LGBT Health Research Falls Far Short

March 31, 2011 -- Lesbians, gays, bisexuals, and transgendered Americans are distinct populations with unique health needs -- but what are those needs?

"We do not know exactly what these experiences and needs are," concludes the report of a panel of medical experts convened by the Institute of Medicine (IOM). The IOM was asked to propose an LGBT research agenda by the National Institutes of Health.

"In detailing just how little is known about the health issues confronting lesbian, gay, bisexual, and transgender people, the IOM report exposes the disturbing fact that our community has been largely ignored in most medical and health services research," Rea Carey, executive director of the National Gay and Lesbian Task Force, says in a news release.

The initials LGBT make it seem that people who are not heterosexual are somehow all alike. But the IOM panel quickly determined that each of these populations faces different health issues, has different access to health care, and faces different medical challenges.

A big problem with finding out what those challenges are is that there has been no systematic effort to find LGBT individuals and ask them about it.

A major change proposed by the IOM -- and likely to be taken up by the National Institutes of Health, the Health and Human Services Department, the CDC, and other data-gathering arms of the government -- is to include questions about sexual identity and sexual preference on future surveys and questionnaires as well as on electronic health records.

"It's easy to assume that because we are all human, gender, race, or other characteristics of study participants shouldn't matter in health research, but they certainly do," IOM Committee Chair Robert Graham, chair of family medicine at the University of Cincinnati, says in a news release.

While this information would be gathered just as questions about ethnicity now are collected, the IOM admits that phrasing such questions will be tricky.

The IOM panel suggests that researchers should look at LGBT health issues from four perspectives:

• Studies taking a life-course perspective should examine challenges that LGBT individuals face during four life stages: childhood, adolescence, early middle age, and later adulthood.
• Studies taking a minority stress perspective should examine the health effects of stigmatization and bias on sexual and gender minorities.
• Studies taking an "intersectional perspective" should examine the health status of LGBT individuals in the context of their racial, ethnic, economic, and geographic diversity.
• Studies taking a social ecology perspective should look at how the health of LGBT individuals is affected by their community and interpersonal relationships.

The panel also advises the National Institutes of Health to study:

• The demographics of LGBT subpopulations
• Social influences on the lives of LGBTs
• Barriers to health care for LGBTs
• The best health interventions for LGBTs
• The specific health needs of LGBTs

In addition, the IOM panel encourages researchers to make better efforts to include LGBT volunteers in future clinical studies.

"We urge HHS [Health and Human Services Department] to use this report as a roadmap to fill the gaps in knowledge relating to the health status of LGBT people and commit to collecting important and lifesaving data on sexual orientation and gender identity in future health surveys," Joe Solmonese, president of the Human Rights Campaign, says in a news release.

"This report is an important step in identifying research gaps and opportunities as part of an overall effort to understand and address the health needs of lesbian, gay, bisexual, and transgender people. We look forward to continuing our work to address these needs and reduce LGBT health disparities," Health and Human Services Secretary Kathleen Sebelius says in a news release.