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NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health. Institute of Medicine US Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Bi sexual research paper. The Health of Lesbian, Gay, bi sexual research paper, Bisexual, and Transgender People: Building a Foundation for Better Understanding.
Washington DC : National Academies Press US ; At a time when lesbian, gay, bisexual, bi sexual research paper, and transgender LGBT individuals are an increasingly open, acknowledged, and visible part of society, clinicians and researchers are faced with incomplete information about the health status of this community.
Although a modest body of knowledge on LGBT health has been developed over the last two decades, much remains to be explored. What is currently known about LGBT health? Where do gaps in the research in this area exist? What are the priorities for a research agenda to address these gaps? This report aims to answer these questions. The committee believes it is essential to emphasize these differences at the outset of this report because in some contemporary scientific discourse, and in the popular media, these groups are routinely treated as a single population under umbrella terms such as LGBT.
At the same time, as discussed further below, these groups have many experiences in common, key among them being the experience of stigmatization. Differences within each of these groups related to, for example, race, ethnicity, socioeconomic status, geographic location, and age also are addressed later in the chapter. Lesbians, gay men, and bisexual men and women are defined according to their sexual orientation, which, as discussed in Chapter 2bi sexual research paper, is typically conceptualized in terms of sexual attraction, behavior, identity, or some combination of these dimensions.
They share the fact that their sexual orientation is not exclusively heterosexual. As explained throughout the report, these differences have important health implications for each group. In contrast to lesbians, gay men, and bisexual men and women, transgender people are defined according to their gender identity and presentation.
This group encompasses individuals whose gender identity differs from the sex originally assigned to them at birth or whose gender expression varies significantly from what is traditionally associated with or typical for that sex i. The transgender population is diverse bi sexual research paper gender identity, expression, and sexual orientation.
Some transgender individuals have undergone medical interventions to alter their sexual anatomy and physiology, others wish to have such procedures in the future, and bi sexual research paper others do not. Transgender people can be heterosexual, homosexual, or bisexual in their sexual orientation. Some lesbians, gay men, and bi sexual research paper are transgender; most are not. Male-to-female transgender people are known as MtF, transgender females, or transwomen, while female-to-male transgender people are known as FtM, transgender males, or transmen.
Some transgender people do not fit into either of these binary categories. As one might expect, there are health differences between transgender and nontransgender people, as well as between transgender females and transgender males. Combining lesbians and gay men under a single rubric, for example, obscures gender differences in the experiences of homosexual people.
Likewise, collapsing together bi sexual research paper experiences of bisexual women and men tends to obscure gender differences. And the transgender population, which itself encompasses multiple groups, has needs and concerns that are distinct from those of lesbians, bisexual women and men, and gay men.
As noted above, despite these many differences among the populations that make up the LGBT community, there are important commonalities as well. The remainder of this section first describes these commonalities and then some key differences within these populations. What do lesbians, gay men, bisexual women and men, and transgender people have in common that makes them, as a combined population, an appropriate focus for this report? In the committee's view, the main commonality across these diverse groups is their members' historically marginalized social status relative to society's cultural norm of the exclusively heterosexual individual who conforms to traditional gender roles and expectations.
To better understand how sexuality- and gender-linked stigma are related to health, imagine a world in which gender nonconformity, same-sex attraction, and same-sex sexual behavior are universally understood and accepted as part of the normal spectrum of the human condition. In this world, membership in any of the groups encompassed by LGBT would carry no social stigma, engender no disgrace or personal shame, and result in no discrimination.
Only a few factors would stand out for LGBT individuals specifically. There would be little reason for the Institute of Medicine IOM to issue a report on LGBT health issues. We do not live in the idealized world described in this thought experiment, however. Historically, lesbians, gay men, bisexual individuals, and transgender people have not been understood and accepted as part of the normal spectrum of the human condition. Instead, they have been bi sexual research paper as deviants.
Although LGBT people share with the rest of society the full range of health risks, they also face a profound and poorly understood set of additional health risks due largely to social stigma. While the experience of stigma can differ across sexual and gender minorities, stigmatization touches the lives of all these groups in important ways and thereby affects their health. In contrast to members of many other marginalized groups, LGBT individuals frequently are invisible to health care researchers and providers.
As explained in later chapters, this invisibility often exacerbates the deleterious effects of stigma. Overcoming this invisibility in health care services and research settings is a critical goal if we hope to eliminate the health disparities discussed throughout this report, bi sexual research paper. It is important to note that, despite the common experience of stigma among members of sexual- and gender-minority groups, LGBT people have not been passive victims of discrimination and prejudice.
The achievements of LGBT people over the past few decades in building a community infrastructure that addresses their health needs, as well as obtaining acknowledgment of their health concerns from scientific bodies and government entities, attest to bi sexual research paper commitment to resisting stigma and working actively for equal treatment in all aspects of their lives, including having access to appropriate health care services and reducing health care disparities.
Indeed, some of the research cited in this report demonstrates the impressive psychological resiliency displayed by members of these populations, often in the face of considerable stress. As detailed throughout this report, the stigma directed at sexual and gender minorities in the contemporary United States creates a variety of challenges for researchers and health care providers.
Fearing discrimination and prejudice, bi sexual research paper, for example, many lesbian, gay, bisexual, and transgender people refrain from disclosing their sexual orientation or gender identity to researchers and health care providers. Regardless of their own sexual orientation or gender identity, moreover, researchers risk being marginalized or discredited simply because they have chosen to study LGBT issues Kempner,and providers seldom receive training in specific issues related to the care of LGBT patients, bi sexual research paper.
