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Health science librarians occupy a unique place in librarianship, guiding healthcare professionals and the public to quality sources of medical research and consumer health information in order to improve patient outcomes and quality of life. A broader impact of health sciences librarianship is its advocacy for improvements in public health. In recent years, health science librarians have been actively involved in advocating for adequate, responsive, and culturally competent health care for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals. Health sciences librarians have advocated for LGBTQ+ individuals through a variety of specialized outreach projects to address health disparities found in the LGBTQ+ community such as HIV/AIDS, women’s health, or substance abuse, have collaborated with public health agencies and community-based organizations to identify health disparities and needs, and have implemented outreach to address these needs.

This chapter maps the landscape of health sciences librarian outreach to LGBTQ+ people. The authors develop this theme through case studies of health science librarians providing health information to the LGBTQ+ community and healthcare professionals. Following an overview of advocacy for LGBTQ+ health by the US National Network of Libraries of Medicine and professional information organizations, they conclude the chapter by discussing the “pioneering” nature of these projects and the common threads uniting them, and by identifying the next steps for continued successful outreach through the development of an evidence base and tailoring of outreach and resources to address other demographic aspects of the members of the LGBTQ+ community.

Purpose: This chapter examines the implementation of lesbian, gay, bisexual, transgender, and queer (LGBTQ) health curricula in medical education, focusing on how this content is presented to students to understand if these curricula can fulfill goals of achieving healthcare equity for LGBTQ populations.

Methodology: This research draws on data from six months of participant observation of an academic medical center and school and 28 interviews with medical faculty, students, community members, administrators, and LGBTQ Health Center employees.

Findings: This research has three findings: (1) this medical school has variable definitions for LGBTQ health, making it a hybrid form of knowledge based in (a) understanding the unique health needs of; (b) being culturally competent to; and (c) being a (structural) advocate for LGBTQ patients; (2) LGBTQ health is integrated into multiple courses in the curriculum; and (3) LGBTQ health is becoming a medical specialty frequently delivered to students by LGBTQ health experts.

Research limitations and implications: This research used snowball sampling to recruit participants engaged in LGBTQ health at the institution; it therefore risks self-selection bias. Findings from this study are not generalizable.

Originality: This research argues that LGBTQ health experts engage in a new kind of diversity and inclusion work because (1) these health experts are not always LGBTQ identified; (2) this work is not necessarily unpaid or involuntary; and (3) it involves a hybrid knowledge requiring an understanding of LGBTQ identity, medical knowledge, and social science. Because these LGBTQ health experts opt into this work, and broadly define it, a message available to other physicians and students is that LGBTQ health remains elective.

Purpose: This chapter explores the role of life course transitions, personal networks, community, and social support in the physical and mental health of LGBTQ+ elders. Specifically, we review the literature on formal and informal supports and resources available to LGBTQ+ elders as they age.

Methodology: We use an intersectional lens that explores dimensions of social identity and social location among diverse subpopulations within sexual and gender minority (SGM) elders. We outline the implications of access (or lack of access) to formal and informal care for SGM elders' physical and mental health and well-being in late life. We examine the availability of these supports in the context of broad inequalities and life events that structure the life course for LGBTQ+ elders and have long-term health implications.

Findings: Our findings from this review demonstrate how social factors over the life course shape SGM mental and physical health later in life for aging LGBTQ+ populations. We reflect on how strained relationships and lack of acceptance compel some to seek alternative sources of support and relationships. Our analysis uncovers individual and institutional sources of support: personal social networks and formal spaces, such as healthcare settings, that connect elders with resources to develop social support and avoid social isolation.

Implications: The implications of our review reveal the unique needs and barriers to practical and social support that SGM older adults face. We explore alternative supports that LGBTQ+ elders need compared with their heterosexual cisgender peers, given the disproportionate rejection they face in a range of public and intimate spaces. We conclude by identifying and celebrating sources of support and resilience as LGBTQ+ elders have crafted alternate support networks and advocated for increased recognition, rights, and care.

Originality and Value: Despite some recent flourishing of research in SGM health, a road map for scholars, practitioners, and community members outlining future research in understudied areas such as LGBTQ+ aging and transgender health would help advance scholarship and policy. Our commentary highlights quantitative and qualitative studies and suggests avenues for research that put in conversation literatures on rural studies, urban sociology, and social networks; gerontology; health; and gender/sexuality studies.

Rates of anxiety, depression, and suicidality have long been known to be elevated among LGBTQ+ communities and it was expected that the COVID-19 pandemic would deepen systemic injustices and inequities in mental health outcomes. However, it remains difficult to document inequities as surveillance systems do not typically capture LGBTQ+-inclusive data necessary to study the impact of COVID-19 on LGBTQ+ population health. This chapter reports on two studies designed to address this gap. The COVID-19 Impacts Study (CIS) documented the early mental health and social impacts of COVID-19 among sexual and gender minority adults, as well as adults with HIV, during the first round of shut-downs and initial economic disruptions. Subsequently, the Youth and Young Adults COVID-19 Study (YYA) measured the impacts of COVID-19 on the mental health outcomes, testing/vaccination behaviors, and stigmatization experiences of LGBTQ+ and BIPOC (Black, Indigenous, People of Color) young people. Several recommendations are discussed – including mandated collection of data on sexual orientation and gender identity in all surveillance systems, policy solutions to better address access and cost barriers, and deep and meaningful engagement that empowers communities.

