ARTICLES AND BOOKS
There is growing research about the unique issues faced by our community. There are few books, like “A Gay Man’s Guide to Prostate Cancer,” developed by our partner nonprofit, Malecare. We hope to publish more and to encourage others to write and research.
Here is a sample of current LGBT cancer research.
Correlates of underutilization of gynecological cancer screening among lesbian and heterosexual women Alicia K. Matthews Ph.D. , Dana L. Brandenburg Psy.D., Timothy P. Johnson Ph.D., and Tonda L. Hughes Ph.D., R.N.
Department of Psychiatry, University of Chicago, Chicago, IL 60637, USA
McLaren Regional Medical Center, Michigan State University College of Human Medicine, Flint, MI 48824, USA Survey Research Laboratory, University of Illinois at Chicago, Chicago, IL 60612, USA Department of Public Health, Mental Health and Administrative Nursing, University of Illinois at Chicago, Chicago, IL 60612, USAAbstract
Background. Study aims were to examine cervical cancer risk factors, screening patterns, and predictors of screening adherence in demographically similar samples of lesbian (N = 550) and heterosexual women (N = 279).
Methods. Data are from a multisite survey study of women’s health conducted from 1994 to 1996.
Results. Differences in sexual behavior risk factors for cervical cancer were observed with lesbians reporting earlier onset of sexual activity (P < 0.05), more sexual partners (P < 0.001), and lower use of safer sex activities (P < 0.01). Lesbian and heterosexual women were equally likely to have ever had a Pap test; however, lesbians were less likely to report annual (P < 0.001) or routine (P < 0.001) testing. Multivariate analyses were used to determine the associations between demographics, health care factors, health behaviors, and worry about health and screening behaviors. Individual predictors of never screening included younger age, lower income, and lack of annual medical visits. Independent predictors of both recent and annual screenings included history of an abnormal Pap test, being heterosexual, and annual medical visits. Conclusion. Data indicate that lesbians are at risk for cervical cancer, yet underutilize recommended screening tests. Findings have implications for research, education, and cancer control among lesbians.Author Keywords: Cervical cancer risk; Cervical cancer screening; Sexual orientation Twenty Years of Public Health Research: Inclusion of Lesbian, Gay, Bisexual, and Transgender Populations Ulrike Boehmer, PhD Ulrike Boehmer is with Boston University, School of Public Health, Boston, Mass, and Center for Health Quality, Outcomes, and Economic Research, Bedford, Mass. Objectives. This study determined to what extent lesbian, gay, bisexual, and transgender (LGBT) populations have been studied over the past 20 years of public health research. Methods. From MEDLINE English-language articles on human subjects published between 1980 and 1999, I identified articles that included LGBT individuals. The abstracts were analyzed with a coding procedure that categorized the content by topic, sexual orientation, and race/ethnicity. Results. LGBT issues were addressed by 3777 articles, or 0.1% of all Medline articles; 61% of the articles were disease-specific, and 85% omitted reference to race/ethnicity. Research unrelated to sexually transmitted diseases addressed lesbians and gay men with similar frequency, whereas bisexual persons were less frequently considered, and the least amount of research focused on transgender individuals. Conclusions. Findings supported that LGBT issues have been neglected by public health research and that research unrelated to sexually transmitted diseases is lacking. Medical Students’ Ability to Care for Lesbian, Gay, Bisexual, and Transgendered Patients Nelson F. Sanchez, MD; Joseph Rabatin, MD; John P. Sanchez, MPH; Steven Hubbard, MS; Adina Kalet, MD, MPH Background and Objectives: Our objective was to assess medical students’ ability to care for lesbian, gay, bisexual, and transgender (LGBT) patients and to identify potential deficiencies in medical school curricula pertaining to this care. Methods: Between March 1 and April 15, 2004, third- and fourth-year medical students at a metropolitan medical school were sent an e-mail requesting participation in a confidential on-line survey of 64 quantitative questions designed to assess their ability to care for LGBT patients. Results: A total of 248 of 320 (77.5%) students responded. Medical students with greater clinical exposure to LGBT patients reported more frequent sexual history taking with LGBT patients, had more positive attitude scores, and possessed higher knowledge scores than students with little or no clinical exposure. Overall, on the 13-item attitude survey, the mean was 4.15 (5=most positive, SD=.55, range 1.86–5.00), indicating a desire and willingness to provide health care to LGBT patients. The mean score on the 14-item knowledge test was 60% (SD=.12) correct. Conclusions: Medical students with increased clinical exposure to LGBT patients tended to perform more comprehensive histories, hold more positive attitudes toward LGBT patients, and possess greater knowledge of LGBT health care concerns than students with little or no clinical exposure.