LGBTQ Flashcards
Homosexuality Identity Development Stage:
- Sensitization
- Identity confusion
- Identity assumption
- Commitment
Homosexuality Identity Development Stage: Sensitization:
Gender-neutral or crossgender interests
Generalized feelings of marginality and difference from same-sex peers.
Homosexuality Identity Development Stage: Identity confusion:
Same-sex arousal or activity
Perception of sexual difference
Inner turmoil and confusion
Homosexuality Identity Development Stage: Identity assumption:
Rewarding contacts with experienced homosexuals Self-definition as homosexual Identity tolerance and acceptance Homosexual association Sexual experimentation Exploration of homosexual subculture.
Homosexuality Identity Development Stage: Commitment:
Homosexuality adopted as a way of life
Indicated internally by integration of sexuality and emotionality
Shifts in the meanings and value assigned the homosexual identity and satisfaction with the homosexual identity
Externally by same-sex love relationships
Identity disclosure to nonhomosexuals, and change in stigma management and strategies.
The Coming Out:
- Several stages and lifelong process
- Come out to the person judged to be supportive and understanding first, to less significant others first, women first. (friends, gay acquaintances, family, strangers)
Meyer’s Minority Stress Theory
Three processes:
- External objective events and conditions (chronic and acute)
- Expectations of such events and the vigilance this expectation requires
- The internalization of negative societal attitudes
Meyer’s Minority Stress Theory: External objective events and conditions examples:
Bullying, having to conceal ones sexuality or live in the gender that is not of one choosing at school and work
Meyer’s Minority Stress Theory: Expectations and vigilance of such events examples:
Walk along a route where one has previously been aggressed, going to a physician’s office where one’s medical issues are not understood or ignored, or in the case of a gender fluid persons, standout in a waiting room because of one’s appearance knowing that you are going to be called using the wrong pronoun and name
Meyer’s Minority Stress Theory: Internalization of negative societal attitudes examples:
The adolescent who as they develop sexual interest realize that they may be the “faggot” that people made fun of in the school yard or the “dirty old man” whom their parent’s had warned about not accepting a ride from.
Stress-ameliorating factors for LGBTQ2 people:
- Coming out
- LGBT group affiliation
- Transitioning
Risk Factors for LGBTQ2 people health: Individuals
- Poor self-esteem
- Identity conflict
- Tobacco use, alcohol and drug abuse
- Obesity and high-fat diets
- Nulliparity, low-parity or late parity.
- Low usage of oral contraceptives.
Risk Factors for LGBTQ2 people health: Family/interpersonal
- Profund social isolation
- Alienation from family
Risk Factors for LGBTQ2 people health: Community
- Lack of knowledge of heathcare professionals
- Homophobia in health care professionnals and others
Psychological Impact on health to be LGBTQ2:
- Rejection by family
- Runaway, throwaway
- homelessness
- Prostitution
- School truancy and dropout
- Restriction on career choice.
Psychosocial Impact on health to be LGBTQ2:
- Limited access to health care
- Difficulty in longterm healthcare planning
Impact on Physical Health to be LGBTQ2:
- Physical injuries (family, friends, others)
- Pregnancy (wanted or unwanted)
- Gastrointerstinal disorders (lifestyle, trauma or infections due to sexual practices)
- Reproductive system (Cancer, STI..)
- Cardiac, respi or nervous problems.
How to approach the patients: General principles
- Knowing yourself, belief system, knowledge gaps, the impact on the relation with the patient and their own belief system.
- Attitudes and Manners (Ask preferred name of use and pronoun of use, avoid labels, dispel myths, be supportive to pt and their family too, use the language the patient is using, validate with the patient knowledge)
Approach to patient: During the history taking
- Explore the issue of sexuality with every patient, their beliefs and myths held
- Take system specific history where apporpriate
- Inquire about co-existing morbidity
Approach to patient: During the sexual history taking
- Timing
- Introducing the sexual history to the patient (Preface, assuring confidentiality, charting)
- Vocabulary (Precise, clarify term unfamiliar to you, gender neutral language like PARTNER, avoid labels such as homesexuality, rape)
Management and preventive health issues:
- Disease specific
- DIet, under or over exercise, vaccination,
- Pap and anal pap, safer sex
- PrEP (pre-exposure prophylaxis) and nPEP (non occupational post exposure prophylaxis)
- Mental health issues
- Safety issues.
PrEP (pre-exposure prophylaxis):
- People who may be at risk of exposure to HIV taking antiviral
- Strong recommendation with moderate quality evidence
- Need to do rule out HIV, STIs and renal disease before.
- 2 regimens: Daily or on demand
- Covered under Quebec medication program
Motreal ressources for LGBTQ2 community:
Jeunesse Lambda
Gai ecoute
Gay Line
Projet 10
Internalized homophobia:
LGBTQ individuals who subconsciously accept negative societal views about sexual minority or gender diverse people and thus, experiencing a loss of self-worth and a lack of self-acceptance.
