Healthcareand Nursing Issues of LGBT Population
Healthcareand Nursing Issues of LGBT Population
Theterm LGBT refers to the lesbian, gay, bisexual and transgenderpeople. This group of the population has unique experiences in termsof healthcare need (Lurye et al., 2008). The government and thesociety do not take a close interest in the LGBT population becauseof lack of understanding about their experiences and health careneeds. However, in the past one decade, the government has continuedto recognize the existence of the LGBT group. The Supreme Court hasalso helped in developing legal framework that would support theexistence of the group through the Defense of Marriage Act (DOMA).The Affordable Care Act (ACA) has also helped in improving the healthissues related to the group. Even though several challenges exist interms of availability of information, the current policies and legalframeworks have helped to develop awareness among the group and inthe general public in order to enhance effective healthcare reforms(Liben, 2008). The health and legal policies have helped inaddressing the behavioral health issues and the aspects ofdisparities among the LGBT people. That has been essential inimproving the access to the quality healthcare services and henceimpressive health care outcomes throughout the nation.
Healthcareand Nursing Policies
Therights of the LGBT people in the United States have increasedsignificantly for the past one decade. Even though the policyframework has not been profound, the public support these people havesignificantly increased, especially with the legalization of thesame-sex marriage (Ashmore et al., 2005). On the other hand, greatergains have been achieved by the group through the legal recognitionof their existence through the Defense of Marriage Act (DOMA). Manystates have continued to ban the marriage of the same sex with littleor no legal protection ontheir sexual-orientation and gender identity in various contexts suchas employment, health and housing (Drescher,2010). In addition, LGBTindividuals have beenexperiencing discriminations that are based their sexual orientationas well as gender identity and this has been contributing to healthproblems.  The policy frameworks to address the aspects ofdiscrimination such as violence and stigma have not been profound andthis has continued to compromise necessary health services for theLGBT individuals (DiCeglie, 2010).
TheKaiser Family Foundation provides a policy framework for what isknown as the health status, coverage and health access by the LGBTpeople in the United States. Affordable Care Act has played apivotal role similar to the DOMA in improving health status of thegroup. They have helped in reducing the number of uninsured LGBTpopulation by making the health system to be more equitable for thegroup. Nevertheless, more outstanding issues have remained unsolved.The implementation of these health policies and the support given bythe Supreme Court through DOMA increased the access to healthcare(Drescher, 2010).Despite all these improvements in the policy framework, the LGBTgroup is treated as the minority and health problems such as HIV Aidsis more prevalence among them (Luryeet al., 2008). Therefore,various campaigns have been launched to create awareness aboutHIV/AIDS among the LGBT group.
LegalDevelopment and Considerations
Theruling by DOMA formed the legal foundation for the existence andrecognition of this group. Through the decision, the Supreme Courtlegalized the same sex marriage as a way of appreciating theexistence of the LGBT population. It implies that the legal frameworkof the United States can now recognize that these people have uniquesexual desires, which must be provided as a way of improving theirphysical and psychological conditions (Haines et al., 2008). Eventhough the DOMA ruling caused the recognition of the LGBT people interms of same-sex marriage by the federal government, many stateshave been adamant to implement the law and recognize the same-sexmarriage.
Consequently,this has limited the independence and legal protection of spouses orthose who intend to engage in the same-sex marriages (Shechner,2010). The situation hascontinued to bar them from accessing insurance services. Irrespectiveof the importance of the ACA and the Supreme Court ruling to extendthe health coverage to the LGBT group, the legal impact in terms ofimplementation will be uneven throughout the country. As a result,the condition has raised concern about many LGBT people who haveremained unsecured through the Affordable Care Act and the DOMA. Inaddition, this group also faces several challenges as they try toaccess healthcare services. These include inaccessibility ofinsurance cover, high costs and low quality health services.
Recentresearch discovered that about 33 percent of the LGBT people withincomes below the 400 percent FPL do not have health insurance cover.This implies that legal policies currently in place do not addressthe issues affecting the group that could qualify to access healthservices as stipulated in the ACA.  They face challenges that inmost cases are greater, especially for the transgender people(Drescher, 2010).These people are likely to be poorer and more uninsured compared tothe LGB population. In addition, the transgender individuals haveoften been excluded from the system because of the aspect of denialto healthcare coverage or due to inexperience care providers who lackessential knowledge about their health needs (Miller et al., 2007).
