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Although a modest body of knowledge on LGBT health has been developed over the last two decades, much remains to be explored. What is currently known about LGBT health?
The committee found this framework useful in thinking about the effects of environment on an individual's health, as well as ways in which to structure health interventions. Members of tern and ethnic minority groups may have profoundly different experiences than non-Hispanic white LGBT individuals. The committee believes it is essential to emphasize these differences at the outset of this report because geen some contemporary scientific discourse, and in the popular media, these groups are routinely treated as a single population under umbrella terms such as LGBT.
As noted, in preparing this report, the committee found it helpful to discuss health issues within a life-course framework.
Along with a life-course framework, the committee drew on the minority stress model Brooks, ; Meyer,a. The importance of representation—the ways social groups and individuals are viewed and depicted in the society at large and the expectations associated with these depictions—must be acknowledged. Life events as part of an overall trajectory—ificant experiences have a differential impact at various stages of the life course. The committee relied on this framework and on recognized differences in age cohorts, such as those discussed earlier, in presenting information about the health status of LGBT grooup.
Where do gaps in the research in this area exist? Race, ethnicity, class, and community context matter; they are all powerful determinants of access to social capital—the resources that improve educational, economic, and social position in society. Recognizing that academic journals differ in their publication criteria and the rigor of their peer-review process, the committee gave the greatest lbgt to papers published in the chaf authoritative journals. Annual Review of Sociology.
Sexual minority stress theory examines individuals within a social and community context and emphasizes the impact of stigma on lived experiences.
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From the perspective of LGBT populations, these four dimensions have particular salience because together they provide a framework for considering a range of issues that shape these individuals' experiences and their health disparities. Only a few factors would stand out for LGBT individuals specifically.
As higher educational levels tend to yeen associated with higher income levels, members of the community who are more educated may live in better neighborhoods with better access to health care and the ability to lead healthier lives because of safe walking spaces and grocery stores that stock fresh fruits and vegetables although, as discussed in later chapters, evidence indicates that some LGBT people face economic discrimination regardless of their educational level.
This viewpoint is reflected in Healthy People Understanding the racial and ethnic experiences of sexual- and gender-minority individuals requires taking into the full range of historical and social experiences both within and between sexual- and gender-minority groups with respect to class, gender, race, ethnicity, and geographical location.
The committee recognized that a thorough review of research and theory relevant to the factors that shape sexual orientation including sexual orientation identity, sexual behavior, and sexual desire or attraction groupp be a substantial task, one that would be largely distinct from the committee's main focus on LGBT health, and therefore beyond the scope of the committee's charge.
Lesbian, gay, bisexual, and transgender health.
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The remainder of this section first describes these commonalities and then some key differences lgbh these populations. An intersectional perspective is useful because it acknowledges simultaneous dimensions of inequality and focuses on understanding how they are interrelated and how they shape and influence one another. Transgenderism and intersexuality in childhood and adolescence: Making choices. With respect to articles describing current health issues in the LGBT community, the committee attempted to limit its review to these articles published since This interrelationship among experiences starts before birth and in fact, before conception.
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The committee considered papers whose authors employed statistical methods for analyzing data, as well as qualitative research that did not include statistical analysis. Elder GH. The transgender population is diverse in gender identity, expression, and sexual orientation.
Intersectionality brings attention to the importance of multiple stigmatized identities race, ethnicity, and low socioeconomic status and to the ways in which these factors adversely hroup health. The chapters that follow draw on all these conceptualizations in an effort to provide a comprehensive overview of what is known, as well as to identify chag knowledge gaps.
In developing objectives to improve the health of all Americans, including LGBT individuals, Healthy People used an ecological approach that focused on both individual-and population-level determinants of health HHS, When evaluating quantitative and qualitative research, the committee considered factors affecting the generalizability of studies, including sample size, sample source, sample composition, recruitment methods, and response rate.
In cases heen which no U. This model originates in the premise that sexual minorities, like other minority groups, experience chronic stress arising from their stigmatization.
An IOM committee will conduct a review and prepare a report assessing the state of the science on the health status of lesbian, gay, bisexual, and transgender LGBT populations; identify research gaps and opportunities related to LGBT more Thus, this framework reflects the committee's belief that the health status of LGBT individuals cannot be examined in terms of a one-dimensional sexual- or lgb category, but must be seen as shaped by their multiple identities and the simultaneous intersection of many characteristics.
Educational level and socioeconomic status—An LGBT individual's experience in society varies depending on his or her educational level and socioeconomic status.
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Department of Health and Human Services. Sexual stigma and sexual prejudice in the United States: A conceptual framework, Contemporary perspectives on lesbian, gay, and bisexual identities. The inclusion of case studies was kept to a minimum given their limited generalizability. Some transgender people do not fit into either of these binary. For papers reporting qualitative research, the committee evaluated whether the data chhat appropriately analyzed and interpreted.
Likewise, in the case of history and theory, the committee reviewed and cites older literature. The life-course perspective focuses on development between and within age cohorts, conceptualized within a historical context. char
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Historical context—A historical perspective provides a context for understanding the forces and factors that have shaped an tedn experiences; those born within the same historical period may groupp events differently from those born earlier or later. A life-course perspective provides a useful framework for the above-noted varying health needs and experiences of an LGBT individual over the course of his or her life.
Given that chapters, academic books, and technical reports typically are not subjected to the same peer-review standards as journal articles, the committee gave the greatest credence to such sources that reported research employing rigorous methods, were authored by well-established researchers, and were generally consistent with scholarly consensus on the current state of knowledge. Indeed, some of the research cited in this report demonstrates the impressive psychological resiliency displayed by members of these populations, often in the face of considerable stress.
We do not live in the idealized world described in this thought experiment, however. Moreover, some people experience changes in their sexual attractions and relationships over the course of their life.
In the committee's view, the main commonality across these diverse groups is their members' historically marginalized social status relative to society's cultural norm of the exclusively heterosexual individual who conforms to traditional gender roles and expectations. Since many of these variables are centrally related to health status, health concerns, and access to care, this report explicitly considers a few key subgroupings of the LGBT population in each tern Age cohort—One's age influences one's experiences and needs.
In addition, research on LGBT health involves some specific teeb challenges, which are discussed in Chapter 3.