March 31, 2011 -- In a landmark moment for the lesbian, gay, bisexual and transgender community, the Institute of Medicine today published a report for the National Insitutes of Health emphasizing the need for more federally funded research on LGBT health problems.
When Elle Groves, 24, was still in school at Colorado State University, a doctor treating her at the campus health services insisted that she was not susceptible to contracting a sexually transmitted disease because she was a lesbian. "Actually, quite the opposite is true. ... The education and awareness about using protection for same-sex female partners is very low and a lot of LGBT women out there don't know that they can still get STDs from unprotected sex with a female partner," says Groves, who now lives in Denver.
"The doctor was also pushing that idea on me -- that I'm not at risk because of [my sexual orientation], which is a blatant lie and very dangerous for women who would have trusted her."
Dr. Howard Grossman, an internist in New York City says many of his LGBT patients have similar stories -- tales of insensitivity, misinformation and prejudice by medical practitioners who either don't understand or are intolerant of their sexual orientation or sexual identity.
"They run the gamut: For instance, if you're a gay man, often the only thing they think about is HIV risk, when gay men need all the regular primary care stuff as anyone else," says Grossman, who treats predominantly LGBT patients in his downtown practice.
Gaps in practitioner education and overall gaps in available data on the needs, risks and concerns of those who identify as lesbian, gay, bisexual or transgender are identified in the IOM report released today.
"It's been a neglected area of health care research, because people don't think of LGBTs as having health issues different from the general population, and because the government wasn't supportive of research in this area," says Dr. Harvey Makadon, director of professional education at the Fenway Institute and member of the committee that published the IOM report.
Dearth of Knowledge, Public Health Problem
Many who are lesbian, gay, bisexual or transgender recognize the IOM report as an enormous step in the direction of health care parity.
"It's been very hard for the last 30 years to get anyone outside of the LGBT community interested in studying the community," Grossman says, noting that most of the research cited in the IOM report stems from studies done by those within the community.
"During the years of the Bush administration, it was basically taboo to even mention anything related to gay and lesbian when you were trying to get research money," says John Culhane, director of the Health Law Institute at Widener University School of Law. "Now we have the opposite -- we have the Institute of Medicine and the Institutes of Health suggesting that not only is it suggested to look at these issues, but there is a crying need for it."
The National Institutes of Healh, for whom the report was specifically intended, voiced Thursday that they will work to support future LGBT research and colllaborate with the National Center for Health Statistics, a component of CDC, "to address and improve the methodology for collecting survey data on sexual orientation and gender identity," according to NIH Director Dr. Francis Collins.
But Grossman expressed some skepticism about how far this call for federal funding would go: "We'll see what happens when the Republicans get hold of it," he said. "The LGBT community may end up being the punching bag on the floor of Congress."
Major Issues ID'd in the Report
The specific purpose of the report was to inform the National Institutes of Health on research needs, but many hope it will motivate a range of health care professionals to start collecting data and looking at the specific health problems facing lesbians, gays, bisexuals and lesbians, says Brian Moulton, chief legislative counsel of the Human Rights Campaign.
The report identifies dozens of health findings regarding LGBT health disparities, synthesizing more than 100 studies from the past decades on this topic.
Hopes for Change in LGBT Awareness
Poor access to health insurance because of discrimination among employee-provided health care to spouses and domestic partners, high rates of mental health problems, including substance abuse, depression and thoughts of suicide, and increased risk of contracting sexually transmitted diseases are just a few of the more pressing concerns identified in the report, says report committee member Judith Bradford, director of the Center or Population Research in Lesbian, Gay, Bisexual and Transgender Health at the Fenway Institute.
Less publicized health problems include a lack of LGBT training in medical schools, the special health risks experienced by elder LGBTs and a dearth of research into almost all areas of the transgender experience.
"We want all sorts of people in the health care system, those who do research, those who provide care, those who work in community programs, and even the general population, to see this report and learn more about LGBT people as a result," says Bradford.