A study reveals that people aged 50 and over who belong to the LGBTQIA+ community have worse health care than the portion of the same age group that is not part of this group. The situation is the same both in private networks and in the Unified Health System (SUS), reveals a study by researchers from Albert Einstein Hospital, Faculty of Medicine, University of São Paulo (USP and University of São Caetano do Sul, published in the journal scientific Clinics.
The researchers point out that 31% of the LGBTQIA+ group are in the worst range of access to health in the country, while the proportion among the population that is not in this group is 18%. To arrive at the results, the team analyzed the responses of 6,693 people from all over Brazil in an online questionnaire, which could be filled out anonymously. In all, 1,332 of the participants identified themselves as LGBTQIA+.
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Comparing responses, it was observed that 74% of heterosexual women reported having had at least one mammogram in their lives. At the same time, the proportion of women with gender identity or sexual orientation that fits them in the LGBTQIA+ acronym was only 40%, which highlights the disparity in relation to health care and may also indicate difficulties on the part of this group of perform exams.
A similar gap can be observed in another piece of data: that of preventive screening for cervical cancer, among people who identify as cisgender women. The percentage of heterosexuals who underwent the test was 73%, against 39% of LGBTQIA+.
As for the preventive exam for bowel cancer, also among cisgender women, the discrepancy is smaller, but it exists. In total, 57% of women said they had taken the test at some point, a number that drops to 50% among LGBTQIA+.
According to the authors of the study, a relevant fact is that more than half (53%) of the group does not believe, or does not know, that doctors know how to deal with the particularities of their health. In addition, 34% of those who responded to the questionnaire believe that the professionals who assisted them did not know their gender identity or sexual orientation, a fact that may show that there are relevant issues for diagnosis and treatment that are still taboo.
“From the moment we become aware of this reality, it reinforces the importance of eliminating inequalities, access barriers”, says Milton Crenitte, one of the authors of the research and geriatrician at Hospital Israelita Albert Einstein. The hospital has already developed specific protocols and actions for LGBTQIA+ patients, since the creation of the Medical Assistance Group aimed at this public.
For Crenitte, one of the mistakes that most influence the way health professionals specifically view this group is limiting care to sexually transmitted infections (STIs), which is explained by the stigma of the 1980s, when the stereotype that associated homosexuality to HIV, which remains to this day, in a way.
“Often, LGBTQ health was treated only in HIV and other STI prevention policies. So, what I think that geriatrics has to contribute to this area of LGBTQIA+ aging is to understand that it goes beyond that. It is necessary to welcome these people, make them enter our practice scenarios, in our health services, to treat high blood pressure, diabetes, do physical activity, treat mental health and also talk about HIV and AIDS”, says the geriatrician.
Crenitte points out that an important fact, nowadays, in the scenario of HIV is that science has changed a lot and advanced a lot in the treatment. “But one thing that remains, 40 years into the HIV epidemic, is serophobia. A space that also needs to be discussed is the discussion of sorophobia, which is prejudice against those living with the virus.”
The fear of becoming targets of LGBTQIAphobia in offices or hospitals even causes many people to fail to undergo regular and preventive follow-up and examinations, which can end up in the diagnosis of diseases that are already at an advanced stage, with little chance of effective treatment. “This is real. Many people from the LGBTQIA+ community, for fear of suffering discrimination or because of previous negative experiences or other barriers to access, which are countless, stop seeking the service”, says Crenitte.
The doctor also highlights a research data that shows that the way the user perceives the availability of the service will impact her decision to leave the house or not to seek help. “Many people, instead of taking preventive care, avoid it and only access health care at the time of an emergency, which is much worse.”
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