TheACA and the Supreme Court’s DOMA ruling would be essential inalleviating some of the healthcare and nursing issues affecting theLGBT group.  For instance, the ACA was established with theobjective of extending healthcare insurance coverage to millions whoare financially uninsured. The legal framework was created to enhanceaccessibility of care services through the expansion of Medicaidprogram and the creation of subsidized health insurance by thefederal government in all states (DiCeglie, 2010). Theimplementation of the ACA should be done without discrimination basedon the individuals’ health conditions, sexual orientation andgender identity.
Onthe other hand, the DOMA ruling helped in developing the federalrecognition for individual who have married the same sex. The mainobjective is to address the health issues of LGBT population suchhealthcoverage for thesame-sexspouses employed bythefederal governmentand the workplace protections ofthe LGBT individuals through theFamily Medical Leave Act (FMLA) (DiCeglie, 2010). Even thoughthese changes will improve the issuance of the health insurancecoverage and access to health services by the LGBT people and theirfamilies in the United States, several issues still remain unsolved(Lurye et al., 2008).It explains why many states are still adamant to implement the samesex marriages among the LGBT individuals, which means many stategovernments do not recognize same concerns for these people,including health needs.
EthicalConsiderations for LGBT Healthcare
Evenafter developing the concepts and idea of the LGBT for severaldecades, many people and clinicians do not give significantconsideration to the health issues related to the LGBT population.However, advancements have been made in the medical realm to improvehealth services for the LGBT group (Ashmore et al., 2005). Forinstance, a specific diagnosis has been developed for the LGBT peopleknown as the Gender Identity Disorder. In this case, the medicalexperts create health service provision approaches that will addressthe health problems related to people whose gender identity andexpressions do not conform to the biologically assigned gender duringtheir birth (Egan & Perry, 2006).
Eventhough the diagnosis related to the gender identity was firstproposed in 1980and published in the Diagnostic and StatisticalManual of Mental Disorders, the practices were rare in medicalcontexts (Shechner, 2010). It was included as a way of identifyingchildren with unexpected gender expressions as well as transsexualadolescents and adults. The diagnosis is part of ethicalconsideration in providing special healthcare to the LGBT group. Thediagnosis was developed as it evolved during the 1980’s. In 1994,the establishment of the DSM-IV helped in creating three diagnosesbased on gender identity (Lurye et al., 2008). In this context, theywere combined into one diagnostic approach called the gender identityDisorder. The approach adopted different criteria for children andadults with the objective of looking at the issue from psychological,biological and environmental aspects as well as other factors thatmight have contributed to the gender identity and the genderorientation. In this sense, the diagnoses tend to determine why theindividual rejects the gender assigned to them at the birth (Martinet al., 2006). It explores the impairment in terms of biological,social, psychological and environment aspects.
Currently,no comprehensive study has fully explored the rapidly emerging genderidentity diagnoses (GID) among children, adolescents as well asadults to include the need of LGBT people in legal and ethicalpractices of care provision (Martin et al., 2006). On the other hand,the existing literature about this kind of diagnosis has contrastingviews as others reject the notion while others support it. Accordingto the extensive research works and available studies, there is nodistinctive medical approach to the LGBT health issues (Ashmore etal., 2005). Many medication approaches on the LGBT population putmore emphasis on the transsexual and transgender who uniquebiological aspects call for special attention. However, the issuesregarding the lesbians and gays are neglected by the society. Thecultural standards and norms in many social contexts do not identifylesbians and gay because they developed gender that is not recognizedby the society. Social and political contradictions about LGBT havediscouraged medical development that would provide effective healthcare to this group (Liben, 2008).
Thecommunity of LGBT is diverse and includes many issues that affectthem directly. These are several of people from different diverseraces, ethnicities, ages, socioeconomic conditions as well asidentities. Through the DOMA and ACA, the federal government hastried to solve health related issues of the LGBT group. However, manyof them are still facing numerous challenges. The main integratingfactor is their social and gender minorities. They experience commonchallenges such as stigma and discrimination. As a result, theystruggle with living at the connection of cultural backgrounds asthey try to be a part of the society in terms of access to healthcareservices. With respect to health care, the LGBT group has sufferednumerous discriminations as they seek an audience in healthcarefacilities. In addition, lack of awareness of health needs byhealthcare professionals has also contributed to their suffering.Consequently, LGBT people are faced with common sets of challenges inaccessing high-quality health services and achieving the highestpossible health standards like other people.
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