The waiting room is packed, and the doctor barely has time to peek into the examination room to say hello. It's not a rare experience, not even uncommon. So it pays to come prepared; and LGBTs have a longer than average list of items to check off. To help you write yours, Between The Lines asked the experts what your doctor should know.
First off, the experts say even your primary care physician should be aware of your sexual orientation.
"I think probably the primary thing the patient needs to make sure is that the doctor is comfortable with the kinds of health concerns that they might have," said Jerry Burns, a nurse practitioner with the Detroit Medical Center. "The patient needs to make sure that the doctor is somewhat comfortable, or somewhat experienced, with the [specific] health issues. If not, you can just pick another doctor."
Most importantly, Burns said, LGBTs need to know their HIV status.
"The people who know they're HIV-positive are going to change their behaviors because they do not want to pass on their HIV and I think that's very important," he said. "Most importantly, when the person knows their own status, they can seek treatment. HIV is a chronic disease. There's still this fear that it is a death sentence. The same thing can be said about a diabetic. If a diabetic does not seek treatment, the diabetes is going to kill that patient. It can become a death sentence for those who do not seek treatment."
Women need to have regular checkups with an OB/GYN specialist, to have regular PAP tests and breast exams. Studies have consistently shown that lesbians are less likely to go to their OB/GYN doctor because they are under the mistaken impression that because they do not need birth control, they do not need a regular check up.
It is important to find a doctor who understands lesbian sexuality and can treat you with compassion. Lesbians do not have to put up with homophobic physicians – there are plenty of competent doctors in Michigan who are happy to have LGBT patients.
Once your primary care physician is well informed, you might want to think about secondary sources to help keep yourself in the best possible shape.
"Each person is different and their needs are different, and I think whatever supports them positively is a good thing," said Burns, who listed a few possible steps LGBTs should take. "I think spiritual practices, I'd probably put them on the top of the list. I think exercise is definitely important. Diet is very important and there is no doubt that diet and nutrition can enhance the body's ability to fight things off. There are some alternative medicines that, depending on the person's needs, I think are quiet beneficial."
Support groups are also an option.
"I think support groups are great as long as they're moving in a positive direction," Burns said.
Mental health is an important factor
Once your physical health is in order, there's your mental health to consider.
"A doctor needs to be informed about your sexuality to be able to ask the appropriate questions," said Joe Kort, a local psychotherapist and author of the best-selling book "10 Smart Things Gay Men Can Do To Improve Their Lives." "For instance, if someone is going through a clinical depression or anxiety disorder that might be why they are experiencing certain physical symptoms like headaches, body aches and having trouble sleeping. A physician might misdiagnose and provide inappropriate medications if he does not have the right information about your mental health.
"Adult sexual abuse survivors have many physical symptoms such as genital pain," Kort continued. "This often has nothing to do with physical origins. They are manifestations of psychological body memories of sexual abuse. A doctor should be aware of this, again, to ensure he can properly treat you."
And there's more.
"Eating disorders, sexual addiction and recovery from chemical addictions often have physical symptoms," said Kort. "Eating disorders cause weight gain and loss and an electrolyte imbalance. Sexual addiction puts one at high risk for STDs and withdrawal from chemical addictions and/or use of them cause many physical symptoms. Doctors need to know what they are looking at and treating."
So who needs psychotherapy and what can a patient do to make that experience more productive?
"I believe everyone could benefit from psychotherapy in that self-awareness prevents mistakes and poor decisions in one's life that cause chaos and regrets," Kort said. "While one cannot totally eliminate this, it can greatly reduce the negatives that one brings into one's life. Most people do not enter psychotherapy until a crisis occurs. Once the crisis ends, they tend to drop out. This is not productive as the person does not then understand what caused the crisis to prevent it in the future. The tools for daily living are not provided other than in a crisis mode. This is why many people go from crisis to crisis in their lives.
"The way to make psychotherapy more productive is to not only go every session and leave the work there," Kort continued. "Bibliotherapy, physical exercise, and creating a supportive social network to love you and hold you up mentally when things are going poorly in your life can be of great help and reduce the amount of time spent going to therapy."
