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Section 26
Discrimination in Healthcare

Question 26 | Test | Table of Contents


Discrimination in Healthcare
Unfortunately, gay, lesbian, bisexual and transgendered people have reasonable fears of discrimination when seeking health care:

- A 1998 survey of nursing students showed that 8 to 12% (depending on whether the respondent rated gay, lesbian or bisexual) despised lesbian, gay and bisexual people, 5-12% found lesbian, gay and bisexual people disgusting and 40-43% believed that lesbian, gay and bisexual people should keep their sexuality private.

- In a 1996 survey of 1,027 New Mexico physicians, 4.3% indicated that they would deny gay and lesbian people acceptance to medical schools and 10.1% believed that gay and lesbian physicians should be discouraged from seeking obstetrics/gynecology training. In the same study, over 20% of the general practitioners, 9.3% of family practice physicians and 4% of pediatricians reported that they would discontinue patient referrals to gay or lesbian surgeons. (The good news is that provider attitudes have improved since a 1986 California study in which 40% of MDs said they were uncomfortable with treating gays and lesbians, 30% opposed admitting gays and lesbians to medical schools, and 40% would not refer clients to gay or lesbian colleagues.)

- A 1991 Midwest study of nursing students' attitudes toward lesbians reported that 50% of nursing students felt that lesbianism was "unacceptable," 28% believed that "lesbians transmit AIDS," and 15% believed that lesbianism was "illegal."

- In survey published in 1988, 84% of lesbians surveyed had experienced a general reluctance to seek health care, finding it nonempathic. This study revealed that 96% of lesbians "anticipated situations in which it could be harmful to them if their health care provider knew they were lesbian."

- A 1985 survey published in the American Journal of Public Health looked at health care professionals' reactions after patients stated that they were lesbian. It revealed that 89% of the professionals had negative reactions: 12% were cool to the news, 30% were embarrassed, 25% responded in an inappropriate way, either by offering mental-health referrals or asking voyeuristic questions, and 22% rejected their lesbian clients overtly by leaving the examination room and having their nurses finish taking the health histories.

A 1981 study showed that when a patient was known to be gay, physicians tended to interpret the presenting problem in sexual terms. When the patient was not identified as homosexual, other diagnoses were more often considered.
- King County Public Health, Culturally competent care for GLBT people: Recommendations for health care providers, http://www.metrokc.gov/health/glbt/providers.htm, 2005

Personal Reflection Exercise #12
The preceding section contained information about the bias against LGBTQ clients in the healthcare system. Write three case study examples regarding how you might use the content of this section in your practice.

Update
Diversity and Discrimination in Healthcare

Togioka, B. M., Duvivier, D., & Young, E. (2023). Diversity and Discrimination in Healthcare. In StatPearls. StatPearls Publishing.


Peer-Reviewed Journal Article References:
Chang, C. J., Kellerman, J. K., Fehling, K. B., Feinstein, B. A., & Selby, E. A. (2021). The roles of discrimination and social support in the associations between outness and mental health outcomes among sexual minorities. American Journal of Orthopsychiatry, 91(5), 607–616.

Hughto, J. M. W., Pachankis, J. E., & Reisner, S. L. (2018). Healthcare mistreatment and avoidance in trans masculine adults: The mediating role of rejection sensitivity. Psychology of Sexual Orientation and Gender Diversity, 5(4), 471–481.

Legate, N., Weinstein, N., Ryan, W. S., DeHaan, C. R., & Ryan, R. M. (2019). Parental autonomy support predicts lower internalized homophobia and better psychological health indirectly through lower shame in lesbian, gay and bisexual adults. Stigma and Health, 4(4), 367–376.

QUESTION 26
A 1981 study showed what common mistake physicians made regarding patients who informed them of their sexual orientation? To select and enter your answer go to Test.

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