LGBT Health Awareness Week

Resources

Own Your Health. Get Checked Out.

Healthy communities require healthy individuals. It is time for all us to get checked out and to get and stay healthy.

It can be hard to talk about our intimate life with anyone. To make sure we stay healthy, we need to help our health care providers help us by talking openly and honestly about our lives and who we are. Coming out is crucial to helping our health care providers help keep us healthy.  We need to come out to our providers about our sexual orientation or gender identity. We need to let them know when we are fighting depression, challenging substance use, and trying to manage our sexual health.

Knowledge is powerful tool in keeping us healthy. Below are six important topics that we all need to talk about with our health care providers.

Six important topics we all should talk about with our health care providers:

Click here to learn more about these six topics.

Click here for more topics for lesbians and bisexual women.

Click here for more topics for gay and bisexual men.

Click here for more topics for trans women.

Click here for more topics for trans men.

Click here for information for providers.

Click here for additional resources and links.

Click here to download all the information on this page as one PDF file.

More information on the six important topics we all should talk about with our health care providers

Mental Health (including depression and anxiety screening)

LGBT people appear to experience higher levels of depression and anxiety than the general population. The problem may be more severe for those LGBT people who remain in the closet or who do not have adequate social supports. Adolescents and young adults may be at particularly high risk of suicide because of these concerns. Talk to your provider about any depression, anxiety or suicidal thoughts that you have.

Sexual Health (including STD and HIV screening)

Talking to your health care provider about your sexual health is an important part of maintaining your whole health. Regular screening for sexually transmitted diseases (STDs) is important part of good sexual health. This includes STD infections for which effective treatment is available (syphilis, gonorrhea, chlamydia, pubic lice, and others), and those for which no cure is available (HIV, Hepatitis A, B, or C virus, Human Papilloma Virus, etc.). There is absolutely no doubt that safe sex reduces the risk of sexually transmitted diseases, and prevention of these infections through safe sex is key. Talk to your provider about your STD screenings and how to protect yourself and others from STDs.

Substance Use (including tobacco and alcohol)

Research indicates that illicit drugs may be used more often among LGBT people than heterosexuals. These include a number of substances ranging from amyl nitrate ("poppers"), to marijuana, Ecstasy, and methamphetamines. There may be added stressors in lives of LGBT people from homophobic discrimination to varying degrees of social support that contribute to higher substance use. Talk to your provider about your substance use habits

Alcohol

Although recent studies have improved our understanding of alcohol use in the LGBT communities, it is still thought that members of the LGBT communities may have higher rates of alcohol dependence and abuse than their straight counterparts. One drink daily may not adversely affect health, however alcohol-related illnesses can occur with low levels of consumption. Talk to your provider about your alcohol consumption.

Tobacco

A recent study found that nearly 40 percent of lesbian and bisexual girls reported that they smoked weekly compared to only 6 percent of heterosexual girls. Additional studies note that gay and bisexual men may use tobacco at much higher rates than straight men, reaching nearly 50 percent in several studies. Tobacco-related health problems include lung disease and lung cancer, heart disease, high blood pressure, and a whole host of other serious problems. In addition, smoking increases the risk of blood clots for lesbian, bi and trans women taking estrogen––blood clots can stop the blood flow within your legs, lungs, brain (stroke) or heart (heart attack).  All LGBT people should be screened for and offered culturally sensitive prevention and cessation programs for tobacco use. Talk to your doctor about getting help to stop smoking.

Heart Health

Heart health is important for all people, including LGBT community members. Smoking and obesity are the most prevalent risk factors for heart disease among lesbians and bisexual women. Similarly, smoking is an important risk factor for gay and bisexual men. Additionally, HIV infection and HIV drug medications may also increase risk for heart disease. Everyone should get an annual clinical exam where blood pressure is checked, cholesterol is measured, diabetes is diagnosed, and exercise is discussed. Preventing heart disease, which is a leading cause of death for both women and men, should be paramount to every clinical visit. Talk to your provider about heart disease prevention.

Fitness (including diet and exercise)

Research confirms that lesbians have higher body mass than heterosexual women. Obesity is associated with higher rates of heart disease, cancers, and premature death. What lesbians need is competent advice about healthy living and healthy eating, as well as healthy exercise. Problems with body image are more common among gay men than their straight counterparts, and gay men are much more likely to experience an eating disorder such as bulimia or anorexia nervosa. While regular exercise is very good for cardiovascular health and in other areas, too much of a good thing can be harmful. The use of substances such as anabolic steroids and certain supplements can adversely affect health. At the opposite end of the spectrum, overweight and obesity are problems that also affect a large subset of the gay community. This can cause a number of health problems, including diabetes, high blood pressure, and heart disease. Talk to your provider about your diet and fitness regimen.

