The LGBTQ+ community includes people of all races and ethnicities, religions and social classes. People who self-identify as lesbian, gay, bisexual, transgender, homosexual, or gender non-conforming may face specific health issues. Many face stigmatization of their identity and may fear discrimination when seeking health care.
Here are answers to six common health questions from members of the LGBTQ+ community:
1. I am afraid to seek medical help for fear of being judged and treated differently. How can I find a reliable and validated supplier?
Trust is paramount to the relationship between patient and healthcare professional. In Mayo Clinic’s healthcare system, compassion and respect are core values that are practiced in every location. Discrimination of any kind is not allowed. All healthcare professionals are expected to be open and welcoming.
Many healthcare professionals have special services for the LGBTQ+ community. You may find a healthcare professional who has identified LGBTQ+ health as a priority aspect of their care.
2. If I can identify as LGBTQ+, where can I find support and resources?
First, being a member of the LGBTQ+ community is okay. Being gay or lesbian is okay. It’s okay to be transgender. It’s okay to be non-binary, gender non-conforming, or gender fluid. Your personality is normal.
You can ask your healthcare team for resources in your area. Pride advice is also an accessible resource that provides counselors specifically for the LGBTQ+ community.
3. I have a new partner. How can I be proactive about sexual health?
If desired, the local medical team can test you and your partner for sexually transmitted infections. You can use barrier methods of contraception, such as condoms or rubber dams, to provide protection. Contraceptives such as pills, injections or patches, implants or intrauterine devices do not protect against sexually transmitted infections.
If you are interested, you can also talk to your healthcare provider about a drug to prevent HIV transmission, more commonly known as pre-exposure prophylaxis or PrEP.
4. I know that the LGBTQ+ community is more likely to smoke and vape, which has a negative impact on our health. For those of us who want to quit smoking, what tools and resources are available to help?
The benefits of quitting smoking are endless. According to the Centers for Disease Control and Prevention, quitting smoking reduces the risk of 12 types of cancer, heart disease, and lung disease.
Here are some tips to help you quit smoking:
- Try to avoid your usual triggers.
If these triggers are unavoidable, develop a plan to focus your attention elsewhere. For example, if you tend to smoke during your break from work, plan to go for a walk instead or call a friend during that time. You can also chew on items such as sugar-free gum or sugar-free hard candies.
- Get moving.
Physical activity can curb cravings.
- Try relaxation techniques.
Try deep breathing or meditation to manage stress instead of reaching for a cigarette.
- Find support.
Help can come from family and friends, a local or online support group, or a helpline. Call 1-800-QUIT-NOW for a free consultation.
Nicotine patches, gum and lozenges contain less nicotine than cigarettes. They help manage cravings, reducing your overall risk, and they’re available for free through 802quits.org. If more help is needed, you can also talk to your healthcare provider about prescriptions such as varenicline, also called Chantix.
5. As I continue to explore and accept myself, this journey is a mixed bag. Although I am sometimes excited and relieved, sometimes I feel depressed and anxious. What should I do?
Mental health is just as important as physical health. Illnesses such as anxiety and depression greatly affect how you feel. Talk to your healthcare provider if you are experiencing mental difficulties. There are several proven treatment options, including medication and counseling. You can also contact your health care provider to find out which counselors in your area are covered by your health plan.
If anyone needs to hear this, contact a crisis center if you are contemplating suicide at any point. You can call to speak to someone on National Suicide Rescue Line call 1-800-273-8255. Or you can contact Crisis text line by texting HOME to 741741. These services are available 24/7 free of charge. Finally, you can seek medical attention at your local emergency room.
6. What kind of planned care is recommended for members of the LGBTQ+ community?
People should visit their medical team for an annual physical. At this appointment, your PCP will perform a physical exam, discuss any concerns you have, and review your medical and social history and medications.
There are many recommended medical checkups at various times in your life. Everyone should be screened for colon cancer starting at age 45. The preferred test for this is a colonoscopy.
All vaccines are highly recommended, including the COVID-19 vaccine. You should also be screened for diabetes, depression, and high cholesterol. It is also recommended that everyone be screened for hepatitis C and sexually transmitted infections, including HIV, at least once. For people aged 55 to 80 who have smoked for a long time or are current smokers, a low-dose CT scan is recommended.
Additional recommended checks include:
- Prostate-specific antigen (PSA) test
This blood test is recommended for cisgender men or people assigned male at birth with an average risk of prostate cancer between the ages of 55 and 69. People at higher risk may benefit from having a PSA test earlier. Usually, the prostate is not removed as part of sex reassignment surgery, so it should be monitored over time.
- abdominal ultrasound
This one-time screening for aortic aneurysm is recommended for cisgender men or people assigned male at birth, who smoke or have smoked previously, and are between 65 and 75 years of age.
A mammogram is recommended annually starting at age 40 for cisgender women with an average risk of developing breast cancer. For women, non-binary people, and other people who are not cisgender men but who were assigned male at birth, a screening mammogram is recommended if you have been taking sex-confirming hormones, such as estrogen, for more than five years. For men, non-binary people, and other people who are not cisgender women, but who were assigned female at birth, it is recommended to have breast cancer screening with mammography annually, starting at age 40.
- Pap smear
This test looks for signs of HPV, sexually transmitted infections, and cervical cancer. It is recommended for anyone with a cervix every three years between the ages of 21 and 29 and every five years between the ages of 30 and 65. Pap smears are not usually recommended for transgender women unless they have had fundus surgery. If so, talk to your healthcare team about screening recommendations.
- bone density
This screening determines if you have osteoporosis or are at risk of developing osteoporosis. A bone density scan is recommended for cisgender women aged 65 years and older.
Words matter. Your medical team should discuss the vocabulary used to describe your anatomy so that you feel comfortable when assisting. Let your team know if someone has said something that makes you feel uncomfortable.
Sarah Robinson, MD, is a resident of the Mayo Clinic Family Medicine Residency Program in Mankato, Minnesota.