N512 module 5 discussion

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Aspen University *

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512

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Health Science

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Oct 30, 2023

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Yes, the federal health survey includes questions on sexual orientation and gender identity. The inclusion of questions about sexual orientation (SO) and gender identity (GI) on federal surveys allows for better understanding of SGM populations relative to the general or other population groups, including economic, housing, health, and other differences. Sex, gender identity, and sexual orientation are key indicators of the demographic diversity in the United States. Sex and gender are often conflated under the assumptions that they are mutually determined and do not differ from each other; however, the growing visibility of transgender and intersex populations, as well as efforts to improve the measurement of sex and gender across many scientific fields, has demonstrated the need to reconsider how sex, gender, and the relationship between them are conceptualized. This is turn affects sexual orientation, because it is defined on the basis of the relationship between a person's own sex or gender and that of their actual or preferred partners. Sex, gender, and sexual orientation are core aspects of identity that shape opportunities, experiences with discrimination, and outcomes through the life course; therefore, it is crucial that measures of these concepts accurately capture their complexity. Recognition of the diversity within the lesbian, gay, bisexual, transgender, queer, intersex, and other sexual and gender minorities - the LGBTQI+ population - has also led to a reexamination of how the concepts of sex, gender identity, and sexual orientation are measured. Better measurement will improve the ability to identify sexual and gender minority populations and understand the challenges they face. LGBTQI+ people continue to experience disparate and inequitable treatment, including harassment, discrimination, and violence, which in turn affects outcomes in many areas of everyday life, including health and access to health care services, economic and educational attainment, and family and social support. Though knowledge of these disparities has increased significantly over the past decade, glaring gaps remain, often driven by a lack of reliable data. Measuring Sex, Gender Identity, and Sexual Orientation recommends that the National Institutes of Health (NIH) adopt new practices for collecting data on sex, gender, and sexual orientation - including collecting gender data by default, and not conflating gender with sex as a biological variable. The report recommends standardized language to be used in survey questions that ask about a respondent's sex, gender identity, and sexual orientation. Better measurements will improve data quality, as well as the NIH's ability to identify LGBTQI+ populations and understand the challenges they face. National Academies of Sciences, Engineering, and Medicine. 2022. Measuring Sex, Gender Identity, and Sexual Orientation. Washington, DC: The National Academies Press. https://doi.org/10.17226/26424. Becker, T., Chin, M., & Bates, N. National Academies of Sciences, E. a. M.(Hrsg.).(2022). Measuring Sex, Gender Identity, and Sexual Orientation.

In June 2009, President Obama issued a directive that extended certain benefits to same-sex domestic partners of federal employees. This directive, known as the Memorandum on Federal Benefits and Non- Discrimination, was significant in several ways and had implications for healthcare access for the LGBTQ+ population. Here's a discussion of its significance: 1. Equality and Non-Discrimination: The directive represented a significant step towards achieving equality and reducing discrimination against same-sex couples. By extending benefits to same- sex domestic partners, it aimed to provide them with similar benefits and protections enjoyed by heterosexual couples. This helped address the disparities and discrimination faced by LGBTQ+ individuals and their families, including in accessing healthcare. 2. Health Insurance Coverage: One of the key benefits extended through this directive was health insurance coverage. Prior to this directive, many same-sex domestic partners were excluded from receiving employer-provided health insurance coverage for their partners. This meant that they often faced financial challenges in accessing healthcare, as they had to pay for private insurance or bear the full cost of medical care themselves. The directive helped alleviate this burden by allowing same-sex domestic partners to access health insurance coverage provided to federal employees. 3. Access to Healthcare Facilities: Another aspect of the directive's significance was its impact on access to healthcare facilities. In many instances, healthcare facilities granted visitation rights only to immediate family members, excluding same-sex partners. This resulted in partners being unable to visit their loved ones or participate in their medical decisions during hospitalizations or critical health situations. The directive aimed to address this issue by allowing same-sex domestic partners to have visitation rights, ensuring that they could be present and involved in the healthcare process. 4. Mental Health and Well-being: The directive also had implications for the mental health and well-being of same-sex domestic partners. By recognizing their relationships and extending benefits, it sent a message of validation and acceptance. This sense of inclusion and support can positively impact the mental health of individuals in same-sex relationships. Improved mental health can, in turn, lead to better overall well-being and healthcare outcomes. 5. Symbolic Importance: Beyond the practical implications, the directive held symbolic importance. It signaled a shift in the federal government's stance towards LGBTQ+ rights and equality. By taking this step, President Obama showed support for the LGBTQ+ community and took a stand against discrimination. This symbolism helped promote a more inclusive and accepting society, encouraging other employers and institutions to consider similar policies and practices. Overall, the directive issued by President Obama in June 2009 was a significant milestone in advancing healthcare access for the LGBTQ+ population. It aimed to reduce discrimination, improve access to health insurance, ensure visitation rights, and promote overall well-being. While there is still progress to be made, this directive marked an important step towards achieving equality and inclusivity in healthcare for same-sex domestic partners. The encounter with the healthcare professional could be considered inappropriate and lacking sensitivity. Here's an analysis of the situation and a suggested approach with more humility:

