Reflection Of Sexuality And Psychiatry

Lesbian, Gay, Bisexual, and Transgender (LGBT) falls within societal minority groups such as low income, people of color, and disables (AHRQ, 2011). Due to their gender identity, discrimination, violence, and even denial of human rights and healthcare services is a common challenge among LGBT population. LGBT still faces many health disparities primarily related to the historic bias of healthcare professionals anti-LGBT manners even though society acceptance has been favorable. According to Ard and Makadon (n.d), “until 1973, homosexuality was listed as a disorder…, and transgender still is.” This stigma prevents healthcare professionals to openly ask questions in a non-judgmental manner related to sexual identity. On the other hand, if the patient senses that the healthcare environment is discriminating they may be reluctant to disclose important information as their sexual orientation; thus, missing important opportunities of been educated about safety and health care risks.

After reading the article “Addressing Health Care Disparities in the LGBT population”, I was so shocked and speechless. Honestly, I did not have an awareness of the health care disparities experienced by the LGBT population. To me, it is a disgrace to read in this day and age that human beings are experiencing health care inequalities by their health care providers simply because of their sexual preferences. As a nurse, I feel that it is of high importance to highlight and address these issues because as stated in the article not only can the LBGT negative experience and stigma have detrimental effects (depression and suicidal ideation) on this population, it can prevent them from ever seeking care regardless of the illness. Thus, hindering

Individuals who identify themselves as lesbian, gay, bisexual, and transgender experience obstacles within the healthcare system. LGBT individuals who encountered negative experiences in the past such as homophobia and stigmatization from others result decrease access to care and unwillingness to disclose their sexual or gender identity. Khalili, Leung, and Diamant (2015) stated in 2007, physicians’ survey results indicated that they were often and sometimes uncomfortable in providing services to LGBT patients. The presence of discrimination behavior means that there is a lack of LGBT-competency within the healthcare system. To decrease discrimination within the healthcare system, it is important for physicians to be competent in order to provide high quality care for LGBT individuals. LGBT-competency training will increase awareness, healthcare knowledge, and will improve communication skills. In addition, LGBT- competency training will also improve physician-patient interactions and will improve patients’ outcome and

Sexual and social stigmas largely affect the health of the lesbian, gay, bisexual and transgender (LGBT) population. While many reports from the Institute of Medicine, Healthy People 2020 and the Agency for Healthcare Research and Quality recognize a need to improve the quality of health care, barriers still remain. LGBT patients face legal discrimination, especially with insurance, a lack of social programs, and limited access to providers competent in LGBT health care. Although the Affordable Care Act increased access to care for LGBT patients, unless these patients feel understood by providers and develop trust in the system, they are not likely to utilize care. Healthcare providers need to recognize how these vulnerabilities, as well as persistent racism and stigma linked to sexual orientation and gender identity, make the healthcare needs of LGBT patients more challenging than the general population. Healthcare providers also need to promote cultural competence within this population and broaden their clinical lens to include health promotion, in addition to addressing concerns mentioned above within the population. Additionally, medical and nursing schools need to ensure that future providers are adequately educated by including information about this population in the curriculum.

Medical practitioners have a history of not accurately reflecting the understandings of people who trans gender, dating back to the 1800s when they upheld the sexually dimorphic model that states that everyone has “one true sex” (Enke, lecture 2/18). Even in the early 1900s, medical professionals advised trans people to take hormones more closely aligned with their designated sex at birth, as it would help them “feel better”. However, medical treatment of people who trans has improved dramatically over the years. Now, in the 21st century, there are laws in place to prohibit discrimination against people who trans. In order to get from that point to this point, it took growth in both the trans community and the medical community. Medicine mimics society just as society mimics medicine, and as the trans community grew more forthright and educated from those within its community as well as the medical field, the medical field grew more understanding of people who trans. It is all a cycle.

They found that most of their subjects had negative experiences with healthcare providers, especially when disclosing their transgender status and, therefore, usually went to urgent care facilities for health problems and instead of obtaining a primary care physician. Some of the subjects in this study disclosed negative experiences as adolescents by school administrators and teachers shaming them, even suggesting that they be home schooled (Cornelius & Whitaker-Brown, 2017). Other students that are LGBTQ+ may have been rejected by family members upon disclosing their sexuality (Parsons, 2016). The school nurse can work at being a safe and trusted faculty member for youth and adolescents who experience discrimination. Perhaps these positive early experiences with healthcare by school nurses would lead to more willingness for LGBTQ+ people to reach out for preventative care into adulthood.