Intimate Partner and Domestic Violence and Safety

Gay and bisexual men experience abuse in intimate partner relationships at a rate of 2 in 5, a rate comparable to that of domestic violence experienced by heterosexual women. Studies of lesbians have found that 47% had experienced repeated acts of violence and that 41% had been abused in at least one relationship with another woman. A survey of transgender and intersex individuals in one city found that 50% had been raped or assaulted by a romantic partner, though only 62% of these individuals (31% of the total) identified themselves as survivors of domestic violence when asked. For more information contact the National Coalition of Anti-violence Projects: www.ncavp.org. Talk to your provider about any violence in your life.

Download this information as a PDF Fact Sheet.

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More Information on the Important Topics for Lesbians and Bisexual Women

Breast Health

Lesbians have the richest concentration of risk factors for this cancer than any subset of women. Combine this with the fact that many lesbians over 40 do not get routine mammograms, do breast self-exams, or have a clinical breast exam, and the cancer may not be diagnosed early when it is most curable. Talk with your provider about mammograms and other screenings for breast cancer.

Gynecological Health

Lesbians have higher risks for some of the gynecologic cancers. What they may not know is that having a yearly exam by a gynecologist can significantly facilitate early diagnosis associated with higher rates of curability if they ever develop. An annual exam screens for HPV and cervical cancer and includes a clinical breast exam; make sure to also talk to your provider about whether additional STD screenings are right for you. Talk to your provider about an annual gynecological exam.

Bone Health

The rates and risks of osteoporosis among lesbians have not been well characterized yet. Calcium and weight-bearing exercise as well as the avoidance of tobacco and alcohol are the mainstays of prevention. Getting bone density tests every few years to see if medication is needed to prevent fracture is also important. Talk to your provider about bone density testing.

HPV Prevention

Research indicates that lesbians and bisexual women are at risk for genital HPV. By age 50, at least 80 percent of women will have acquired genital HPV infection. Unfortunately, many lesbians and bisexual women do not receive adequate pap test screening. A Pap test can detect pre-cancerous and cancerous cells on the cervix. Regular Pap testing and careful medical follow-up, with treatment if necessary, can help ensure that pre-cancerous changes in the cervix caused by HPV infection do not develop into life threatening cervical cancer. All women should receive regular pap test screening. Talk with your provider about screening and treatment for HPV.

Download this information as a PDF Fact Sheet.

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More Information on the Important Topics for Gay and Bisexual Men

Prostate and testicular health

Gay men may be at risk for prostate and testicular cancers. Screening for these cancers occurs at different times across the life cycle, but issues and challenges in receiving culturally sensitive care for gay men may be negatively impact access to screening services. All gay men should undergo these screenings routinely as recommended for the general population. Talk to your provider about routine screenings for prostate and testicular cancers.

Colon health

While both men and women are at risk for colon cancer, HIV-positive men may be at greater risk for colon cancer. Screening for this cancer begins at age 50, but issues and challenges in receiving culturally sensitive care for gay men may be negatively impact access to screening services. All men should undergo these screenings routinely as recommended for the general population. Talk to your provider about routine screenings for colon cancers

Anal health

Of all the sexually transmitted infections gay men are at risk for, human papilloma virus (HPV)—which causes anal and genital warts—is often thought to be little more than an unsightly inconvenience. However, these infections may play a role in the increased rates of anal cancers in gay and bisexual men. Some health professionals now recommend routine screening with anal Pap Smears, similar to the test done for women to detect early cancers. Safe sex should be emphasized. Treatments for HPV do exist, but recurrences of the warts are very common, and the rate at which the infection can be spread between partners is very high. Talk with your provider about screening and treatment for HPV.

Hepatitis Prevention

Men who have sex with men are at an increased risk of sexually transmitted infection with the viruses that cause the serious condition of the liver known as hepatitis. These infections can be potentially fatal, and can lead to very serious long-term issues such as cirrhosis and liver cancer. Fortunately, immunizations are available to prevent two of the three most serious viruses. Universal immunization for Hepatitis A Virus and Hepatitis B Virus is recommended for all men who have sex with men. Safe sex is effective at reducing the risk of viral hepatitis, and is currently the only means of prevention for the very serious Hepatitis C Virus. Talk to your provider about immunizations for Hepatitis A Virus and Hepatitis B Virus.

Download this information as a PDF Fact Sheet.

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More Information on the Important Topics for Trans Women

Hormone Therapy

Hormone therapy involves taking estrogen and sometimes an anti-androgen to promote breast development, soften skin, lighten body and facial hair, decrease fat in the belly and increase fat in the hips and thighs. It is not risk-free, and you should not take estrogen without medical supervision and regular blood tests. If you are taking hormones without medical supervision, it is important that you see a health care provider and discuss the hormones you are taking. Talk with your provider about initiating or maintaining hormone therapy.

Breast Health

Once breast growth occurs as the result of hormone therapy, it is important that you learn how to do a breast self-examination and that you do one every month. You should also get an annual breast exam and an annual mammogram after five years of taking estrogen. Talk with your provider about mammograms and other screenings for breast cancer.

HPV Prevention

A Pap test can detect pre-cancerous and cancerous cells on the cervix. Regular Pap testing and careful medical follow-up, with treatment if necessary, can help ensure that pre-cancerous changes in the cervix caused by HPV infection do not develop into life threatening cervical cancer. All post-operative transsexual women should receive regular pap test screening. Talk with your provider about screening and treatment for HPV.

Prostate Health

Even if you’ve had sex reassignment surgery, it’s important that you get an annual prostate exam  after age 50, or age 40 if you’re African-American. Taking estrogen should reduce prostate problems, but there is a slight chance it may cause prostate enlargement. Talk to your provider about routine screenings for prostate cancer.

Download this information as a PDF Fact Sheet.

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More Information on the Important Topics for Trans Men

Hormone Therapy

Age, family and personal health risk factors, organ systems present and other medications will affect how your body responds to testosterone. Taking testosterone will also influence how general medical conditions are managed. Testosterone may cause acne, balding, increased fat around abdomen, cancers of liver and reproductive organs, high blood pressure, increases in red blood cell levels, high cholesterol, liver problems, infertility or high levels of calcium in the blood. It may also aggravate polycystic ovaries and uterine fibroids. If you are taking hormones without medical supervision, it is important that you see a health care provider and discuss the hormones you are taking. Talk to your provider about initiating or maintaining hormone therapy

Contraception/Pregnancy

It is possible to get pregnant while on testosterone, although infertility occurs after continued use. Taking testosterone before or during pregnancy may cause birth defects. Consider using contraception to reduce the risk of pregnancy if you have penetrative vaginal sex with a non-transgender man. Talk to your provider about contraception.

Pelvic and Breast/Chest Health

All body parts need care! Make sure to get yearly pelvic and breast/chest exams if you still have those parts. It's important to remember that chest (top) surgery does not remove 100% of breast tissue, so a cancer risk still exists, and a monthly breast/chest self-exam is recommended. An estimated 25% of trans men may be affected by polycystic ovary syndrome (PCOS) and people with PCOS are at increased risk for breast cancer, endometrial cancer, and endometrial hyperplasia (overgrowth of the lining of the uterus). All transgender men with intact cervixes should receive regular pap test screening. Talk to your provider about pelvic and chest exams and appropriate diagnostic tests.

Download this information as a PDF Fact Sheet.

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Information for Providers

Create safe environments to promote healthy LGBT people

Ensuring that all patients receive culturally competent care is at the core of high quality health care. To provide the best care possible, clinicians must create a safe environment that fosters open communication about all the issues that effect and affect the health and well being of the client being served. Accurate knowledge of sexual orientation and gender identity impacts care for STDs, risk for HIV, counseling, cancer risk, screening, parenting, depression, alcohol use, smoking, and violence, among others. Being aware of your patient’s sexual orientation and gender identity allows you to provide the most optimal care.

Sexual orientation gives clues to a patient’s sexual behaviors. But it is important to not only make assumptions about sexual practices- ask questions to be able to make informed decisions about your patient’s care. Open communication is critical to your provision of high quality health care.

Six important topics to talk about with all LGBT clients

Topics for Lesbians and Bisexual Women

Topics for Gay and Bisexual Men

Topics for Trans Women

Topics for Trans Men

Download this information as a PDF Fact Sheet.

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Additional Resources and Links

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