GLBT health: One community, many issues
by Rebecca Perlow
09-14-2007

While there are health concerns that cut across all age, class and gender barriers within the gay, lesbian, bisexual and transgender (GLBT) community, there are several health issues unique and specific to each group.

Among gay men, there has been increased concern in the medical community over the spread of both hepatitis C and human papilloma virus or HPV. Hepatitis C attacks the liver and is associated with liver cancer. Spread of the virus through unprotected sex is rare but possible, and approximately 80 percent of those infected exhibit no symptoms. Among gay men, HPV infection can lead to anal cancer.

“Right now the rates of anal cancer are roughly the same as the rates for cervical cancer were before the medical community began giving regular pap tests,” Joel Ginsberg, executive director for the Gay and Lesbian Medical Association, said. “There’s a lot of talk [in the medical community] about doing anal pap tests or recommending them for men who have sex with men, men who are having receptive anal intercourse and particularly those who are HIV positive.”

Depression and emotional stress are two problems that affect the entire GLBT community. According to the GLMA, there is also a strong connection between untreated depression and substance abuse.

“When people are depressed or have other mental health problems, they often don’t go in for medical treatment at all,” said Catherine Williamson, family nurse practitioner at Southampton Health Care. “And this could lead to behaviors that might be viewed as self-medicating, such as alcohol or drugs and overeating.”

Many lesbians and bisexual women suffer from a variety of weight-related problems. According to a 2006 study by the University of California, bisexual women were more than twice as likely to have had an eating disorder compared to lesbians and straight women. Weight problems can put lesbian and bisexual women at risk for breast and uterine cancer.

“When people are overweight, they have higher circulating estrogen. Estrogen is stored in our fat cells and increased estrogen puts women at increased risk for breast and endometrial cancer,” Williamson said.

Within the transgender community, finding willing, competent health care providers is the most major concern.

“There are health care providers that won’t see transgender people just on the basis of bias,” said John Otto, with the National Center for Transgender Equality.

Other problems experienced by the transgender community include problems related to unmonitored hormones and non-medical silicone injections. Unregulated estrogen and testosterone put transitioning men and women at risk for blood clots, strokes, high cholesterol, blood pressure and infection from illegal injections.

Many transgender people will pay for their own medical needs to avoid making insurance claims. Most employers have not considered transgender employee needs in their medical benefits plans and can get away with not covering them.

“Most transgender people pay out of pocket for hormone, lab work, surgery and monitoring of hormone use. Considering hormone use continues for the rest of one’s natural life, it can get pretty expensive,” Otto said.

Less is known about the medical concerns among bisexual men and women. According to the University of California study, suicide rates among out bisexual women were twice those of straight women. Bisexual men reported higher rates of psychological stress than both gay and straight men. Since little is known about bisexuality, bisexual men and women can be widely disparaged in both the gay and straight communities.

“That is a real problem because it’s that stigma that often prevents people from getting the help they need,” Ginsberg said. Organizations like the GLMA and the Mautner Project have posted lists of major health concerns on their respective websites and continue to provide invaluable information to the GLBT community.

You can e-mail Rebecca Perlow at ladyjane52983@hotmail.com.

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