LGBT Older Adult Healthcare Insights

Lesbian, gay, bisexual, and transgender individuals aged 65 years and older.

Chronic stress experienced by individuals belonging to minority groups due to prejudice, discrimination, and societal stigma.

The individuals a person chooses to consider family, often in addition to or instead of their biological family.

The state of being alone or lacking meaningful social connections.

Testing for health conditions before symptoms develop, aimed at early detection and prevention.

Medical interventions that help individuals align their physical appearance with their gender identity.

A detailed account of an individual's sexual experiences and practices, used for assessment and healthcare guidance.

Tailoring healthcare screenings to the specific age and health risks of an individual.

The presumption that everyone is heterosexual, leading to the marginalization of LGBTQ+ individuals.

The process of disclosing one's sexual or gender identity to others, including healthcare providers.

Men who have sex with men.

Women who have sex with women.

Distress caused by a mismatch between one's gender identity and the sex assigned at birth.

A person's internal, deeply held sense of being male, female, or another gender.

How a person communicates their gender to the world through clothing, behavior, and other outward expressions.

A person whose gender identity aligns with the sex assigned at birth.

A person whose gender identity differs from the sex assigned at birth.

A person who identifies outside of the traditional gender binary.

Understanding a patient's sexual and gender identity allows for more inclusive and appropriate care.

Older gay men may face unique challenges, including societal stigma, limited access to healthcare, and higher rates of certain health conditions.

Factors such as societal stigma, fear of discrimination, and past experiences can contribute to hesitation in disclosure.

Heterosexism creates a hostile environment for those who do not conform to societal expectations of heterosexual identity, leading to discrimination and marginalization.

Healthcare providers can create a welcoming environment by using inclusive language, being sensitive to patient needs, and educating themselves on LGBT healthcare issues.

The pronouns a person uses to refer to themselves, such as "he/him/his", "she/her/hers", or "they/them/theirs".

When societal stigma against LGBTQ+ individuals is internalized by an individual, leading to self-hatred and prejudice.

Regular medical tests to detect early signs of anal cancer, often recommended for men who have sex with men (MSM).

A common virus that can cause genital warts and certain cancers, including anal cancer.

Sexual activity involving receiving penetration in the anus.

Abnormal cell growth in the anus, which may indicate the early stages of anal cancer.

A specialized examination of the anus using a magnified scope to detect abnormalities.

A test to collect cells from the anus for examination, similar to a Pap smear for the cervix.

A combination of medications used to control HIV infection, delaying or preventing the onset of symptoms or progression to AIDS.

Negative attitudes, beliefs, and behaviours directed towards a particular group of people.

Unfair treatment or prejudice against a person or group based on their identity.

The process of planning for future healthcare decisions when someone may not be able to make them for themselves.

A person appointed to make healthcare decisions for another when they are unable to do so.

Conditions common in older adults that can affect their health and well-being.

Evidence gathered from people who know the patient well, such as family or friends.

A feeling of discomfort or distress due to a mismatch between one's assigned gender and their gender identity.

Healthcare services that respect and affirm a person's gender identity.

A healthcare setting where patients feel safe and respected, regardless of their sexual orientation or gender identity.

A consistent and standardized approach to asking questions about a person's sexual orientation and gender identity.

Using gender-specific language to describe medical exams, which can exclude transgender patients.

A strong, trusting relationship between a patient and their healthcare provider.

Factors that increase the risk of developing fragile bones.

People whose gender identity differs from the sex assigned to them at birth.

The wide range of ways people experience and express their gender.

A comprehensive list of organs a transgender patient possesses, considering possible discrepancies between assigned sex at birth and gender identity.

Recommendations for preventative screenings in transgender individuals, considering both assigned sex at birth and gender identity.

Remaining breast tissue after gender affirming surgery in transgender men.

Typically follows standard guidelines, with no elevated risk compared to cisgender women.

Recommended for transgender women who still have a prostate, following standard guidelines for older adults.

Involving the patient in discussions about the risks and benefits of screening and aligning with their preferences.

Generally recommended for older transgender individuals regardless of assigned sex at birth.

Treatment for transgender women involving estrogen and antiandrogens to promote female secondary sex characteristics.

Can increase the risk of blood clots, cardiovascular events, and stroke.

Treatment for transgender men involving testosterone to promote male secondary sex characteristics.

Can increase the risk of hair loss, polycythemia, and potentially cardiovascular events.

Regular check-ups to assess the effects of hormone therapy and manage any potential side effects.

A potential consideration in older adults, involving a discussion of risks and benefits with the patient.

A legal document that outlines a person's healthcare wishes in case they become unable to make decisions for themselves.

Physician Orders for Life-Sustaining Treatment, a medical form that provides specific instructions for end-of-life care.

In fact, or in reality, without legal recognition.

