Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Treating LGBTQ youth affected by violence: Here’s what you should know

Olivia Low, MD
Education
October 25, 2016
259 Shares
Share
Tweet
Share

“Being able to feel safe with other people defines mental health; safe connections are fundamental to meaningful and satisfying lives.”
– Dr. Bessel van der Kolk

On my last day of rotation in the psychiatric emergency room, we received a new patient. The keywords and phrases rang through the air: “teenager,” “transgender,” “homeless,” “assaulted recently,” “says she feels a full-grown baby kicking.”

I immediately asked if I could see this patient, and was sent out to admit her. She had short, disheveled pink hair and was sleeping in a cocoon of thin, white hospital sheets. Security guards stood next to me, prepared for any kind of dangerous situation, but it became clear that this person was the one actually in danger.

She told me her story in snippets of incomplete sentences. Her living conditions and relationships had been unstable and complex. As I gathered her history, it became clear that it was not possible for her to be pregnant, for a number of reasons. She had received numerous psychiatric diagnoses, none of which seemed to explain her current presentation of a possible pregnancy delusion. It was a narrative entangled with trauma, and our conversation felt like such a minor point in a story that went far beyond the confines of our small, dimly lit corner of the ER. Eventually, she was admitted to the unit, and I was left wishing I could still be involved in her care.

Unfortunately, stories like hers are far too common, and more and more data are being published to shed light upon the experience of LGBTQ youth in our country. As healthcare providers, we have a responsibility to pay attention.

The evidence is striking: Queer youth need support

In a first-of-its-kind report, the Centers for Disease Control (CDC) recently revealed stark evidence about the prevalence of violence against queer youth in America. The report illustrates the results of a 2015 nationwide survey in high schools to assess specific health-risk behaviors in “sexual minority” students versus heterosexual students.

Sexual minorities were defined as those who identified as “lesbian, gay, bisexual, or not sure” and those who had had “sexual contact with the same sex or both sexes.” The results show that queer students experienced higher rates of violence by several metrics:

  • Being physically forced to have sex (18 percent LGB vs. 5 percent heterosexual)
  • Sexual dating violence (23 percent LGB vs. 9 percent heterosexual)
  • Physical dating violence (18 percent LGB vs. 8 percent heterosexual)
  • Skipping school for safety concerns (13 percent LGB vs. 5 percent heterosexual)
  • Being threatened or injured with a weapon at school (10 percent LBG vs. 5 percent heterosexual)

In addition, the results show a severe disparity in mental health among queer youth, who had higher rates of:

  • Attempted suicide in the last 12 months (29 percent LGB vs. 6.4 percent heterosexual)
  • Seriously considering suicide (43 percent LGB vs. 14.8 percent heterosexual)
  • Feeling sad or hopeless to the point of stopping usual activities (60 percent LGB vs. 26 percent heterosexual)

These numbers are staggering, and further elucidate the gravity of these issues. Nevertheless, there are a few limitations to this study worth mentioning. It does not include transgender youth, nor does it discuss the compounded barriers that queer and trans youth of color face. It also does not account for homeless youth or those who are not in school. Further, it does not attempt to explain the complex reasons behind these vast health disparities.

Researchers have studied these issues before, both in the context of LGBTQ adults and with specific regard to youth. Nevertheless, the evidence demonstrated by the CDC’s survey should serve as an impetus for continued advocacy and discussion of the oppression that young queer people face every day.

What we can do: A call for change

As medical students and providers, we may encounter queer youth before, while or after they experience violence and mental health issues. Though the challenges they endure are systemic, entrenched problems, we can start by examining our personal relationships with our patients. There is no doubt that affecting institutional and societal change is necessary, but enacting justice must also start with ourselves. Here are a few suggestions:

Confront discrimination. Evidence shows that members of the LGBT community routinely encounter disrespectful attitudes, discriminatory treatment and prejudicial policies from healthcare providers. Some even face refusal of care. Beyond the fact that it is ethically unacceptable to discriminate against our patients, researchers have demonstrated that perceived discrimination is associated with greater mental illness and emotional distress among LGBT youth. Thus it is crucial to examine our own implicit biases and assumptions, and to address these issues with our medical teams, classmates and colleagues. Discrimination is directly related to poorer health outcomes and perpetuates injustice.

Do not assume. A simple way to engender trust is to be aware of our verbal communication, including nonjudgmental wording and tone. It is critical never to make assumptions about people based on how they look and act. Not all transgender people feel as if they are “trapped in the wrong body.” Not all gay women have relationships only with other women. Rather than assume, we should invite patients to share their own identities and behaviors. We should ask what pronouns they prefer. Most importantly, we should reflect the language that our patients use to describe themselves, ask for clarification when needed and apologize if we make a mistake. Someone who feels affirmed by sensitive language use will be more likely to experience better care.

