LGBT Health Issues : be.georgetown.edu

Men who have sex with men and women who have sex with women encounter some specific barriers to accessing health care. Some lesbians, gay men, and bisexuals fear homophobic responses from health care providers. A 1987 National Lesbian Health Care Survey found that 45% of respondents were assumed to be heterosexual and treated rudely by health care workers, 25% of respondents were assumed to have a "traditional family," 16% felt that they could not disclose their lesbianism to health care workers, and 14% encountered health care workers who were ignorant about lesbians.1 Lesbians also may have to contend with sexism of health care providers. Additionally, most lesbians and gay men cannot share partner health benefits.

Mental health: stress, depression, suicide

80% of lesbian, gay, and bisexual youth report severe isolation problems. They may experience social isolation (having no one to talk to), emotional isolation (feeling distanced from family and peers because of their sexual identity), and cognitive isolation (lack of access to information about sexual orientation and homosexuality).2 Half of all lesbian and gay youth interviewed in a 1987 study report that their parents rejected them due to their sexual orientation.3 In a 1993 study, 33% of lesbian, gay, and bisexual youth reported they were not comfortable being open at school, and 49% reported hiding their sexual orientation from teachers. 63% said they felt overwhelmed to the point that they couldn't get things done. Those who knew about their sexual orientation for longer periods had lost more friends and reported more mental problems.

A 1989 study published by the Department of Health and Human Services found that gay and lesbian youth are two to three times more likely to commit suicide that other youth, and 30% of all completed suicides are related to issues of sexual identity.5 The National Gay and Lesbian Task Force found that 41% of male adolescents seeking services at agencies for gay youth had attempted suicide, compared with 22% of their heterosexual counterparts at a shelter for runaways.6

The Gay, Lesbian, and Straight Teachers' Network also has an article on Youth suicide: "An overview of the issues that contribute to the disturbing prevalence of youth suicides in the GLBT population. Includes case studies, intervention strategies and clinical models of risk assessment." For a more detailed look at research on homosexuality and youth suicide, check out "The Homosexuality Factor in the Youth Suicide Problem" by Pierre J. Tremblay (1995).

There are many hotlines, support groups, and counseling centers available for lesbians, gay men, bisexuals, and people who may be questioning their sexuality, such as DC's Sexual Minority Youth Assistance League (SMYAL), which provides a safe, comfortable space for youth ages 14-21 who are lesbian, gay, bisexual, transgender, or who may be questioning their sexuality or gender identity.

Substance Abuse

The Triangle Club (202-659-8641) and Mental Health and Addiction Treatment Services of Whitman Walker Clinic (202-797-3518) provide services for lesbians, gay men, and bisexuals who may be abusing alcohol or drugs.

Homelessness

26% of gay youth are forced to leave home because of their sexual identities.7

HIV/AIDS

A San Francisco study of gay and bisexual men revealed that 14% of the men between ages 17 and 22 were HIV positive - a figure 4% higher than young men in the 23-25 age group.8 The high rate of homelessness among gay, lesbian, and bisexual youth may be related to risk factors such as having to exchange sex for money and using illegal drugs. Since much of the discussion surrounding HIV and AIDS has identified groups of people such as "gay men" as a risk group rather than emphasizing the behaviors, such as unprotected sex and sharing needles used to inject drugs, through which HIV is transmitted, some men who have sex with men but who do not identify as gay may think they are not at risk. Since lesbians have been left out of much of the discussion and research about HIV and AIDS, many women who have sex with women may think that they are not at risk.

The Whitman Walker Clinic provides information, STI, and HIV testing to individuals on a walk-in basis. Contact the clinic for more information.

Relationship Violence

The Second Closet: Domestic Violence in Lesbian and Gay Relationships examines myths and stereotypes about same-sex violence, prevalence of same-sex violence, and problems in dealing with same-sex violence through the criminal justice system. The paper was written by Lee Vicks and includes an extensive bibliography.

1National Lesbian Health Care Survey. Conducted by: Judith Bradford, PhD, Caitlin Ryan, MSW, National Gay and Lesbian Health Foundation, November 1987. Prepared by: Survey Research Laboratory, VCU. Funded by: NIMH, Ms. Foundation, Chicago Resource Center. 1925 respondents from all 50 states, ages 17-80.

2Hetrick, E.S. and A.D. Martin, "Developmental Issues and Their Resolution for Gay and Lesbian Adolescents," Journal of Homosexuality, 14(1/2): 25-43 (1987).

3Remafedi, G., "Male Homosexuality: The Adolescent's Perspective," Pediatrics, 79: 326-330 (1987).

4D'Augelli, A.R. and Hershberger, S.L., "Lesbian, gay, and bisexual youth in community settings: Personal challenges and mental health problems," American Journal of Community Psychology, 21: 421-448 (1993).

5Gibson, P., "Gay Male and Lesbian Youth Suicide," Report of the Secretary's Task Force on Youth Suicide, U.S. Department of Health and Human Services, 1989.

6National Gay and Lesbian Task Force, "Gay Rights in the United States and Canada," New York: National Gay and Lesbian Task Force, 1982.

7National Gay and Lesbian Task Force, "Anti-Gay/Lesbian Victimization," New York 1984; and Remafedi G., "Male
Homosexuality: The Adolescent's Perspective," Pediatrics, 79: 326-330 (1987).

8AIDS Office, Bureau of Epidemiology and Disease Control, San Francisco City Clinic Special Programs for Youth and Department of Welfare, "The Young Men's Survey: Principle Findings and Results," San Francisco,
California, June 1991.