1. Inappropriateness: The doctor's response of immediately associating being gay with HIV testing is problematic. It perpetuates a stereotype that assumes all gay individuals are at higher risk for HIV, which is not accurate. The assumption that being gay automatically necessitates an HIV test is stigmatizing and can make the patient feel judged or misunderstood. 2. Lack of sensitivity: The doctor's question about alcohol consumption, without any context or relevance to the patient's concerns, seems disconnected from the conversation. It may imply a bias or assumption about the patient's lifestyle based on their sexual orientation, which is not appropriate or respectful. A more humble and patient-centered approach could involve the following steps: 1. Establish rapport: Begin by creating a warm and welcoming environment to help the patient feel comfortable. Show empathy, respect, and non-judgmental attitude throughout the encounter. 2. Active listening: Allow the patient to express their concerns and experiences without interruptions. Give them space to share their feelings, thoughts, and questions related to their health. 3. Open-ended questions: Ask open-ended questions that encourage the patient to provide more information about their overall health, lifestyle, and concerns. This will help gather relevant information without making assumptions or generalizations. 4. Individualized risk assessment: Conduct a comprehensive risk assessment tailored to the patient's specific circumstances. Explore factors that may contribute to their health risks, such as sexual behavior, substance use, or other relevant factors, while being mindful not to make assumptions based on stereotypes. 5. Education and support: Provide evidence-based information on relevant health concerns and discuss preventive measures. This could include discussions on sexual health, safe sex practices, and the importance of regular screenings for sexually transmitted infections (STIs), including HIV. Ensure that the information provided is inclusive, respectful, and sensitive to the patient's sexual orientation. 6. Consent and shared decision-making: Involve the patient in the decision-making process by explaining the reasons behind any recommended tests or interventions. Seek their consent before proceeding with any tests or treatments. Remember, humility in healthcare means recognizing and respecting the unique experiences and perspectives of each individual patient. It involves actively listening, avoiding assumptions and stereotypes, and providing care that is tailored, inclusive, and supportive. Krehely, J. (2009). How to close the LGBT health disparities gap. Center for American Progress , 1 (9).

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Bolibol, A., Buchmueller, T. C., Lewis, B., & Miller, S. (2023). Health Insurance Coverage And Access To Care Among LGBT Adults, 2013–19: Study examines health insurance and access to care among LGBT adults. Health Affairs , 42 (6), 858-865.

Draft: The government health survey asks about sexuality and gender identity. Federal surveys using Sexual Orientation and Gender Identity questions to help assess Sexual and Gender Minority communities' economic, housing, health, and other distinctions from the general population. US population variety is reflected in gender, sexual orientation, and sex. The growing visibility of transgender and intersex populations, as well as efforts to improve sex and gender measurement across many scientific fields, has shown the need to rethink how sex, gender, and their relationship are conceptualized. Because sexual orientation is based on a person's sex or gender and that of their partners, this impacts it. Sex, gender, and sexual orientation are fundamental parts of identity that affect opportunities, discrimination, and life outcomes, thus it's important to appropriately evaluate them. The LGBTQI+ population's variety has led to a reevaluation of sex, gender identity, and sexual orientation. Better measurement will help identify sexual and gender minority communities and their issues. LGBTQI+ people still face harassment, discrimination, and violence, which impacts health, access to health care, economic and educational success, and family and social support. Over the last decade, awareness of these inequities has grown, but data gaps persist. Measuring Sex, Gender Identity, and Sexual Orientation advises that the National Institutes of Health (NIH) capture gender data by default and not confound gender with sex as a biological characteristic. The paper suggests standardizing survey questions regarding sex, gender identity, and sexual orientation. Better measures will help the NIH identify and understand LGBTQI+ people. In June 2009, President Obama issued a landmark decree that improved LGBTQ+ healthcare access. It intended to prevent discrimination, enhance health insurance, ensure visiting rights, and promote well- being. This directive moved same-sex domestic partners closer to healthcare equity and inclusiveness. This order provided health insurance coverage. Before this decision, many same-sex domestic partners were denied employer-provided health insurance for their spouses. They had to pay for private insurance or the whole cost of medical care, which made getting healthcare difficult. Allowing same-sex domestic partners to use federal employee health insurance eased this burden. The directive also affected healthcare facility access. Healthcare institutions sometimes restricted visits to immediate relatives, barring same-sex partners. During hospitalizations or serious illnesses, spouses were unable to visit or participate in medical choices. The directive granted same-sex domestic partners visiting privileges to ensure their participation in healthcare. The directive affected same-sex domestic partners' mental health. Recognizing their partnerships and offering perks showed acceptance and affirmation. Same-sex couples' mental health can benefit from this assistance. Mental health improves well-being and healthcare results. The instruction was symbolic as well as practical. It changed the federal government's LGBTQ+ rights attitude. President Obama supported LGBTQ+ people and against prejudice by adopting this action. This symbolism encouraged other companies and institutions to adopt inclusive policies. The encounter presented for this discussion; the doctor behaved insensitively. The doctor's instant association of gayness with HIV testing is improper. It promotes a false perception that all LGBT people are HIV-positive. Being homosexual inevitably requires an HIV test, stigmatizing and can make the patient

feel judged or misunderstood. The doctor's alcohol query seemed unrelated to the patient's worries. It may suggest a sexual orientation-based lifestyle prejudice. In healthcare, humility implies honoring each patient's unique experiences and viewpoints. Listening, avoiding prejudices, and offering personalized, inclusive, and supportive care are required. I would start by making the patient feel at home. Show empathy, respect, and non-judgment. I would also incorporate some active listening, letting the patient talk and express their health concerns. I would also ask open-ended questions to get the patient to talk about their health, lifestyle, and concerns. This will gather important data without assumptions or preconceptions. By doing this, it allows to develop a customized risk assessment, while avoiding prejudices, investigate sexual behavior, drug use, and other health hazards. I would also provide evidence-based health information and discuss prevention. Sexual health, safe sex, and STI testing, including HIV, may be discussed. Provide inclusive, courteous, and sensitive information concerning the patient's sexual orientation. It is also important to explain recommended testing and actions to the patient to help them decide. Get their consent before testing or treating. Becker, T., Chin, M., & Bates, N. National Academies of Sciences, E. a. M.(Hrsg.).(2022). Measuring Sex, Gender Identity, and Sexual Orientation Bolibol, A., Buchmueller, T. C., Lewis, B., & Miller, S. (2023). Health Insurance Coverage And Access To Care Among LGBT Adults, 2013–19: Study examines health insurance and access to care among LGBT adults. Health Affairs , 42 (6), 858-865. Krehely, J. (2009). How to close the LGBT health disparities gap. Center for American Progress , 1 (9). National Academies of Sciences, Engineering, and Medicine. 2022. Measuring Sex, Gender Identity, and Sexual Orientation. Washington, DC: The National Academies Press. https://doi.org/10.17226/26424.

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