America’s LGBT community has been in the news a lot this year. The U.S. Supreme Court recently legalized same-sex marriage nationwide, there have been disputes in some states about the scope of anti-discrimination laws against sexual minorities, and the Caitlyn Jenner story has mainstreamed an issue that was long ignored.
There have also been stories about health problems in the LGBT community. Statistics from the CDC show metro Atlanta has one of the highest rates of new HIV cases in the country, concentrated among African-American males who have sex with males.
There’s another health problem, though, that’s taking a significant toll in the LGBT community, and awareness is the first step to making significant inroads against it. According to the National Institutes of Health (NIH), it’s estimated that up to 33 percent of the gay and lesbian population abuses alcohol and drugs, compared to less than 10 percent of the general population. This number is even higher for transgender individuals.
What’s more, LGBT youths are anywhere from two to five times more likely to use drugs and alcohol than heterosexual youths, the NIH has found.
The underlying reason for higher rates of substance abuse is the stress caused by the discrimination and stigmatization that this population faces on a daily basis, which contributes to their much higher rates of depression and anxiety when compared to heterosexuals. This is compounded by a dearth of health care services – both in general care, preventive medicine and addiction treatment – tailored specifically to this population.
When people from the LGBT community receive health care services in mainstream settings, many are not forthright about their sexual orientation because of fear of discrimination, and also a reluctance by many providers to take a full health history, thereby reducing the likelihood of success with the treatment plan.
There is hope, though. Health care that’s designed specifically for the LGBT population, and that will provide a safe, supportive and affirming environment, has a greater success rate than mainstream health care. A 2015 NIH research report emphasizes the necessity that addiction treatment programs establish treatment programs that are transgender- and/or LGBT-specific.
In order to successfully help LGBT individuals, providers must be formally trained in treating this population.
For instance, these providers must understand the health issues that are especially serious in the LGBT community. For instance, research suggests lesbians are more likely to be obese and to smoke, and are less likely to receive general, preventive treatment.
The providers also must have cultural competence in dealing with the LGBT population and ensuring that such patients feel safe in their care. They need to advance communication and provide patient-centered care.
In order to make significant improvements to the health status of this growing population, a fundamental shift must occur in the mindset of the health care system and health care providers. Individual people can, with support, make changes and make things better, as we are trying to do.
Sadie Hosley, MA, LADC, LPCC, is the regional recovery representative of Georgia Detox and Recovery Centers’ LGBTQ program focused on addiction treatment; Tina Black, LCSW, is the vice president of operations with Georgia Detox and Recovery Centers, a RiverMend Health treatment center.