DQ6-Reply

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Please reply to Lauren M – Please note minimum of 200 words. No sources citation needed.

Rights and respect for the LGBT population have come such a long way in recent years. Despite the progress that has been made, the LGBT population continues to receive subpar healthcare. It is very important that LGBT youth receive quality healthcare. LGBT youth are at an increased risk for sexually transmitted diseases, substance abuse, heart disease, cancers, obesity, bullying, physical or sexual abuse, anxiety, depression, and suicide (Hafeez et al., 2017). It is also important to note that LGBT youth make up 40% of all young people experiencing homelessness. The LGBT population is much more hesitant to seek out healthcare and those that do often experience disparities in care. Many factors could be contributing to the failure of LGBT to use healthcare services or to receive quality care. Psychological factors include the stress of coming out and victimization. One factor could be the hesitance of LGBT individuals to report their sexual identity to their clinicians. This results from a justified fear of discrimination from health care workers and the health care system. A behavioral factor in not seeking healthcare might include engaging in high-risk sexual behaviors. LGBT individuals might feel shame or fear of being judged for their behavior, so they do not seek out health care. Members of the LGBT population are also less likely to hold health insurance coverage (Hafeez et al., 2017).

A population health nursing intervention that might promote more effective use of health care services would be visiting high schools and assessing individual students. This might be hard to accomplish due to staffing and time constraints but if community nurses could get one on one time with each student and assess them for being part of the LGBT community, the nurses could provide them with support and resources for accessing healthcare. The nurse would especially focus on the importance of testing frequently for sexually transmitted diseases and mental health care for depression. The nurse would teach students where to go to access these services. If the LGBT population starts making their health a priority in their youth, hopefully they will be more inclined to continue as they age. Community health nurses can also help reduce health disparities within the LGBT population by learning and better understanding the specific health risks that this population may experience. Community health nurses should also conduct mental health screenings and promote a culturally sensitive health care environment. Nurses can do this by using the correct pronouns, not making assumptions, practicing therapeutic listening, and providing LGBT health education to other health professionals (Medina-Martinez et al., 2021).

References

Hafeez, H., Zeshan, M., Tahir, M.A., Jahan, N., & Naveed, S. (2017). Health care disparities among lesbian, gay, bisexual, and transgender youth: A literature review. 
Cureus, 9(4). doi: 10.7759/cureus.1184. 

Medina-Martínez, J., Saus-Ortega, C., Sánchez-Lorente, M.M., Sosa-Palanca, E.M., García-Martínez, P., & Mármol-López, M.I. (2021) Health inequities in LGBT people and nursing interventions to reduce them: A systematic review. 
Int J Environ Res Public Health, 18(22). doi: 10.3390/ijerph182211801

Please reply to Geoffrey H – Please note minimum of 200 words. No sources citation needed.

         Even after the passing of the affordable care act, the LGBTQ community still faces discrimination in today’s healthcare system. If they continue to face hurdles in accessing care, they will inevitably avoid seeking preventative, yearly, and acute care that would substantially impact their lives. The LGBTQ community deserves to access and receive quality healthcare without being discriminated against, stigmatized, or overlooked because of their sexual orientation. 

The stigma surrounding the LGBTQ community significantly affects how they are treated during their healthcare visit. Changing these views will require a multi-faceted approach, starting with the healthcare staff. Dr. Poretsky, an endocrinologist in New York, is trying to de-stigmatize his peers, stating, “there is nothing wrong with being transgendered; it’s not a disease, and there is still progress to be made (usatoday.com).” 

Insurance, specifically coding and billing, is another area that requires reform to meet the needs of the LGBTQ community. Health insurance companies do not recognize many procedures surrounding the community, creating obstacles when it comes to repayment or coverage. For example, treating a transgender male who requested a hysterectomy became an issue when it came time to label the procedure and request coverage from the insurance company. The patient was given the option of labeling the procedure abnormal uterine bleeding, in which case the procedure would be covered or say it’s for gender affirmation. The patient chose the latter, and insurance coverage was denied, a lawsuit followed, and the patient won in court, requiring all trans care to be covered by the state of Pennsylvania under Medicaid (usatoday.com). This is just one example of the difficulties the LGBTQ community must go through to get the appropriate care and coverage. 

Education also significantly provides equal, fair, and streamlined healthcare to the LGBTQ community. Nursing and medical schools need to have updated curriculum and training regarding the views and needs of the LGBTQ community. Almost all nurses and physicians practicing in the field today had little to no training on these issues. The hospital system I work for does have yearly training in the form of a quick powerpoint and quiz. It however does not go far enough in terms of being comfortable with the issues at hand and how to meet the needs of the LGBTQ community. 

I personally believe that education in the form of classroom and bedside training is the key to bridging the gap between the community and healthcare provider. It could also start with nursing educators developing curriculum that could be implemented into the hospital staff to keep current staff up-to-date. 

Moniuszko, S. M. (2021, October 1). 
How doctors’ assumptions about LGBTQ patients can be harmful to their health. USA TODAY. Retrieved September 5, 2022, from