Abstract
March 31, 2011 was an historic day for sexual and gender minorities and those who study and respond to the health disparities and healthcare needs of this increasingly visible population. On that day, the Institute of Medicine released its consensus report on The Health of Lesbian, Gay, Bisexual and Transgender People: Building a Foundation for Better Understanding. The study committee adopted four conceptual frameworks to examine influences on health care access, health status, and health outcomes of LGBT people. A life-course perspective recognizes that events at each stage of life influence subsequent stages; experiences are shaped by age and historical context. The minority stressmodel demonstrates that LGBT people experience chronic stress from societal discrimination and stigma. An intersectional perspective acknowledges that LGBT individuals have multiple, interactive social identities, including race/ethnicity, income, gender, sexual orientation and gender non-conformity. The social ecology model recognizes that influences on individuals are broader than the immediate environment, encompassing the impact of families, communities, and societal structure. Through these lenses, the committee reviewed existing literature, identified priority research areas, and made recommendations to increase knowledge about this population.
Frameworks adopted for the IOM study echo those of Healthy People, the Nation's leading program to improve the health of Americans. Healthy People 2020 incorporates a new topic area for LGBT health, recognizing that the health-related concerns of LGBT people are affected by societal attitudes and other determinants of health. With the historic inclusion of LGBT populations in this program, we can expect increased national awareness of health disparities among sexual and gender minorities and increased attention to documenting and addressing these needs. To present a context for the scientific study of LGBT health, this seminar will review current estimates and distribution of sexual and gender minority population groups, present available research outcomes about their health, discuss methodological approaches to studying this population, and summarize key observations and recommendations from the IOM report. To assess opportunities for addressing an overarching goal of Healthy People to achieve health equity, eliminate disparities, and improve the health of all groups, the seminar will focus attention on the extent to which LGBT health concerns have been addressed in the past and present ideas for expanded attention within the HP2020 program.
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