What is Pride Month?
Pride Month is a global celebration of the lesbian, gay, bisexual, transgender, questioning, and all other gender identities (LGBTQ+) community. About 1.5 million people in the UK and 13.9 million people in the US join in parades, events, concerts, and marches throughout the month in commemoration. 
Pride Month is celebrated every June to honour the LGBTQ+ community, commemorate the Stonewall Riots of 1969, and promote equal rights, acceptance, and awareness of LGBTQ+ issues worldwide. This month is a time for both celebration and reflection on the progress made and the challenges that still exist in achieving full equality.
The Stonewall Riots were a series of demonstrations by members of the LGBTQ+ community in response to a police raid that took place at the Stonewall Inn in New York City on June 28, 1969. These riots are widely considered a pivotal event in the LGBTQ+ rights movement.
Despite significant advancements in legal rights and societal acceptance, LGBTQ+ individuals still face substantial discrimination, health disparities, and barriers to access in many areas, including healthcare. The impact of these disparities is evident in both physical and mental health outcomes.
Health Challenges faced by the LGBTQ+ Community
The LGBTQ+ community often face unique health risks and challenges that can affect their wellbeing. Some key issues include:
Mental Health: LGBTQ+ individuals are at higher risk for mental health issues, such as depression, anxiety, and suicidal ideation, due to stigma, discrimination, and social isolation.
- About half of the LGBTIQ+ community have experienced depression
- 1 in 8 young LGBTQ+ people have attempted suicide
Substance Abuse: Rates of substance use and abuse are higher in the LGBTQ+ community, often as a coping mechanism for stress and discrimination.
- 1 in 6 LGBTQ+ people reported that they consumed alcohol every day
- 1 in 8 young LGBTQ+ took drugs at least once a month
HIV/AIDS: Gay and bisexual men, transgender women, and other members of the LGBTQ+ community continue to face a higher risk of HIV/AIDS. This is exacerbated by barriers to healthcare access and stigma.
Cancer: LGBTQ+ individuals may have a higher risk for certain cancers due to risk factors like tobacco and alcohol use, and limited access to cancer screenings.
Access to Care: Discrimination in healthcare settings can discourage LGBTQ+ individuals from seeking necessary medical care, leading to delayed diagnoses and poorer health outcomes. It is crucial for healthcare providers to create a welcoming and affirming environment to address these risks effectively.
- Almost 25% have witnessed discrimination from healthcare staff
- 1 in 7 people in the community avoid medical treatment for fear of discrimination
LGBTQ+ Representation in Clinical Trials
When study drugs are ready to move into Phase 1 clinical trial testing, a small number of healthy adults are recruited to test the potential medicine’s safety and efficacy. Phase 1 clinical trials typically lack diverse recruitment, which is a critical issue as it can set a precedent for underrepresentation in subsequent trial phases, leading to a lack of comprehensive data on how different populations respond to new treatments. This can result in less effective healthcare solutions and poorer health outcomes for underrepresented groups, exacerbating existing health disparities.
Historically there has been a lack of LGBTQ+ representation in clinical trials. Arguably, this could be a result of how trial protocols are written, and inclusion/exclusion criteria are decided. For example, biological sex requirements in protocols typically dichotomize participants into male and female categories, overlooking non-binary and gender diverse individuals who may not identify within these binary constructs. This exclusion can perpetuate invisibility and marginalisation of gender diverse populations in clinical research.
Transgender individuals, whose gender identity differs from their assigned sex at birth, are often excluded or misclassified in clinical trials based on biological sex requirements. This exclusion not only limits their access to potentially life-saving treatments, but also perpetuates a lack of evidence-based healthcare for transgender populations.
These are just two examples of how the LGBTQ+ can be excluded from clinical trials, exacerbating the health inequality and discrimination this community faces.
Patient Recruitment Recommendations
Cultural Sensitivities: Ensure that recruitment processes for clinical trials are culturally sensitive to address the diverse backgrounds and experiences of LGBTQ+ individuals. This helps improve communication, adherence to protocols, and overall patient experience.
Cultural Factors in Symptom Recognition: Recognize that cultural differences may influence how symptoms are identified and reported. Tailor educational materials to address these nuances and ensure they are inclusive.
Access to Specialised Care: Be aware of disparities in access to specialised care among different LGBTQ+ subgroups. Develop strategies to ensure equitable access to clinical trials and address barriers that might prevent participation.
Targeted Outreach Campaigns: Develop outreach campaigns specifically targeting LGBTQ+ communities, especially those with higher prevalence of certain health issues. Tailor messaging to address their unique concerns and information needs.
Conclusion
Understanding the unique health challenges faced by the LGBTQ+ community is crucial in the journey toward more equitable healthcare outcomes. While significant progress has been made, many disparities remain. Continued efforts to raise awareness, promote acceptance, and improve access to inclusive healthcare are essential.
Pride Month serves as a reminder of the ongoing struggle for equality and the importance of creating a world where everyone, regardless of their sexual orientation or gender identity, can live healthy and fulfilling lives. Through ongoing research, inclusive practices, and targeted outreach, we can work towards a future where all individuals receive the care and support they need.
References:
Hafeez H, Zeshan M, Tahir MA, Jahan N, Naveed S. Health Care Disparities Among Lesbian, Gay, Bisexual, and Transgender Youth: A Literature Review. Cureus. 2017 Apr 20;9(4):e1184. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5478215/
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Centers for Disease Control and Prevention, 2023. HIV and Gay and Bisexual Men. [Online] Available at: https://www.cdc.gov/hiv/data-research/facts-stats/gay-bisexual-men.html?CDC_AAref_Val=https://www.cdc.gov/hiv/group/msm/index.html
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The Trevor Project, 2023. National Survey on LGBTQ Youth Mental Health. [Online] Available at: https://www.thetrevorproject.org/survey-2023
Accessed 19 June 2024.
National Institute on Drug Abuse, 2024. LGBTQI+ People and Substance Use. [Online] Available at https://nida.nih.gov/research-topics/lgbtqi-people-and-substance-use
Accessed 19 June 2024.
World Health Organization, 2024. Improving LGBTIQ+ health and well-being with consideration for SOGIESC. [Online] Available at: https://www.who.int/activities/improving-lgbtqi-health-and-well–being-with-consideration-for-sogiesc
Accessed 19 June 2024.
LGBT in Britain – Health (2028). [Online] Available at: https://www.stonewall.org.uk/resources/lgbt-britain-health-2018
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