By Andrew M. Seaman
(Reuters Health) - Lesbian, gay, bisexual and transgender (LGBT) communities have their own specific needs when it comes to health and medicine, according to experts.
Yet LGBT people often avoid seeking medical care because they're afraid they might face discrimination or that doctors might not understand their special health needs, said Barbara Warren, an expert on LGBT health and health policy, speaking at a discussion on LGBT health sponsored by the Thomson Reuters Pride At Work chapter in New York City on January 15.
Or they may seek medical care, but not "come out" to their healthcare providers.
Does it matter if healthcare providers know whether a patient is lesbian, gay, bisexual or transgender? Yes, said Warren, who is director of LGBT Programs and Policies in the Office of Diversity and Inclusion at Mount Sinai Health System in New York City.
Warren said LGBT health concerns should be discussed for several reasons.
First, people will have better health outcomes if they feel comfortable with their providers. Additionally, the LGBT community suffers from the stress of being a minority, which can impact people's health. And certain clinical issues are different in the LGBT community.
For example, she said, members of the LGBT communities - especially lesbian and bisexual women - may be at an increased risk for some cancers and conditions if they don't get regular healthcare.
"We do know that a percentage of LGBT people avoid and delay screening and care because of fear about or experience of stigma, discrimination or simply lack of knowledge about LGBT people and their health amongst providers," said Warren. "If you avoid or delay screening and care and you have an issue that may be precancerous, by the time you get into screening and care you're there because it has become acute and you already have a progressed disease."
"All of those are factors that go into why it's important both for your providers to be trained and sensitive and to get it, and why it's important for you to come out to your providers as who you are and be as open as you can be," Warren said.
She said the National LGBT Cancer Network advocates training providers to be sensitive in helping a person come out and to do all the screenings that are necessary.
While estimates vary, a 2014 report from the Centers for Disease Control and Prevention (CDC) says about 97 percent of U.S. adults identify as straight, about 2 percent as gay or lesbian and about 1 percent as bisexual.
The LGBT community also faces an increased burden of mental health concerns, including depression, anxiety and substance abuse - but this doesn't mean LGBT people are inherently mentally ill, Warren said.
Instead, she said, LGBT mental health issues are largely related to the stresses of belonging to a minority group. "We can change that by changing the way the world perceives, treats and includes LGBT people."
Kellan Baker, also speaking at the Thomson Reuters event, said there has been a lot of progress on U.S. policy issues regarding LGBT health.
"We have seen an incredible explosion of initiatives that are inclusive of or focusing on LGBT communities from the federal government over the last five years," said Baker, a senior fellow with the LGBT Research and Communications Project at the Center for American Progress in Washington, D.C.
He highlighted Healthy People 2020, which lists the nation's objectives on health and includes a topic area specific to LGBT health.
Also, Baker said, the 2010 Affordable Care Act - better known as Obamacare - "has a lot to offer LGBT community members. One of the biggest things is simply the expansion of health insurance coverage."
Baker said access to coverage ties into many of the topics Warren mentioned, such as getting screened for certain conditions and seeing a healthcare provider on a regular basis.
However, more work is needed to connect LGBT people with the information they need to get health insurance and access to healthcare, he said.