Identify and respond to trauma. Physicians cite various barriers to asking about trauma, such as a lack of time and a lack of ability to respond appropriately. As the CDC has illustrated, we need to ask our patients about the various forms of violence they may have faced. Our actions may be triggering for myriad reasons. In someone who has been assaulted, for example, a routine physical exam could set off a neurological response that causes serious distress and further harm. Educating ourselves about trauma and how to respond with compassionate competence is part of our responsibility as medical providers. As Dr. Bessel van der Kolk explains, we cannot “treat” the horrible events of people’s pasts, but we can deal with “the imprints of the trauma on body, mind, and soul.”

Honor resiliency. By virtue of existing in today’s world, our queer and transgender patients are extremely resilient, brave and beautiful. They are artists, thinkers, scientists, activists, survivors and so much more than a statistic or a chart in our medical records. They are human beings who deserve exceptional care, just as all our patients do.

Olivia Low is a medical student.  She blogs at the Doctor’s Tablet.

Image credit: Shutterstock.com

Prev

One device slows down health care. Get rid of it.

October 25, 2016 Kevin 5
…
Next

What’s the big rule that medical professionals don’t follow?

October 25, 2016 Kevin 8
…

Tagged as: Medical school

Post navigation

< Previous Post
One device slows down health care. Get rid of it.
Next Post >
What’s the big rule that medical professionals don’t follow?

More by Olivia Low, MD

  • Gender-diverse youth need pediatrician advocates

    Olivia Low, MD

Related Posts

  • America’s inadequate LGBTQ medical education

    Haidn Foster
  • Treating the patient’s body is not synonymous with treating the patient

    Steven Zhang, MD
  • Bias when treating supporters of President Trump

    Anonymous
  • Gun violence in America is a national emergency

    Hussain Lalani, MD and Justin Lowenthal 
  • Fight gun violence with science

    Jamie Coleman, MD
  • It’s time to seriously study gun violence

    Michael B. Bagg

More in Education

  • The secret to success in medical school: self-awareness and courage

    Kaelor Gordon
  • Is mandating pre-medical training widening disparities in the U.S. physician workforce?

    Deepak Gupta, MD and Sarwan Kumar, MD
  • Equalizing the future of medical residencies: standardizing work hours and wages

    Deepak Gupta, MD and Sarwan Kumar, MD
  • From studying to baby kicks: Navigating motherhood in medical school

    Natalie Eichner-Seitz
  • The power of advocacy: a medical student’s journey to helping an uninsured immigrant

    Fabiola Plaza
  • From AI to love: the key to a better future in medical education

    Stevan Walkowski, DO
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • The untold struggles patients face with resident doctors

      Denise Reich | Conditions
    • The psychoanalytic hammer: lessons in listening and patient-centered care

      Greg Smith, MD | Conditions
    • The heart of a Desi doctor: Balancing emotions and resources in oncology

      Dr. Damane Zehra | Physician
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • The heart of a Desi doctor: Balancing emotions and resources in oncology

      Dr. Damane Zehra | Physician
    • Safe sex for seniors: Dispelling myths and embracing safe practices [PODCAST]

      The Podcast by KevinMD | Podcast
    • Overcoming Parkinson’s: a journey of laughter and resilience

      Cynthia Poire Mathews, FNP | Conditions
    • The untold struggles patients face with resident doctors

      Denise Reich | Conditions
    • Maximize sleep efficiency with stimulus control

      Pedram Navab, DO | Conditions
    • The Iranian diaspora’s fight for liberty: Overcoming challenges in the largest women’s rights movement of our century

      Montreh Tavakkoli, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • How This Doctor Found Purpose After a Devastating Injury
  • House Lawmakers Squabble Over HHS Budget
  • Infant Formula Crisis Exposed FDA and Industry Failings, Lawmakers Say
  • Building Vaccine Trust Among the General Public
  • Is It Business as Usual for the Drug Industry?

Meeting Coverage

  • Phase III Trials 'Hit a Home Run' in Advanced Endometrial Cancer
  • Cannabis Use Common in Post-Surgery Patients on Opioid Tapering
  • Less Abuse With Extended-Release Oxycodone, Poison Center Data Suggest
  • Novel Strategies Show Winning Potential in Ovarian Cancer
  • Children Do Well With Fewer Opiates After Surgery
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • The untold struggles patients face with resident doctors

      Denise Reich | Conditions
    • The psychoanalytic hammer: lessons in listening and patient-centered care

      Greg Smith, MD | Conditions
    • The heart of a Desi doctor: Balancing emotions and resources in oncology

      Dr. Damane Zehra | Physician
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • The heart of a Desi doctor: Balancing emotions and resources in oncology

      Dr. Damane Zehra | Physician
    • Safe sex for seniors: Dispelling myths and embracing safe practices [PODCAST]

      The Podcast by KevinMD | Podcast
    • Overcoming Parkinson’s: a journey of laughter and resilience

      Cynthia Poire Mathews, FNP | Conditions
    • The untold struggles patients face with resident doctors

      Denise Reich | Conditions
    • