LGBTQ

Question 1

Homosexuality Identity Development Stage:

Answer 1

1. Sensitization
2. Identity confusion
3. Identity assumption
4. Commitment

Question 2

Homosexuality Identity Development Stage: Sensitization:

Answer 2

Gender-neutral or crossgender interests

Generalized feelings of marginality and difference from same-sex peers.

Question 3

Homosexuality Identity Development Stage: Identity confusion:

Answer 3

Same-sex arousal or activity
Perception of sexual difference
Inner turmoil and confusion

Question 4

Homosexuality Identity Development Stage: Identity assumption:

Answer 4

Rewarding contacts with experienced homosexuals
Self-definition as homosexual
Identity tolerance and acceptance
Homosexual association
Sexual experimentation
Exploration of homosexual subculture.

Question 5

Homosexuality Identity Development Stage: Commitment:

Answer 5

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.

Question 6

The Coming Out:

Answer 6

• 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)

Question 7

Meyer’s Minority Stress Theory

Answer 7

Three processes:

1. External objective events and conditions (chronic and acute)
2. Expectations of such events and the vigilance this expectation requires
3. The internalization of negative societal attitudes

Question 8

Meyer’s Minority Stress Theory: External objective events and conditions examples:

Answer 8

Bullying, having to conceal ones sexuality or live in the gender that is not of one choosing at school and work

Question 9

Meyer’s Minority Stress Theory: Expectations and vigilance of such events examples:

Answer 9

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

Question 10

Meyer’s Minority Stress Theory: Internalization of negative societal attitudes examples:

Answer 10

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.

Question 11

Stress-ameliorating factors for LGBTQ2 people:

Answer 11

• Coming out
• LGBT group affiliation
• Transitioning

Question 12

Risk Factors for LGBTQ2 people health: Individuals

Answer 12

• 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.

Question 13

Risk Factors for LGBTQ2 people health: Family/interpersonal

Answer 13

• Profund social isolation

- Alienation from family

Question 14

Risk Factors for LGBTQ2 people health: Community

Answer 14

• Lack of knowledge of heathcare professionals

- Homophobia in health care professionnals and others

Question 15

Psychological Impact on health to be LGBTQ2:

Answer 15

• Rejection by family
• Runaway, throwaway
• homelessness
• Prostitution
• School truancy and dropout
• Restriction on career choice.

Question 16

Psychosocial Impact on health to be LGBTQ2:

Answer 16

• Limited access to health care

- Difficulty in longterm healthcare planning

Question 17

Impact on Physical Health to be LGBTQ2:

Answer 17

• 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.

Question 18

How to approach the patients: General principles

Answer 18

• 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)

Question 19

Approach to patient: During the history taking

Answer 19

• Explore the issue of sexuality with every patient, their beliefs and myths held
• Take system specific history where apporpriate
• Inquire about co-existing morbidity

Question 20

Approach to patient: During the sexual history taking

Answer 20

• 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)

Question 21

Management and preventive health issues:

Answer 21

• 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.

Question 22

PrEP (pre-exposure prophylaxis):

Answer 22

• 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

Question 23

Motreal ressources for LGBTQ2 community:

Answer 23

Jeunesse Lambda
Gai ecoute
Gay Line
Projet 10

Question 24

Internalized homophobia:

Answer 24

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.

Question 25

Heterosexism is refers to:

Answer 25

assumption that heterosexuality is the norm and a lack of awareness or acknowledgment that other orientations or genders exist alon the spectrum of “normal”

Question 26

Example of heterosexism in healthcare system:

Answer 26

• Asking clients about their marital status or sexual relationships using gendered terms, such as asking a man, “and do you have a wife?”
• Asking woman what type of contraception they use without first assesing if they are sexually active or if their sexual partners are woman, men, or another.

Question 27

Example of Gender-segregated spaces for trans bodies?

Answer 27

Public washrooms, change rooms, sports leagues, shelters, and prisons.

Question 28

Minority stress is refer to:

Answer 28

The stress that LGBTQ experience as a result of stigma,

prejudice, and discrimination.

Question 29

Primary prevention interventions:

Answer 29

• Intervention around Healthy living and stree management
• Creating groups or classes for LGBTQ people to learn stress coping techniques, or healthy nutrition and physical activity (stategies for helping them deal with the distress caysed by stigma and discrimination)
• Further upstream, approaches to prevent health problems toward preventing harassment and violence, and so focus on the structural environments of laws and policies.
• Home visits for lesbian and bisexual fathers advertised through the LGBTQ community newspapers and community groups.
• LGBTQ-inclusive sexual health education among high school.

Question 30

Secondary prevention level:

Answer 30

• Screening for hypertension
• Provide counselling ans testing for sexually transmitted infections, including HIV.
• Engage in outreach to the community with info about mammograms and pap smears or testicular and protate exams, using tran-sensitive language and offers referrals.
• Smoking cessation programs.
• Screening for family violence or intimate partner violence, for suicidal ideation or for substance use and abuse.

Question 31

Tertiary prevention interventions:

Answer 31

• Help HIV-positive LGBTq people with medication adherence, referrals to appropriate healthcare services to manage with side effect of the rx.
• Locating LGBTQ-specific substance abuse treaetment programs that attend to societal stigma and unaddressed trauma services.
• Supporting effective self-care among people with diabetes, or strategies for managing depression, or exercise programs for people with arthritis or after cardiac bypass surgery.