The Untold Story Of The LGBTQ Community In Chronic Pain

Bruce Jenner’s transition into Caitlyn Jenner resulted in massive media coverage that highlighted the transgender community like never before and ushered in wider social acceptance of the LGBTQ (lesbian, gay, bisexual, transgender, questioning) community, reports MedCity News. On the heels of Jenner’s reveal, New York announced plans to mount an awareness initiative around transgender health issues.

And the health issues—and disparities—are many across the LGBTQ community.

Mood disorders like anxiety and depression, which exacerbate or cause pain conditions, plague the community, as do substance abuse issues. LGBTQ individuals are also more likely to commit suicide, smoke, drink, and use drugs, according to HealthyPeople.gov. LGBTQ teens face exceptionally high rates of homelessness.

Meanwhile, doctors lack familiarity with the community’s needs. Just 9% of medical offices linked to universities have procedures in place to connect LGBTQ patients to knowledgeable doctors, according to research from the University of California, Los Angeles Health Sciences. An even smaller percentage of offices, just 4%, had policies in place to identify LGBTQ-savvy physicians.

That’s one of the reasons that people in the community are likely to delay seeking health care. Although social attitudes are changing, fear of encountering discrimination prevents many gay, lesbian, and transgendered individuals from finding the care they need, researchers said.

Recent research 

The community’s health needs are very specific and vary within the subgroups. For example, research from Rice University found that bisexual people are generally less healthy than homosexuals.

Bisexual men and women experience worse health and lower quality of life than gay men and lesbian women.

Research on the LGBTQ community is limited, and research investigating data specific to the subcategories is even more rare, making the Rice University research extremely valuable, researchers said.

They found that up to nearly 20% of bisexual men and women considered their health “poor or fair.” Meanwhile, up to 12% of gay and lesbian men and women rated their health as poor. Interestingly, homosexuals reported better health than heterosexuals, with up to 16% of straight men and women rating their health as poor.

The research also evaluated social factors, and found that bisexual men and women are more likely to be low-income smokers with a low level of educational attainment than the other groups. Rice assistance professor of sociology Justin Denney says:

“If bisexuals are minorities within the minority and experience unique and more extreme forms of discrimination, this might contribute to disparities in things like earnings, educational attainment, the propensity to smoke cigarettes, and other factors that affect wellbeing.”

Health risks vary within the community

In general, because people who identify as LGBTQ are more likely to smoke, drink, do drugs, and be overweight, they’re also more likely to develop heart disease, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).

Lesbians and bisexual women are more likely than heterosexual women to develop cancer, partially because they’re less likely to have children. Hormones released during pregnancy and breastfeeding are believed to offer protection against several types of cancer.

Lesbians are also less likely to exercise and more likely to be overweight, which is a risk factor for diabetes. Some women report difficulty finding lesbian-friendly activities or exercise partners. Lesbians also tend to have different beauty standards than straight women and may not be influenced by the desire to be skinny, SAMHSA says.

Interestingly, bisexual women are more likely than heterosexual women to exercise, with more than 70% of bisexual women reporting adequate levels of physical activity compared to about 52% of straight women. However, bisexual men and women report the lowest levels of emotional health when compared to gay and lesbian groups. High levels of depression and suicide also affect bisexuals, as they do other people in the LGBTQ community.

Meanwhile, gay men are more likely than straight men to suffer from body image problems and develop disorders like bulimia or anorexia. Like lesbians, gay and bisexual men are also at an increased risk for some types of cancer. Gay men, especially African American men, are more likely to develop HIV/AIDS.

Transgender populations are the least studied, and little is known about the effects of hormones taken to accentuate certain gender attributes. For example, females who transition into males may face an increase risk of ovarian cancer and loss of bone density from taking testosterone.

Chronic pain in the LGBTQ community

Not much research exists about the prevalence rates of chronic pain disorders among gay, lesbian, bisexual, and transgender individuals.

There is some speculation that gay men may be more likely to develop fibromyalgia than straight men, although research hasn’t been done to flesh this out, writes sociologist and nursing professor Barbara Keddy.

The biggest hurdle for this community is finding appropriate medical care, but fortunately great strides are being made to help those in the LGBTQ community feel more comfortable visiting the doctor.

More medical schools are undertaking efforts to equip future doctors with the ability to navigate the health care system’s disparities with more awareness and compassion. At Albert Einstein College of Medicine, for example, students now have the option to take a three-month course teaching them how they may inadvertently perpetuate health disparities. In the course, students participated in role-playing sessions, such as portraying an AIDS patient refusing a certain treatment.

A study examining the pilot course’s effects found it gave students greater confidence, according to research from Academic Medicine. The course was so successful that school administrators may make it a required one.

Giving future doctors greater tools to navigate encounters with LGBTQ patients is critical for addressing health disparities and treating chronic pain within the community, says the Association of American Medical Colleges (AAMC).

Surveys also show doctors aren’t comfortable with LGBTQ issues. AAMC plans to make greater efforts to incorporate community-sensitive information into existing courses, rather than add new courses into the curriculum.

Many people have deeply ingrained beliefs about sex and gender, making the topic very difficult to address. For example, many doctors have little control over their facial expressions, which could make an LGBTQ person feel judged. And some doctors may have a difficult time discussing sexual health with someone in the community.

Are you in the LGBTQ community? What have your experiences been with health care?

Image by Robert Couse-Baker via Flickr