Discrimination contributes to poorer heart health for LGBTQ adults

More than half (56%) of LGBTQ adults and 70% of those who are transgender or gender non-conforming report experiencing some form of discrimination, including the use of harsh or abusive language, from a healthcare professional.

A new American Heart Association Scientific Statement, published in the journal Circulation, suggests improving the cardiovascular health of the LGBTQ population will require a multi-faceted approach that includes researchers, clinicians and public health experts.

In terms of health, LGBTQ orientation is considered a “sexual minority,” and transgender or gender non-conforming is considered a “gender minority.”

The statement examines existing research about LGBTQ-specific links to cardiovascular health disparities, identifies gaps in the body of knowledge and provides suggestions for improving cardiovascular research and care of LGBTQ people.

LGBTQ populations face unique health stressors

Professor Billy Caceres, chair of the writing group for the statement and an assistant professor at the Columbia University School of Nursing in New York City, said: “This is particularly important now, at a time when there is increased awareness of health inequities related to unequal treatment and discrimination.

“LGBTQ individuals are delaying primary care and preventative visits because there is a great fear of being treated differently. Being treated differently often means receiving inadequate or inferior care because of sexual orientation or gender identity.”

LGBTQ populations face unique stressors, such as family rejection and anxiety over concealment of their sexual orientation or gender identity. Multi-level minority stressors and general stressors often interact in complicated ways to impair LGBTQ health. In addition, LBGTQ adults in historically underrepresented racial or ethnic groups experience higher poverty levels, insecure housing and fewer health care options compared to their white LGBTQ peers.

The writing group noted trust toward healthcare professionals is still lacking among many members of the LGBTQ community, and healthcare professionals need more education on how to provide appropriate care for LGBTQ patients.

The writing committee suggests assessment and documentation of sexual orientation and gender identity information in electronic health records could provide an opportunity to address specific health concerns for LGBTQ patients, and to strengthen our ability to examine cardiovascular health of LGBTQ adults more broadly. They also note basic understanding of the terminology of LGBTQ identities is important. The statement includes a glossary to detail and clarify the various key words and terms used to describe members of the LGBTQ community such as bisexual, transgender, gay, gender nonbinary, etc.

Professor added: “Healthcare systems need to play a significant role – to enact policies to encourage and support researchers and health care professionals to ask these questions in a respectful manner and to implement structures that emphasise the clinical importance of understanding the many layers related to caring for people with a minority sexual orientation or gender identity.”