(Fam Med 2006;38(1):21-7.)Sexualities, Vol. 6, No. 2, 131-171 (2003) DOI: 10.1177/1363460703006002001 Sexualizing Governance and Medicalizing Identities: The Emergence of `State-Centered’ LGBT Health Politics in the United States Steven Epstein University of California, San Diego In recent years, `state-centered’ LGBT (lesbian, gay, bisexual, and transgendered) health advocacy has emerged as a distinctive form of health activism in the United States. These advocates seek the inclusion of lesbians, gay men, bisexuals, and transgendered persons as subjects and objects of biomedical research. Much of their attention has focused on changing the policies, practices, and priorities of agencies of the US Department of Health and Human Services, including the National Institutes of Health. This emphasis has developed out of the convergence of two trajectories: the histories of specific activist movements that show an increasing willingness to engage directly with the state; and the adoption by the state of a `policy paradigm’ for including `special populations’ within the concerns of federal health agencies. The impact of state-centered LGBT health advocacy can be traced in a number of specific domains. However, the partial successes of these efforts raise troubling questions about the medicalization of LGBT identities and the limitations of biomedical citizenship. Key Words: health activism • health policy • LGBT health • medicalization • the state Support providers of sexual minority women with breast cancer, Who they are and how they impact the breast cancer experience . Journal of Psychosomatic Research , Volume 59 , Issue 5 , Pages 307 – 314 U . Boehmer , K . Freund , R . Linde Objective The aim of this study was to identify the factors associated with adjustment to breast cancer among sexual minority women with breast cancer and their support person. Methods In a cross-sectional study, sexual minority women with breast cancer and their support provider were asked to self-report social support, distress, and coping, using standardized measures. Results Twenty-three (77%) women had a support provider participating in the study. Disclosure of sexual orientation, less helpless-hopeless coping, and support provider perception of high fighting spirit were related to lower patient distress. Lower support provider distress was related to more patient disclosure of sexual orientation, a larger social network, and an underestimation of fatalistic patient coping. An overestimation of patients’ anxious preoccupation coping was linked to higher support provider distress. Conclusions Providing opportunities to sexual minority patients and their support providers to focus on issues such as disclosure of sexual orientation and coping may lower patient and support provider distress. LGBT Disease Prevention and Health Promotion: Wellness for Gay, Lesbian, Bisexual, and Transgender Individuals and Communities Authors: Patricia D. Mail a; Lauretta Safford b Published in: Clinical Research and Regulatory Affairs, Volume 20, Issue 2 January 2003 , pages 183 – 204 Preventive Health Behaviors Among Lesbian and Bisexually Identified Women Page Range: 1 – 13 DOI: 10.1300/J013v44n02_01 Copyright Year: 2006 Brooke E. Wells MA, Graduate Center of the City University of New York David S. Bimbi PhD Candidate, Graduate Center of the City University of New York Diane Tider MPH, Center for HIV/AIDS Educational Studies and Training Jason Van Ora MA, Graduate Center of the City University of New York Jeffrey T. Parsons PhD, Professor, Department of Psychology, Hunter College of the City University of New York, New York, NY, 10021 Book The Health of Sexual Minorities Public Health Perspectives on Lesbian, Gay, Bisexual and Transgender Populations10.1007/978-0-387-31334-4_21 Ilan H. Meyer and Mary E. NorthridgeDeborah J. Bowen2, Ulrike Boehmer3 and Marla Russo2 RESEARCH AND PRACTICE The Outing of Philip Morris: Advertising Tobacco to Gay Men Elizabeth A. Smith, PhD and Ruth E. Malone, PhD, RN Elizabeth A. Smith is with the Department of Social and Behavioral Sciences, School of Nursing, University of California San Francisco. Ruth E. Malone is with the Department of Social and Behavioral Sciences, School of Nursing and the