Every person, whether or not they’re lesbian, gay, bisexual, transgender (sometimes shortened to trans or trans*) and queer, or questioning (LGBTQ+) or not, deserves to have access to health care to be healthy and confident, mentally and physically.
However, people who identify as members of the LGBTQ+ community are left far behind. Members of this population have worse health outcomes than their heterosexual counterparts.
On this blog, we’re outlining the health disparities of LGBTQ+ people and how a community health program can bridge the gaps in care for this vulnerable population.
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People who identify as LGBTQ+ have low rates of health insurance, are often harassed and discriminated against, and sometimes legally persecuted. Such is the case of trans children as part of a recent law in Texas.
Furthermore, someone who is LGBTQ+ can be of any ethnicity, religion, or social class, which means that health disparities they might face tied to those factors can be an additional difficulty.
Altogether, LGBTQ+ people are more likely to use substances or engage in risky behaviors, develop cancer and other diseases and suffer from mental illnesses.
Additionally, cultural bias or sensitivities can make access to healthcare even more difficult as individuals navigate the nuances of sexuality and gender identity.
And trans people, who have the same health as cisgender people, also have specific needs for care related to their transition. There’s also an added obstacle of finding a healthcare provider that’s skilled in treating these cases and can do so without bias or preconceived notions, as every patient deserves access to judgment-free care to address their unique needs.
But first, what exactly does it mean to be transgender? “Transgender” is a term that refers to the ways some people feel that their gender identity doesn’t match the sex they were assigned at birth. On the contrary, “Cisgender” refers to people who feel their assigned sex and gender identity are the same. Transgender people express feelings of being born in the wrong body, with many of them suffering from body dysphoria.
Transgender individuals are four times more likely to struggle with mental health issues than their cisgender peers. They also need access to treatments like hormone replacement therapy, also known as gender-affirming hormone therapy. And in some cases, they may need gender-affirming surgery — although not all trans people elect to go through surgery. This article provides some details about trans health care.
Not all providers understand trans issues and what kind of services to provide. Unfortunately, in many cases, personal beliefs and politics influence the way transgender people can or cannot get the care they need. And across the country, new bills and regulations are affecting their rights to healthcare.
Here’s where community health workers can help.
People who identify as transgender undoubtedly need support, and community health workers (CHWs) and others with similar titles can be the right ones to give it, especially when it comes to navigating the health system, insurance, and access to life-saving services. CHWs can supply connections within the healthcare community to help, and they can also provide culturally competent support and care.
Some health systems have started to recruit transgender community health workers for specific support. Typical functions for a trans CHW could include everything other CHWs would do, especially:
- Care coordination
- Social determinants of health (SDOH) assessments
- Culturally competent care
- Substance use
- Mental health
Have a closer look at each of these areas and how you can provide support in these areas.
Care coordination is an important way to make sure patients and clients find answers to questions and connect with specialists with an understanding of trans issues.
As a care coordinator, a CHW may meet with trans patients before their appointment to answer specific questions, help them navigate insurance, provide resources like pamphlets, or simply sit by and provide moral support to the patient. In some cases, like gender-affirming surgery, the care coordinator may handle transportation and/or post-surgery at-home care for the patient.
It’s essential to remember that trans people still face the same health challenges as cis people. But they have the added layer of complexity that being trans can bring to their care. Access to nutritious food, safe shelter, and clean water are some examples of social determinants of health. The US Department of Health and Human Services outlined five domains of SODH.
CHWs can help providers and health systems have a better understanding of SDOH in communities, including trans communities. These assessments can help those providers deliver the right kind of care and support.
All people in agencies and communities can be advocates for trans clients. CHWs can help share anti-discrimination resources and help to advocate. Trans advocacy means promoting equality and respect for all patients regardless of their gender identity. It also means giving trans patients the education they need to make informed health choices that aren’t affected by the prejudice or opinions of others.
Cultural competence means understanding a patient’s cultural background and how it can possibly interfere with their care. Cultural competence is one of CHWs’ biggest strengths as they largely come from the communities they serve. It’s this shared understanding that makes CHWs an excellent option for addressing health care for at-risk populations.
For CHWs working with trans patients, cultural competence includes learning and using the correct terminology, addressing the health risks in a tactful manner, and acting appropriately when it comes to the multi-faceted obstacles the patient may face when seeking health care.
A good example of CHW’s cultural competence when working with trans patients is supporting patients who are experiencing transphobia. Transphobia is the fear, hatred, or discrimination of a person on the condition of being trans.
LGBTQ+ people have a disproportionately high rate of substance abuse, which comes with health challenges of its own. Unfortunately, factors like stigma and discrimination drive trans people, especially youth, to this dangerous coping mechanism. The lack of culturally competent health care is another key factor.
Community health workers can address substance abuse by facilitating addiction recovery programs. They can educate trans patients about the health risks of substance abuse, and most importantly, by addressing the social determinants that may lead a patient to substance abuse in the first place.
People who are trans are not mentally ill. However, because of minority stress, discrimination, and other SDOH, they can suffer from mental health issues like depression and anxiety. On top of these challenges, they’re also experiencing the same daily stressors as the rest of the population. So it’s safe to say that trans people need access to mental health care.
Getting support and resources (like therapy or prescription medicine for anxiety or depression) can greatly impact the quality of life for trans patients. It can also help them navigate the process of transitioning to their affirmed gender identity, both socially and medically. Community health workers can make a world of difference in trans people’s experience when accessing mental health by providing support, advocating, and helping them understand the program or resources available to them.
Ways To Be a Good Trans Ally
A trans ally is someone who doesn’t belong to the community but advocates on their behalf. Trans allyship has many different facets, such as voting for candidates whose political agenda includes trans rights, contacting local representatives to oppose legislation that diminishes these rights and advocating for equal rights at all levels.
Allies can also help in day-to-day life by:
- Addressing trans people by their preferred pronouns, even sharing their own pronouns to normalize the practice and remove the stigma.
- Listening to trans people and learning from their experiences with an open mind.
- Speaking up when someone is discriminating, making transphobic jokes, or otherwise being offensive toward a trans person.
- Being mindful when speaking and doing so respectfully.
In healthcare specifically, being a trans ally means helping individuals feel safe and supported when accessing the care they need. This can look like helping them fill forms, educating them and those within your agency about trans issues and policies, and preventing mistreatment such as inadequate questions or misgendering during the patient’s experience.
Ultimately, the role of trans allies is to provide the transgender community with the platform and tools they need to express themselves safely and access their deserved rights.
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