12-6, n26
8
True Or False

• Gay and bisexual men are at higher risk for HIV
  but lower risk for gonorrhea and chlamydia.

• FALSE
• Even when men who have sex with men refrain from
  unprotected anal sex, they may engage in other
  activities such as unprotected oral sex that
  increases risk for both gonorrhea and chlamydia.

Power Point Slide 12-7, n27
9
Barriers to Adequate Health Care

• Many gays and lesbians do not disclose their
  sexual orientation to their healthcare providers.
  
• Many LGBT persons are reluctant to use mainstream
  healthcare services.
• Gay and Lesbian Medical Association Survey (1994)
  results indicate substandard care for LGBT
  patients.

Power Point Slide 12-8, n28
10
Mental Health Issues

• Recent research on mental health issues for LGBT
  persons indicates that there is a higher rate of
  bipolar and depressive disorders in gay men than
  among heterosexual men.
• Atkinson et al. found higher rates of lifetime
  depression in homosexual males compared with
  heterosexual men.
• Gilman et al. found significantly higher
  prevalence rates of depressive disorders in
  lesbian women compared with heterosexual females.
  
• Distinct barriers to mental health service
  utilization have been described for sexual
  minorities that include
• A tendency to pathologize LGBT identity
• Lack of LGBT-sensitive care
• Discrimination and marginalization of LGBT
  clients
• Unwillingness to address LGBT-related issues in
  treatment
• Unwillingness to work with partners and lovers of
  LGBT
• clients.

Power Point Slide 12-9, n29
11
Research on Interpersonal Violence in the LGBT
Community

• Overall the same rate in same-sex relationships
  as in heterosexual relationships.
• 8 rate of partner violence in a diverse,
  nonclinical sample of nearly 2,000 lesbians.
• 17 of gay men reported having been in a
  physically violent relationship (Gay and Lesbian
  Community Action Council 1987).
• 40 of 228 gay male perpetrators abused drugs
  (Farley 1996).
• 25-33 of same sex couples report some sort of
  abuse (Page, 2000).

Power Point Slide 12-10, n30
12
Assessment and Intervention

• Ask about interpersonal violence in private
• Ensure confidentiality
• Ask questions in an affirming and culturally
  sensitive manner
• Empathize with clients feelings
• Look for indicators of interpersonal violence
• Use third-person examples to screen possible
  batterers
• If a client is identified as either a victim or
  batterer, refer him or her to an LGBT support
  group, to an LGBT affirmative batterers
  intervention program, and for ongoing
  consultation with an LGBT domestic violence
  treatment expert

Power Point Slide 12-11, n31
13
CASE EXAMPLES

• How would you proceed
• with the assessment?
• What questions would
• you ask and how would
• you ask them ?

• Ron
• DeeDee

Power Point Slide 12-12, n32