Center for Tobacco Control Research and Education, University of California San Francisco. Objectives. This case study describes the events surrounding the first time a major tobacco company advertised in gay media. Methods. We analyzed internal tobacco company documents, mainstream newspapers, and the gay press. Results. Philip Morris was unprepared for the attention its entry into the gay market received. The company’s reaction to this incident demonstrates that its approach to the gay community both parallels and diverges from industry strategies toward other marginalized communities. Conclusions. The tobacco industry’s relationship to the gay community is relatively undeveloped, a fact that may provide tobacco control advocates an opportunity for early intervention. The gay community’s particular vulnerabilities to the industry make development of gay tobacco control programs crucial to reducing gay smoking prevalence and industry presence in the community. Comparison of Lesbian and Heterosexual Women Page Range: 109 – 130 DOI: 10.1300/J013v45n04_06 Copyright Year: 2007 Objectives: Using data collected as part of the Multisite Women’s Health Study, we examined the differences between lesbians and heterosexual women on objective breast cancer risk calculations using the Gail Model. Health risk behaviors and screening behaviors for breast cancer were also examined. It was hypothesized that lesbians would have higher objective cancer risk estimates and report more behavioral and screening risk factors for breast cancer than heterosexual women. Methods: Secondary data analyses were conducted using data from a study of women’s health conducted from 1994 to 1996. Using a cross sectional design, a convenience sample of lesbian (n = 550) and heterosexual (n = 279) women was recruited from Chicago, New York City and Minneapolis-St. Paul. Data were collected using a self-administered questionnaire. Results: Estimates of 5-year and lifetime breast cancer risk were higher for lesbians compared to heterosexual women. Groups did not differ in self-perceptions of being overweight, but more lesbians reported heavier drinking and more reported abstinence from alcohol. Group differences in adherence to breast cancer screening were not significant. Conclusions: Findings suggest a small but statistically significant difference in the calculated breast cancer risk estimates of lesbian and heterosexual women, which seem to be largely accounted for by differences in reproductive risk factors. doi:10.1300/J013v45n04_06: Silent Voices and Invisible Walls Exploring End of Life Care with Lesbians and Gay Men Page Range: 51 – 64 DOI: 10.1300/J077v24n01_05 Copyright Year: 2006 Kathryn M. Smolinski, Executive Director, Association of Oncology Social Work, Yvette Colón MSW, Director of Education & Internet Services, American Pain Foundation, Baltimore, MD, 21201-4111Journal of Psychosocial Oncology: The Official Journal of the Association of Oncology Social Work Volume: 24 Issue: 1 ISSN: 0734-7332 Pub Date: 8/9/2006 The needs and desires of lesbians and gay men with cancer at the end of their lives are not fundamentally different from any other dying individual’s needs. There are, however, significant legal restrictions and societal attitudes that can negatively affect the dying experiences of lesbians and gay men. Lesbians and gay men face many challenges at the end of their lives, including issues of disclosure in the healthcare setting, discrimination, misconceptions, legal and financial barriers and the disenfranchised grief of surviving same-sex partners. Oncology social workers can play a prominent role in advocating for these individuals to allow for dignity and support in spite of these barriers and provide effective interventions to help in assisting lesbians and gaymen with healthcare decision-making and end-of-life care planning. New National Survey Shows Financial Concerns and Lack of Adequate Health Insurance are Top Causes for Delay by Lesbians in Obtaining Health Care. Harris Interactive (2005-03-11). ^ Cochran, S.D.; Mays, V.M.; Bowen, D.; Gage, S.; Bybee, D.; Roberts, S.J.; Goldstein, R.S.; Robison, A.R. (2001). “EJ, & White, J.