IOM Recommends Attention to LGBT Health

Caitlin RyanNASW member Caitlin Ryan served on the IOM committee.

Little is known about the health needs of the LBGT population, says the Institute of Medicine in its March 31 report, “The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding.”

To remedy this, the IOM recommends that sexual orientation and gender identity be treated like other demographic information — such as age, race and ethnicity — and collected in federally funded health research. This will require standardized measures for sexual orientation and gender identity, which don’t exist yet.

The IOM also recommends capturing this data in electronic health records, calling for improved methods for collecting and analyzing sexual orientation and gender identity data and increased participation of sexual and gender minorities in research.

Historically, researchers studying the health status of LGBT populations have relied on sampling methods that don’t involve random selection, making it hard to generalize their findings. What’s more, much of the research to date has focused on gay men and lesbians — less so on bisexual and transgender people — and few studies have focused on children, older adults and racial and ethnic minorities, the IOM found.

“Building a more solid evidence base for LGBT health concerns will not only benefit LGBT individuals, but also add to the repository of health information we have that pertains to all people,” the IOM concludes in a brief.

NASW member Caitlin Ryan, director of the Family Acceptance Project at San Francisco State University, served on the 17-member IOM committee that drafted the recommendations.

Ryan co-authored a study investigating the effect of family acceptance on young LGBT adults’ mental and physical health, published in the November 2010 Journal of Child and Adolescent Psychiatric Nursing. She found that family acceptance in adolescence is associated with positive health outcomes in young adulthood, such as higher self-esteem, and is protective against negative health outcomes, such as depression, substance abuse and suicidal ideation and attempts.

Just like many other studies on LGBT issues, Ryan’s study relied on a nonprobability sampling method. “LGBT individuals are a hidden population; thus, we cannot claim that this sample is representative of the general population of LGBT individuals,” the study, available in the Publications section at the Family Acceptance Project, warns.

She noted in an interview with NASW News that the IOM’s recommendations are not necessarily new, but policymakers may take them more seriously now that the IOM has thrown its weight behind them.

“We just experienced a period of time when members of Congress were investigating federally funded researchers studying LGBT,” Ryan said. “It had a chilling effect on the science. ... This report is a sea change in terms of how people will think about LGBT health in terms of research and practice.”

Ryan said she hopes social work educators use the report and apply it in the training of social workers, and suggests that it be required reading. “This report provides a roadmap for guiding research and lays out for social work schools the state of the science to inform training and practice,” she said. “We are very unprepared in our knowledge and training related to core aspects of human development, such as sexual orientation and gender identity.”

She said she also hopes the IOM report will encourage more social work researchers to apply their specific skills and perspectives to help diminish health disparities for LGBT.

The U.S. Department of Health and Human Services has recommended a series of actions to improve the health and well-being of LGBT. [no longer available]

In related news, a new report by the Williams Institute at the University of California at Los Angeles School of Law estimates that 3.5 percent of Americans are lesbian, gay or bisexual and 0.3 percent are transgender, totaling approximately 9 million — a figure, the report notes, equivalent to the population of New Jersey.

“Estimates of the size of the LGBT community vary for a variety of reasons,” the report says. “These include differences in the definitions of who is included in the LGBT population, differences in survey methods, and a lack of consistent questions asked in a particular survey over time.”