This is both an interpersonal and organizational dilemma as physicians are not aware of the health disparities within the LGBT community and behave in a discriminatory manner. As stated by the National LGBT Cancer Network (2013), on average, throughout their medical education, medical students receive under five hours of training regarding LGBT issues. The lack of information and emphasis regarding this community at the level of medical schools and health institutions influences the quality of care that the patient will receive. According to a study regarding transgender and gender non-conforming people executed by Grant, et al. (2010), 50% of the respondents reported teaching their health provider about care specific to them. A study established that, due to the medical staff’s ineffectiveness to become aware of the issues relevant to LGBT adults, nearly 56% of lesbian, gay, or bisexual respondents and 70% of transgender or gender non-conforming respondents had experienced: abusive language, denial of care, excessive precautions, blaming, or abusive care by the medical providers (Lambda Legal, 2010). In addition to this, many do not receive preventative care, such as Pap smears and screening, when attending a medical institution. According to

Starting my clinical experience this week, I felt confident in the interview process. I knew what information I wanted to gather for my care plan. I also knew that all the information I needed would not be found in the chart. I had to gain the patient’s trust so that he or she could open up to me. Upon finding out that my patient was a transgender male, I was uncomfortable. Despite of my knowledge and my experiences in the healthcare field, I was afraid of offending the patient by referring to him as the wrong sex or the wrong name. Therefore, I said to myself “In this profession, I must be non-judgmental and put all my personal opinions aside to care for the patient”. That is when I started to feel confident in my ability to be compassionate

A professional who has a strong bias consisting of disgust and rejection related to gender dysphoria would be deemed incompetent to work with transgender clients (Kaplan, Francis, Hermann, Baca, Goodnough, Hodges, Spurgeon, Wade, 2017.) According to Mizock and Lundquist (2016), these types of professionals address transgender clients

While things like marriage and anti-discrimination laws have made it safer and more accepting in the mainstream for lesbian, gay, and bisexual people, the transgender community remains largely unchanged by these things. One area in particular has remained almost completely stagnate since the 1980’s, medicine. Most medical professionals willing to aid transgender individuals in Hormone Replacement Therapy (HRT) and Sexual Reassignment Surgery (SRS) operate under the gatekeeper model. The gatekeeper model is loosely defined as the practice where any combination of doctors, therapists, and psychiatrists take the majority of responsible for the diagnosing and, “treatment,” of a transgender person seeking either HRT or SRS. Under this model nearly sole responsibility falls to that group of professionals, and because of that many problems in terms of proper diagnosis, ethics, and safety have sprung up. More recently a very small amount doctors have been operating under a new model. This model, called informed consent, allows the transgender individual to take some responsibility for their treatment, and in a lot of cases subvert the massive amount of unreasonable hoops and rules the gatekeeper model has. The informed consent model of treatment for transgender individuals is the superior model by far in terms of diagnosis, safety, and ethical treatment.

A nurse centered-care approach that is responsive to the unique needs of LGBT patients can increase the patient–provider connection and guarantee that patients pursue routine follow-up care. It is important for all hospitals to provide and support these diversity patients. LGBT affected by these battles every day and often hide their sexual orientation. Some people are aggressive, unfriendly and not accepting of them.

Many physicians stated they recalled incidences of derogatory remarks and acts of discrimination that dated to their years in medical school. The physicians expressed how fellow colleagues would not refer patients to them because of their LGBT identification. When polled, 28% of heterosexual physicians stated they felt uncomfortable inquiring about the health needs of an LGBT individual because they were not trained to properly do so and only 29% of

I just really don’t understand what is wrong with me. I try to spice things up with my husband and we try new thing and I never get that ‘wow’ factor. I’ve talked to my doctor about it and she said that there is nothing physically wrong with me. I honestly have never had an orgasm and I don’t know how to tell my husband because I don’t want to hurt his feelings.

I really enjoyed the use of psychology to breakdown sexuality. On page 4 it discusses how Freud believed it was geared towards pleasure and not just reproduction. Last semester I watched a video about Freud’s Psychosexual Stages, which discussed how our life experiences play a role in our sexuality.

Growing up with people judging your gender preference is hard for some people. They feel as if they have nobody there for them. Little do they know there actually are people there for them. There’s a campaign called It Gets Better. They feel as if there’s no one there for them or nowhere for them to turn to. They may feel this way but in actuality there is always somewhere they can turn. There’s this community called the LGBT community. This community is made up of a group of people who are lesbian, gay, bisexual, and transgender, and is bullied because of reasons such as; it’s a boy who wants to be a girl or a girl who wants to be a boy, or other things such as they was a girl or boy and got their gender changed to be what they felt it should