(2001). Cancer-related risk indicators and preventive screening behaviors among lesbians and bisexual women”. Am J Public Health 91: 591-597. ^ a b Valanis, B.G.; Carter, R.A.; Alerts, T.C. (2000). “Sexual Orientation and Health”. Archives of Family Medicine 9: 843-853. doi:10.1001/archfami.9.9.843. Retrieved on 2007-12-24. {{cite journal = Semin Oncology volume = 2000 Aug;27(4):471-9 author = Palefsky JM. title = Anal squamous intraepithelial lesions in human immunodeficiency virus-positive men and women. ^ Klamen, Debra L.; Grossman, Linda S.; Kopacz, David R. (1999). “Medical Student Homophobia”. Journal of Homosexuality 37: 53-63. doi:10.1300/J082v37n01_04 Breast health, early detection behaviors and health care experiences among rural lesbian and bisexual women Lyndall A. Ellingson, PhD, Department of Health and Community Services, California State University, Chico, Butte Hall 607, California State University, Chico, Chico, CA 95929-0505, This study surveyed rural lesbian and bisexual women’s access to breast health care, early breast health detection behaviors, and experiences of revealing sexual orientation to health care practitioners. Three hundred rural northern Californian lesbian and bisexual women were surveyed via a mail questionnaire (response rate: 45%). Results include demographic variables including the ethnicity, income, relationship status, parity, and breast cancer morbidity of this sample. Frequency of regular gynecological care, frequency of clinical breast examination, frequency of breast self-examination, frequency of mammography, and experiences of ‘coming out’ to practitioners are also reported. Implications include recognizing barriers rural lesbian and bisexual women have in obtaining breast health care and the relationship of these barriers to sexual orientation, and the importance of reinforcing early detection behaviors among this population. Program information on a related rural LGBT breast health community outreach program, “Health Pride”, will also be presented. Effects of gender identity on experiences of healthcare for sexual minority women. Hiestand KR, Horne SG, Levitt HM. The University of Memphis, Memphis, TN 38152, USA. kthiestand@yahoo.com While research examining healthcare experiences of sexual minority individuals is growing, thus far research has been limited on lesbian gender identity and its relationship to physical and mental health. This study explores access to and experiences of healthcare with a sample of 516 butch and femme identified lesbian and bisexual women. In comparison to femme-identified women, it was found that butch women had routine gynecological examinations significantly less frequently, perceived poorer treatment in healthcare settings, were more likely to be out within healthcare settings, placed more importance on securing LGBT-positive healthcare practitioners, and had more difficulty finding LGBT-positive medical doctors. No differences were found for mental health. The results suggest that butch women may be more at risk for physical health concerns than femme women, in particular those illnesses that can be prevented or treated with regular gynecological care (e.g., uterine or cervical cancer). Implications of the study include greater awareness among healthcare professionals of sexual minority gender identity in addition to sexual identity, and more support for butch-identified women to access vital healthcare services. Primary care health issues among men who have sex with men. Gee R. Sacramento Family Medical Clinic, Sacramento, California, USA. rgee@sacfamily.com PURPOSE: The purpose of the article is to examine “appropriate” health care for men who have sex with men (MSM), which is not to suggest “special” health care. As a group, MSM are at increased risk for sexually transmitted infections, anal cancer, and mental health disorders. Focus areas in this article will address health issues that the primary care nurse practitioner (NP) may encounter in clinical practice: anal carcinoma, sexually transmitted diseases (STDs), high-risk sexual practices, depression, and substance abuse were topics chosen for inclusion in this article. These topics were among those highlighted in the Healthy People 2010 Companion Document for LGBT Health, which served to examine the healthcare disparities and lack of access to needed services related to sexual orientation. DATA SOURCE: Extensive literature review of research articles, journals, clinical practice guidelines, books, and public health department Internet Web sites. CONCLUSIONS: There are unique health disparities that exist for MSM related to social, emotional, and mental health factors, in addition to physical issues such as STDs. There is an increasing need for primary care providers to be aware of these disparities, as well as the factors that influence these disparities, in order to provide multidimensional care and health counseling that is unique to NP practice. IMPLICATIONS FOR PRACTICE: Both the primary care NP and the patient should be aware of the unique healthcare issues among MSM that should be incorporated into the patient’s routine health maintenance program. As primary care providers, it is within the standards of practice for NPs to provide culturally competent care, along with health promotion and disease prevention for MSM.