In addition, research on LGBT health involves some specific methodological challenges, which are discussed in Chapter 3. Not only are lesbians, gay men, bisexual women and bi sexual research paper, and transgender people distinct populations, but each of these groups is itself a diverse population whose members vary widely in age, race and ethnicity, geographic location, social background, religiosity, and other demographic characteristics.
Since many of these variables are centrally related to health status, health concerns, and access to care, this report explicitly considers a few key subgroupings of the LGBT population in each chapter:. Although these areas represent critical dimensions of the experiences of LGBT individuals, the relationships of these variables to health care disparities and health status have not been extensively studied. In the context of the issues outlined above, the IOM was asked by the National Institutes of Health NIH to convene a Committee on LesbianGayBisexualbi sexual research paper, and Transgender Health Issues and Research Gaps and Opportunities.
The member committee included experts from the fields of mental health, biostatistics, clinical medicine, adolescent health and development, aging, parenting, behavioral sciences, HIV research, demography, racial and ethnic disparities, and health services research.
The committee's statement of task is shown in Box The study was supported entirely by NIH. Statement of Task. An IOM committee will conduct a review and prepare a report assessing the state of the science on the health status of lesbian, bi sexual research paper, gay, bisexual, and transgender LGBT populations; identify research gaps and opportunities related to LGBT more The majority of individuals affected by disorders of sex development do not face challenges related to sexual orientation and gender identity, although homosexuality, gender role nonconformity, and gender dysphoria defined as discomfort with the gender assigned to one at birth [see Chapter 2 ] are somewhat more prevalent among this population compared with the general population Cohen-Kettenis and Pfafflin, The committee acknowledges that while very little research exists on the subject of intersexuality, it is a separate research topic encompassing critical issues, most of which are not related to LGBT issues, and hence is beyond the scope of this report.
In a similar vein, the committee decided not to address research and theory on the origins of sexual orientation. The committee's task was to review the state of science on the health status of LGBT populations, to identify gaps in knowledge, and to outline a research agenda in the area of LGBT health.
The committee recognized that a thorough review of research and theory relevant to the factors that shape sexual orientation including sexual orientation identity, sexual behavior, and sexual desire or attraction would be a substantial task, one that would be largely distinct from the committee's main focus on LGBT health, and therefore beyond the scope of the committee's charge. This study was informed by four public meetings that included 35 presentations see Appendix A.
Three of these meetings were held in Washington, DC, while the fourth took place in San Francisco. In addition, the committee conducted an extensive review of the literature using Medline, PsycInfo, and the Social Science Citation Index see Appendix B for a list of search termsas well as other resources. The committee's approach to the literature is described below, followed by a discussion of the various frameworks applied in this study.
A brief note on the terminology used in this report is presented in Box A Note on Terminology. As discussed, the committee adopted the commonly used shorthand LGBT to stand for lesbian, gay, bisexual, and transgender. In cases in which the literature refers only to lesbian, gay, and bisexual populations, bi sexual research paper, the term LGB appears more While acknowledging that peer-reviewed journals are the gold standard for the reporting of research results and making bi sexual research paper effort to consult works published in major research journals, the committee chose to include in this study what it bi sexual research paper to be the best empirical literature available: journal articles, book chapters, empirical reports, and other data sources that had been critically reviewed by the committee members.
Recognizing that academic journals differ in their publication criteria and the rigor of their peer-review process, the committee gave the greatest weight to papers published in the most authoritative journals. Given that chapters, academic books, and technical reports typically are not subjected to the same peer-review standards as journal articles, the committee gave the greatest credence to such sources bi sexual research paper reported research employing rigorous methods, were authored by well-established researchers, and were generally consistent with scholarly consensus on the current state of knowledge.
With respect to articles describing current health issues in the LGBT community, bi sexual research paper, the committee attempted to limit its review to these articles published since In the area of transgender populations, however, much of the most current research was conducted prior to and is cited throughout the report.
Likewise, in the case of history and theory, the committee reviewed and cites older literature. When evaluating quantitative and qualitative research, the committee considered factors affecting the generalizability of studies, bi sexual research paper, including sample size, bi sexual research paper, sample source, sample composition, recruitment methods, and response rate.
The committee also considered the study design, saturation the point at which new information ceases to emergeand other relevant factors. In some cases, the committee decided that a study with sample limitations was important; in such cases, these limitations and limits on the extent to which the findings can be generalized are explicitly acknowledged, bi sexual research paper. The inclusion of case studies was kept to a minimum given their limited generalizability.
Research on U. samples was given priority. In cases in which no U. samples, however, this research is cited. This was frequently the case for research involving transgender people. Only English-language articles were considered. The committee considered papers whose authors employed statistical methods for analyzing data, as well as qualitative research that did not include statistical analysis.
For papers that included statistical analysis, the committee evaluated whether the analysis was appropriate and conducted properly. For papers reporting qualitative research, the committee evaluated whether the data were appropriately analyzed and interpreted. The committee does not present magnitudes of differences, which should be determined by consulting individual studies. In some cases, the committee used secondary sources such as reports.
However, it always referred back to bi sexual research paper original citations to evaluate the evidence. In understanding the health of LGBT populations, multiple frameworks can be used to examine how multiple identities and structural arrangements intersect to influence health care access, health status, and health outcomes. This section provides an overview of each of the conceptual frameworks used for this study.
First, recognizing that there are a number of ways to present the information contained in this report, the committee found it helpful to apply a life-course perspective.
Bisexuality: The Invisible Letter \
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