LGBT health information has been increasingly available over the past year, to the point where content from my most recent blogs has already become dated. This post provides an update and highlights some newly available LGBT health information from 2011.
Since Employment nondiscrimination for LBGT PAs was posted in November 2010, four more states have enacted laws to prohibit employment discrimination on the basis of sexual orientation and gender identity, raising the total to 16 states and the District of Columbia. Keeping up with LGBT health: Why it matters to you patients from March 2011 references HP2020's debut of LGBT health as one of 13 new topic areas. Another remarkable feature of HP2020 is that while previous editions have required mid-course revisions, HP2020 is a living (digital) document that is continually being revised. The LGBT health topic area was updated as recently as this month and now includes a link to the CDC website's LGBT health content, which is also updated regularly.
The issues covered within Protection for LGBT PA students from May 2011 have not seen any improvement for the PA profession. However, medical students have set the bar in this area. The American Medical Student Association's Committee on Gender and Sexuality created an LGBT Residency and Medical School Directory to help applicants gauge how medical schools and residencies rate in their protection of LGBT students and residents. In addition, in a recent study on LGBT health curriculum in the Journal of the American Medical Association, September 2011, 70% of medical school deans in the United States and Canada surveyed gave their programs grades of "fair," "poor," or "very poor" for the quality and quantity of LGBT content in their curriculum, and students at one-third of responding medical schools received no such training in their clinical years. On average, the surveyed schools devoted five curriculum hours to LGBT health issues. Nine schools devoted no preclinical hours, and 44 schools devoted no clinical training hours to LGBT topics.
2011 Healthcare Equality Index, July 2011, noted hospitals that desire accreditation by the Joint Commission will now be evaluated for compliance with their new LGBT-inclusive nondiscrimination standards. PA Marylou Hernandez's JAAPA blog of December 2011 celebrates the Joint Commission's publication of Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care for the LGBT Community: A Field Guide. This companion document is intended to assist health care providers in achieving compliance with the Joint Commission's new accreditation standards that are inclusive of same-sex couples and their dependent children, and transgender patients.
Also in 2011, the President issued a Memorandum directing Secretary Sebelius to develop recommendations to promote the equal treatment of LGBT Americans, provide enhanced resources for LGBT health issues, and develop better information regarding LGBT health needs. The US Department of Health and Human Services (HHS) 2011 recommendations are on their way toward implementation. This month HHS issued a summary update summarizing specific actions that HHS has taken through 2011. HHS recently conducted LGBT listening sessions around the country to inform the development of a set of 2012 recommendations.
The Department of Justice recently announced revisions to the 1927 FBI definition of rape, which had been defined as forced, nonconsensual vaginal penetration by a penis. The national Uniform Crime Report which captures this data will provide health care professionals with more complete data on sexual violence, including oral or anal penetration; rape of males; penetration of the vagina and anus with an object or body part other than a penis; rape of females by females; and nonforcible rape.
Finally, I'd like to highlight HRSA's October 2011 release of Women's Health USA 2011, which identifies priorities, trends, and disparities in women's health. For the first time, this report features data on the health of lesbian and bisexual women and recognizes that health disparities exist among women by sexual orientation.
In terms of LGBT health, 2011 was a truly remarkable year. The benefits to patients of these advances and new information will depend upon PAs' awareness and our ability to integrate it into our practices.
Diane Bruessow practices in Middle Village, New York. This blog post expresses her personal views and does not express or represent the views or policies of AAPA.