对于LGBTQ患者来说，歧视可能成为获得医疗服务的障碍

In recent years, medical experts have been awakening to the specialized needs of LGBTQ people. But one of the most significant barriers to their care can sometimes be right in their doctor's office.

贾米森·格林对此有切身体会.

"One of the worst things is actually just anticipating having to explain yourself,格林说。, 70, 谁在1988年开始了从女性到男性的医学转变. "It causes tremendous stress and anxiety to think about being thrown out of a doctor's office or being laughed at or being treated insensitively to the point of feeling abused."

绿色, 他住在温哥华, 华盛顿, and is a former president of the World Professional Association for Transgender Health, 他遇到过一个连格林的眼睛都不肯正视的医生吗.

尽管他能找到好医生, 太, 他知道其他变性人所遭受的侮辱.

歧视并不局限于变性患者. 同性恋, 女同性恋, bisexual and other sexual or gender minority people encounter doctors who are ill-informed, 问不恰当的问题或拒绝治疗.

"We hear stories very frequently from people going into a provider's office and having an inappropriate encounter,”医生说。. 米切尔·伦恩是 骄傲研究, the first long-term national health study of people of all LGBTQ identities, 格林是该组织的志愿者大使.

绿色 gives the example of health care workers who refuse to call people by their preferred name. Lunn has heard of a transgender person with a respiratory complaint being subjected to an unnecessary genital exam while trainees observed.

调查显示，这种歧视是多么普遍.

Lunn, an assistant professor of medicine in nephrology at Stanford University in California, cited 2015年美国.S. 变性人的调查, which found a third of transgender people who saw a health care provider in the prior year had at least one negative experience, 比如被口头骚扰或拒绝治疗.

2014年的报告 倡导组织Lambda Legal发现超过一半的女同性恋, gay or bisexual survey respondents and 70% of transgender people had experienced discrimination while seeking health care.

其后果可能危及生命. "If you're never showing up to a provider's office because you're discriminated against every time you go there, 那么你的高血压可能永远不会被诊断出来, 尽管你35岁就得了,伦恩说。. “然后你会在65岁或55岁时心脏病发作或中风.“或者有人可能会跳过本来可以检测出癌症的筛查.

加州大学洛杉矶分校法学院的威廉姆斯研究所表示，大约有4人死亡.5% U.S. adults – 11 million people – identify as LGBT; about 1.400万人认为自己是跨性别者.

这是很多人. M. 布雷特·库珀, an assistant professor of pediatrics at UT Southwestern Medical Center in Dallas, but the problems they encounter are not widely discussed by the general public.

People who haven't been discriminated against say, "'I can't believe this would happen!’”库珀说。, who is co-chair for the Society for Adolescent Health and Medicine's special interest group on LGBTQ health. “嗯，确实如此. 这不仅仅发生在小城镇. 发生在达拉斯. 它发生在纽约市. 到处都是."

库珀, who led a 2018 study that showed the benefits of exposing medical students to a lecture on LGBTQ topics, 说更好的教育能有所帮助.

“这真的只是试图教育人们, 当你问问题时, 例如, 关于丈夫、妻子或伴侣, 或者如果你需要询问某些私密的身体部位, 你不会对那个人有什么妄加猜测, 你要么让它保持开放式，要么给那个人多个选择."

库珀 said there has been a dearth of research on LGBTQ topics – something 骄傲研究 seeks to address. 这是一项长期的努力，到目前为止已经收集了13800人的数据.

"We have something like 10 to 12 papers that are somewhere in the pipeline right now, 从写作到审查,伦恩说。.

Some are asking basic questions about the ways people identify their sexuality. Others are looking at possible links between migraine headaches and the trauma of being stigmatized; or the differences in substance abuse based on identity; or a skin cancer study focused on gay men, 谁比直男更有可能使用日光浴床.

Thanks to policies that require inclusion of sexual and gender minority people in research, 并为此类研究提供资金, "we're totally at a time when people are talking about sexual and gender minority health in a new way,伦恩说。.

最后, 库珀希望每个人都能了解情况, 他们有权享受的敏感护理, 从任何医生那里, 在任何地方. "LGBT folks want to be treated in the office just like any other patient that would walk through the doors."

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