Recipients of AcademyHealth’s Presidential Scholarship for New Health Services Researchers were invited to blog about select sessions during the 2013 Annual Research Meeting. The following session summary is written by Amber Goedken, Pharm.D., Ph.D., University of Iowa College of Pharmacy.  I chose to blog on this session because of my lack of awareness of lesbian, gay, bisexual, and transgender (LGBT) health issues.  I anticipated that attending this session would give me insight into the unique challenges the LGBT community faces, and I expected it would reveal gaps in knowledge that I might be able to fill through my own research. I think it is important to understand as much of the health care landscape as possible to identify areas where research is needed. My objective for the remainder of this blog is to provide an overview of the session that I hope will be helpful to individuals like me, those who know little about this area but are interested in learning more and who were unable to attend the session. I will also note how the speakers addressed any questions I had prior to the session. This session was one of the most interesting sessions I attended at the meeting. The panel offered diverse approaches to the topic and complemented each other well. The conceptual framework of intersectionality was introduced. This framework recognizes that we cannot define individuals by a single characteristic. Not all women face the same issues and circumstances. An African American lesbian woman is different from an African American woman. The characteristics of an individual have a multiplicative effect; they are not simply additive. This raised my awareness of the diversity of groups that fall under the umbrella of LGBT and the unique issues that each might face. Also discussed were the top 10 issues in LGBT health. One of the issues that stuck with me is there is a difference between sexual orientation and gender identity, and there is a lack of information within available data sources that reveals these different characteristics. National surveys may not ask these questions, so it is difficult for researchers to identify these different groups within the data. Thinking of my own research, I realized this information is lacking from the data I mainly use, the Medicaid Analytic eXtract. Those data contain information only on whether an individual is male or female. While a very rich data source, I would not be able to select an LGBT group from this data and would have to find another source to pursue this work. The intersection of health and policy for LGBT individuals was discussed in terms of how policies around LGBT issues impact health. Research has identified an increased likelihood of mood disorders and other negative health outcomes in states with constitutional bans on same-sex marriage. On the flip side, policies allowing same-sex marriage or domestic partnerships offer benefit in the form of lower psychological distress and fewer sexually transmitted infections. The panel did not present examples of discrimination in health care experienced by LGBT individuals that I wondered about, but the fear of discrimination, rejection, and/or poor care was highlighted as a concern of veterans who have been reluctant to disclose their sexual identities to their providers for fear of losing their benefits due to Don’t Ask, Don’t Tell, even though this was a Department of Defense policy and not a VA policy. Though the number in attendance was smaller than other sessions I have attended, there was obviously tremendous passion for these issues from the panel and the audience. The session provided an opportunity for individuals doing research on LGBT issues to connect, and the desire to create a network of such researchers was expressed and well-received. Because this is a developing field, it appears the continued support of AcademyHealth will be integral in facilitating interaction among these researchers. [Editor's Note: for more on this session, see session moderator Don Allensworth-Davies' video on the AcademyHealth YouTube channel.]

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