I’ve taken care of pretty much the full spectrum of LGBT patients, including transexuals at various stages of surgical and hormonal therapy. I think the problems I see are very similar to people who don’t disclose all sorts of other things that they do or things that have happened to them. I’ve had trouble when patients don’t disclose alcohol abuse or that they are survivors of sexual or physical abuse.
My best skill as a doctor is the ability, even when shocked, to deliver a non-committal, attentive, “Oh, okay. Tell me about it.” (and then be alert, patient, and quiet for a while.)
If I could teach doctors one thing, it would be to listen to their patients – especially when they seem reluctant to talk or “Oh, one more thing.” And if I could teach patients one thing, it would be that I really need them to talk to me!
In general, LGBT people have an increased risk of developing cancer and contracting sexually transmitted diseases, including HIV, experts say. They also are more likely to drink alcohol, smoke, use drugs, be overweight, attempt suicide and engage in other risky behaviors than heterosexual counterparts, according to physicians who specialize in treating LGBT individuals. Yet they remain medically underserved, data show.
Twenty-eight percent of transgender and gender nonconforming people postponed medical care when they were sick or injured due to concerns about discrimination, said a 2010 survey of about 7,000 people by the National Center for Transgender Equality and the National Gay and Lesbian Task Force. Gender nonconforming individuals are defined as people who do not fit stereotypes about how they should look or act based on the sex they were at birth.
More than one in five LGBT adults withheld information about their sexual practices from their doctor or other health care professional, said a 2004 survey by Witeck-Combs Communications/Harris Interactive.