Oppression and Discrimination leads to health disparities in the LGBTQ+ population
- Kimberly Presta
- Nov 28, 2021
- 3 min read
Updated: Dec 7, 2021
Oppression and discrimination towards the LGBTQ+ population leads to health disparities and negative health outcomes. According to the publication on Guidance: Reporting on vulnerable populations LGBTQ+ people 2020, “Health care workers may, either consciously or unconsciously, make decisions to deny or delay treatment on the basis of their patients' LGBTQ+ status (2020). Furthermore, this delay may lead to premature and untimely prognosis for poorer health outcomes.
As health care providers we have a duty to advocate for equitable access to care for all. This advocacy may be evident in our day to day work and also in our political actions when we vote and if we choose to become active in lobbying for policy change as is noted in the Registered Nurses Association of Ontario’s position paper on Racism (2004). Effective policy requires not just the stated goal but the structures to support and promote policy implementation (RNAO, 2021).
According to the Healthy People 2020 initiative the social determinants that affect the health of LGBTQ+ relate to the impact from oppression and discrimination (Healthy People 2020). One example of the impact from oppression and discrimination is demonstrated when a same sex partner is not permitted to be listed in the person’s life as family added in the health care coverage, or ability to be legally married. According to healthy people 2020, “Discrimination against LGBT persons has been associated with high rates of psychiatric disorders, substance abuse, and suicide” (2020) although this data has not consistently been included in surveys at the national or provincial level (2020).
Another example of discrimination upon the vulnerable population of the LGBTQ+ continues to occur during the COVID-19 Pandemic. Blame was occurring on the LGBTQ+ community for causing the spread of the COVID-19 virus in the second wave in South Korea (2020). According to the report infections occurred after restrictions were relaxed in early May, 2020 and were traced to nightclubs in Seoul’s Itaewon area, known to be a gathering place for gay people (2020).Nurses are tasked to model appropriate behaviour and promote a climate of inclusivity and mutual respect; Identify and challenge systemic issues and barriers, recognize and acknowledge that racism/discriminatory behaviour can have a tremendous impact on the individual (RNAO, 2021). Moreover, the unconscious bias could have other unintended consequences that ripple, for example, on contact tracing during a pandemic, or other communicable disease risk. Fear of disclosure of contacts due to judgement and stigma can further impact the community and lead to ongoing transmission. Public safety is at risk as a consequence of judgmental, and discriminating health care provider. The fear of judgement impedes individuals from accessing care, and further providing names of contacts if required for their care. Fear that the persons sexuality or relationships will be exposed further impairs and impedes access to care (RNAO, 2021).
Clearly, inability to have a loved one/partner included in their health benefits is an act of discrimination, further impacting financial burden, health interventions and health inequity. Essentially families and loved ones negatively impacted by a disease or illness and its financial burden of care causing increased barriers to equitable health care, and impact the emotional and psychosocial health of all involved.
What has become evident is the need for collecting data on those who identify within the LGBTQ+ population and will assist with addressing health inequities. Although collection of data on the LGBTQ+ will further assist with identifying the health inequities, collecting data on other stigma that is intersectional are interrelated. With the collection of data we can learn how to better care for the LGBTQ+ population. Health inequities that are attributable to the social determinants of health identified will help to identify the health inequity barriers.
Moreover, according to Turan, people in diverse settings experience intersecting forms of stigma that influence their mental and physical health and corresponding health behaviors (2019). What is needed is further qualitative, quantitative, and mixed methods approaches to reduce the significant knowledge gaps that remain in our understanding of intersectional stigma, shared identity, and their effects on health. Education for healthcare providers on removing stigma, learning to provide inclusive health care, and language. As we know patients/clients who come to health care centres are coming for care, collateral information such as backgrounds and health histories are gathered to create a better picture of the overall health. By leaving out such an important part of who this person creates further barriers to whole person health care.
Resources:
A Provider’s Introduction to Substance Abuse Treatment for Lesbian, Gay, Bisexual, and Transgender Individuals. Retrieved November 18, 2021
Guidance: Reporting on vulnerable populations LGBTQ+ people. June 26, 2020. Retrieved November 18, 2021
Lesbian, Gay, Bisexual, and Transgender Health New, Retrieved November 18, 2021.
Registered Nurses Association of Ontario (RNAO) Retrieved November 22, 2021. https://rnao.ca/search/node/position%20statement
Turan, J.M., Elafros, M.A., Logie, C.H. et al. Challenges and opportunities in examining and addressing intersectional stigma and health. BMC Med 17, 7 (2019). https://doi.org/10.1186/s12916-018-1246-9
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