2 results
fourteen - Mental health inequalities among LGBT older people in the United States: curricula developments
- Edited by Julie Fish, De Montfort University, Leicester, Kate Karban, University of Bradford
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- Book:
- LGBT Health Inequalities
- Published by:
- Bristol University Press
- Published online:
- 11 March 2022
- Print publication:
- 18 March 2015, pp 237-252
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- Chapter
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Summary
Introduction
Large-scale studies and national population-based surveys have been used to explore the interactions between sexual orientation, gender identity and mental health outcomes in the United States (US), Canada, and other English-speaking countries. These studies illuminate the ways in which lesbian, gay, bisexual and trans (LGBT) adults experience inequalities in mental health outcomes when compared with their heterosexual peers. For example, lesbians and bisexual women are at greater lifetime risk for substance abuse and dependence than heterosexual men and women (King et al, 2008). Gay men experience higher rates of mood and anxiety disorders than their heterosexual male peers or lesbians (Bostwick et al, 2010). Bisexual women are more likely to report poorer outcomes related to mood, anxiety, and suicide than their heterosexual, lesbian or gay counterparts (Steele et al, 2009). Trans individuals cite discrimination, negative body image and the complexity of intimate partner relationships as significant factors affecting mental health (Bockting et al, 2006).
One additional factor not included in these studies is the effects of ageing on mental health outcomes within the LGBT population. While Fredriksen-Goldsen and Muraco (2010) specify the need to focus on the additional factors of age, cohort affect, culture and individual life experiences when studying any aspect of the LGBT population, few studies have utilised these when exploring mental health inequalities among LGBT adults. This chapter describes how incorporating these factors will illuminate ways in which LGBT mental health inequalities may shift over the lifecourse and offers suggestions for developing best practices.
Sexual orientation, gender identity and mental health outcomes
Despite enjoying access to similar economic resources than their heterosexual counterparts, LGBT adults living in the US experience significant inequalities in mental health outcomes when compared with their heterosexual peers. Numerous studies explore the rates of depression, anxiety, suicidality, substance abuse and self-harm in the LGBT population (Cochrane and Mays, 2006; Herek and Garnets, 2007; Institutes of Medicine, 2011). In a meta-analysis of lesbian, gay and bisexual (LGB) mental health studies published worldwide, King et al (2008) compared these rates to existing data on non-LGB populations. They determined that the risk for depression and anxiety were 1.5 times more likely in LGB individuals, that lesbians and bisexual women experienced a higher risk of substance dependence and the lifetime prevalence of suicide rates was substantially higher in gay and bisexual men. Studies of mental health and trans adults are few.
seven - Unique experiences and needs of LGBT older people: one community in rural California responds
- Edited by Julie Fish, De Montfort University, Leicester, Kate Karban, University of Bradford
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- Book:
- LGBT Health Inequalities
- Published by:
- Bristol University Press
- Published online:
- 11 March 2022
- Print publication:
- 18 March 2015, pp 131-144
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- Chapter
- Export citation
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Summary
VIGNETTE
Mike, a slight man in his mid-sixties, stood in the crowded room of healthcare professionals and told his story – life as a young trans person, undergoing counselling, living as a male, and implementing a hormone therapy regimen prior to breast removal. Mike shared that he had not pursued surgeries on his ‘lower half ‘ to turn his vagina into a penis, because of cost, complexity and questionable success. Having recently lost his partner of many years, Mike predicted that a time would come when, unable to care for himself, he would need to reside in a nursing home. In a soft-spoken voice he concluded by saying, “When that happens, I don't want to be viewed as abhorrent. I don't want to know that workers are repulsed when they touch me. I am a person.” The silent audience could hear Mike's vulnerability as he shared these feelings during a training sponsored by the LGBT Roundtable of San Joaquin County, California.
Introduction
This chapter presents the efforts of one community in the United States (US) to better understand and address health and ageing needs of lesbian, gay, bisexual and trans (LGBT) older people, including Mike. The chapter introduces readers to the LGBT Roundtable of San Joaquin County, California; it describes how this collaborative advocates for equal access to services and to eliminate heteronormative bias in services to LGBT older people. The chapter reviews the societal context for Mike's lived experience of growing old and being LGBT in the US and how that experience differs from those of heterosexual older people as well as younger LGBT populations. The chapter discusses the seminar at which Mike presented his story and identifies training content that can be adapted for use by local communities. Lastly, the chapter examines the importance of social workers and other health providers taking immediate steps to make services to ageing individuals, including Mike, more LGBT-competent and friendly.
Origin and composition of the collaborative
In 2007 and 2009, California implemented two important laws to prevent discrimination based on gender identity and sexual orientation of LGBT older people such as Mike. The Older Californians Equality and Protection Act 2006 required ageing services agencies to identify and address the needs of LGBT older people through culturally competent service delivery systems.