The process of stopping smoking cigarettes or other tobacco products.

A person assigned male at birth but identifies as female.

A screening test that uses low-dose X-rays to detect breast cancer.

Sexual intercourse where the individual receives the penis anally.

A swab taken from the back of the throat and the tonsils to test for infections.

Using condoms inconsistently during sexual activity.

As families of choice age, their members may experience health issues, reducing their ability to care for one another, leading to vulnerability in the elderly.

Due to dwindling families of choice and potential lack of support from families of origin, LGBT elders are more prone to social isolation.

LGBTQ+ elders entering nursing homes may experience discrimination similar to what they faced throughout their lives, leading to fear and potential secrecy.

Families of choice lack the same legal recognition as blood relatives, making it challenging for chosen family members to act as legal decision makers.

Legal marriage for same-sex couples provides protection for healthcare decision-making, economic rights, and financial planning benefits.

Benefits for same-sex couples include health insurance inclusion, social security, Medicare, asset sharing, and inheritance rights.

Important considerations include identifying a surrogate decision maker, specifying healthcare preferences, and addressing legal issues surrounding chosen families.

LGBTQ+ adults often rely on families of choice for support, creating unique social structures that differ from traditional family models.

Despite societal discrimination, LGBTQ+ individuals show resilience by forming families of choice, demonstrating strength in building their own support networks.

Open discussions with LGBTQ+ patients about their family structures, care preferences, and legal status are crucial for providing appropriate healthcare.

Directing patients to advocacy organizations can provide support and guidance regarding legal rights, discrimination, and healthcare access.

The US Preventative Services Task Force (USPSTF) recommends against prostate-specific antigen screening for prostate cancer in men over 70 years old (grade D).

Colon cancer screening guidelines for women who have sex with women (WSW) follow the same established guidelines as older adults in general.

Lesbian women may have a higher prevalence of breast cancer risk factors like nulliparity, alcohol use, smoking, and obesity compared to heterosexual women.

There are inconsistent data on mammogram screening participation among WSW, though they may have increased risk for breast cancer.

A study using the National Health Interview Survey estimated a higher age-adjusted relative risk for breast cancer death in WSW (RR 3.20; 95% CI 1.01–10.21).

Pap smear recommendations for cervical cancer screening in LGBT women follow the general population guidelines and do not include specific recommendations for LGBT women.

LGBT individuals have a higher rate of smoking compared to heterosexual individuals across all age groups.

The higher prevalence of smoking among LGBT individuals makes screening for smoking, smoking cessation counseling, lung cancer, and abdominal aorta aneurysm screening essential.

The CDC recommends hepatitis A and B vaccinations for men who have sex with men (MSM) but does not specify age cutoffs.

Meningitis vaccination is also recommended for MSM in certain areas, such as urban settings.

Older adults, including those in the LGBT community, often remain sexually active but condom use may decline with age, increasing the risk of STIs.

Older men who have sex with men (MSM) may not perceive themselves at high risk for HIV or other STIs despite risks associated with unprotected anal sex.

It's important to obtain a detailed sexual history from LGBT older adults, similar to heterosexual older adults, to assess their risks and inform screening strategies.

A sexual history should include sexual activity, number of partners, barrier protection use, gender of partners, types of sex, and any history of STIs.

Testing recommendations for STIs include throat swabs, rectal swabs, vaginal swabs, urine tests, and HIV/syphilis testing, depending on the types of sexual activity.

Transgender individuals, particularly transgender women, have a significantly higher risk of HIV infection compared to the general population.

The tendency to overlook or invalidate the experiences and identities of bisexual individuals. It often involves assuming their sexuality based on their current relationship.

A critical part of comprehensive healthcare involves asking patients about their sexual history, including past and present sexual activity, partners, and practices. This information is essential for appropriate screening and care.

Creating a welcoming and respectful environment where LGBT patients feel comfortable sharing their full medical history and discussing their needs.

Using consistent forms and questions to gather information about all patients, including their sexual orientation, gender identity, and social support networks.

Encouraging patients to express their end-of-life wishes and designate a surrogate decision-maker who will make healthcare choices on their behalf in case of illness or incapacitation.

Hormone therapy, such as estrogen use, can have long-term risks and benefits. It's essential to discuss these with patients, including potential risks like blood clots, and monitor their health accordingly.

A healthcare professional with specialized knowledge and experience in providing care for transgender individuals, addressing their unique needs and concerns.

As LGBTQIA+ individuals age, their families of choice become increasingly important for their well-being, providing emotional support, practical assistance, and companionship.

LGBT older adults often face unique social challenges, such as ageism within the LGBT community and the lack of accessible resources tailored to their specific needs.

Regular screenings and diagnostic tests are critical for maintaining the health of LGBT older adults, addressing their specific health risks and preventing potential complications.