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The Forgotten Minorities: Health Disparities of the Lesbian, Gay, Bisexual, and Transgendered Communities
In lieu of an abstract, here is a brief excerpt of the content:

I woke up early that morning for an appointment with my primary care provider; I did not want to be late because I was a new patient and had waited a month for the appointment. Since I had moved across town to attend college, it was no longer feasible to go to my long-time primary care provider (PCP). Although seeing a new PCP made me slightly apprehensive, I had no idea that I would leave the physician’s office feeling ashamed.

The office seemed like any other office—pamphlets about women’s health were displayed in a holder attached to the wall, there were comfortable chairs for waiting, and magazines were lying on a table ready for perusal. The receptionist at the front desk was friendly and welcoming. At check-in, I began to describe my medical history on a patient intake form that listed the typical medical questions that one would expect. Then I reached the section of the intake form that requested demographic information. One question asked for “Current relationship status” and the response options were: Single; Married; and Widowed. I didn’t fit any of those descriptions. I also noticed the omissions of questions concerning sexual orientation and gender identity. Thus, I checked the box for single despite my two-year long relationship with my partner.

When the nurse led me to the exam room to assess my vital signs, she made small talk and we laughed a little, which made me slightly more comfortable. When the PCP came into the room, she introduced herself and shook my hand. We reviewed the information in my intake form together and everything seemed straightforward until she asked me if I was sexually active. I told her that I was, to which she replied, “Would you like birth control?” When I told her that I didn’t need it, she proceeded to tell me about unwanted pregnancy and the benefits of birth control, even though I did not request this information. She asked, “So, are you using protection to prevent pregnancy?” I simply said, “I don’t have sex with men.”

That statement was met with a long pause as she just stared at me. The moment seemed to linger forever and I did not know which of us was more uncomfortable.

“So, you’re a lesbian?” she asked, to which I quickly replied, “I’m gay.”

I suddenly felt embarrassed. She sighed deeply as if to indicate that what I had just disclosed was deeply disturbing. She did not say anything else and stepped out of the room. I was left in the examining room wondering what would happen when she returned. At one point, I considered leaving. She returned with the nurse, who stood in the corner watching as the PCP conducted what seemed like an extremely superficial and rushed physical examination. At the end of my exam, I was given directions to a laboratory for some blood tests and a business card for the provider’s office so that I could make a follow-up appointment. I never did get the blood tests and I never returned to that provider.

At the time, I did not suspect that many of my future experiences with health care providers would involve repetitive and awkward explanations about my relationship status, my sexual identity, and why I didn’t need birth control.

Unfortunately, experiences like this are not rare for lesbian, gay, bisexual, and transgendered (LGBT) people seeking access to medical services; it seems that many LGBT people have negative experiences with their health care providers and the health care system. In addition to the lack of adequate, informed, and culturally sensitive provider and patient education, the LGBT communities face undue health disparities and inequities that should be addressed. (See below.) Health care professionals should be made aware of these disparities in order to improve quality and cultural sensitivity in care for this underserved population.

On April 15th, 2011, President Obama signed a presidential memorandum regarding hospital visitation and health decision making for same-sex partners. It states that hospitals accepting Medicare and Medicaid must respect patients’ advance directives and “respect the rights of patients to designate visitors.” These hospitals...


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