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.