Purpose: This paper presents an exploratory analysis of minority stress and resiliency processes among parents in LGBTQ families. The paper examines two unique minority stress processes – (1) parents experiencing sexual and/or gender minority stress due to the stigmatization of their own identities as individuals and (2) parents sharing the gender minority stress faced by their transgender and gender expansive (TGE) child, and in the context of their parent–child relationship.

Methodology: Between 2017 and 2018 in-depth, in-person qualitative interviews on the topics of gender, stress, and resilience were conducted with 12 parents in LGBTQ families. Audio recordings were transcribed and then open coded using ATLAS.ti qualitative data analysis software. Analyses of data were informed by critical intersectional theories that locate gender and sexuality within structures of social and racial oppression.

Findings: Interview data indicate that minority stress is experienced by parents experiencing sexual and/or gender minority stress due to the stigmatization of their own identities, as well as among parents sharing the gender minority stress faced by their TGE child in the context of their parent–child relationship. Parents described community resilience and minority coping through interpersonal, community, and institutional support. This paper provides evidence that sexual and gender minority stressors are enhanced and resiliency factors are reduced among those experiencing racism and economic disadvantage.

Research limitations: This is an exploratory study conducted with a small sample of parents in a specific geographic area.

Originality/Value: These data provide initial evidence to support further analyses of the dyadic minority stressors within parent–child relationships in LGBTQ families

Purpose: We respond to a call for studies of “embodied experiences of stigma in context” by investigating how transgender embodiment shapes perceived needs for access to and experiences of “sex-specific” cancer screenings (SSCS) (e.g., breast and prostate exams, Pap smears) in the North American healthcare system.

Design/Methodology/Approach: We analyze data from semistructured interviews with a diverse sample of 35 transgender-identified adults. Based on thematic narrative analysis, we explore four themes in relation to embodiment: discrimination; discomfort and hyperawareness of genitalia; strategic reframing and active management; and SSCS health care encounters as positive and gender affirming.

Findings: In relation to SSCS, transgender individuals experience discrimination, do emotion work, and actively manage situations to obtain needed health care, and sometimes forego care because barriers are insurmountable. Health care providers' responses to transgender embodiment can disrupt health care encounters, but they can also facilitate access and create opportunities for affirmation, agency, advocacy, and new forms of interaction. Embodiment- and gender-affirming interactions with health care providers, which varied by gender, emerged as key influences on participants' experiences of SSCS.

Research Limitations/Implications: Our sample primarily includes binary gender-identified individuals, and while our interview guide covered many topics, the SSCS question did not explicitly reference testicular exams.

Practical Implications: Cancer prevention and detection Cancer prevention and detection require health care professionals who are prepared for differently embodied persons. Preventive cancer screenings are not “sex-specific”; they are relevant to individuals with medically necessary needs regardless of gender identity or embodiment.

Social Implications

Originality/Value: Few medical sociologists have focused on transgender embodiment. Findings enhance our understanding of how transgender embodiment and minority stress processes influence access to needed SSCS.

Purpose: We review theory and research to suggest how research on sexual and gender minority (SGM) population health could more completely account for social class.

Approach: First, we review theory on social class, gender, and sexuality, especially pertaining to health. Next, we review research on social class among SGM populations. Then, we review 42 studies of SGM population health that accounted for one or more components of social class. Finally, we suggest future directions for investigating social class as a fundamental driver of SGM health.

Findings: Social class and SGM stigma are both theorized as “fundamental causes” of health, yet most studies of SGM health do not rigorously theorize social class. A few studies control socioeconomic characteristics as mediators of SGM health disparities, but that approach obscures class disparities within SGM populations. Only two of 42 studies we reviewed examined SGM population health at the intersections of social class, gender, and sexuality.

Research implications: Researchers interested in SGM population health would benefit from explicitly stating their chosen theory and operationalization of social class. Techniques such as splitting samples by social class and statistical interactions can help illuminate how social class and SGM status intertwine to influence health.

Originality: We synthesize theory and research on social class, sexuality, and gender pertaining to health. In doing so, we hope to help future research more thoroughly account for social class as a factor shaping the lives and health of SGM people.

Purpose: To understand how lesbian, bisexual, transgender, queer, and asexual (LBTQA+) young women interpret the social construction of “lesbian obesity” in the context of their lived experiences and membership in the LGBTQ+ community.

Methodology: Individual, in-depth interviews were conducted with a convenience sample of 25 LBTQA+ women, ages 18–24, to explore how participants perceive and experience dominant discourses about gender, sexuality, and weight. Interviews were analyzed using a combination of deductive and inductive coding approaches.

Findings: Participants resisted public health discourse that frames obesity as a disease and the implication that their sexual identities put their health at risk. Many participants viewed their sexual identities and membership in the LGBTQ+ community as protective factors for their health statuses in general and their body image in particular.

Implications: Our findings suggest a need to reconsider the utility of the concept of “lesbian obesity” to characterize the significance of elevated rates of overweight and obesity in this population. Public health and clinical interventions guided by body positive approaches may be of greater relevance for sexual minority women.

Originality: This study centers the perceptions and experiences of LBTQA+ young women in order to examine how the intersections of sexual minority identity, dominant cultural ideals about weight, and obesity discourse inform their health.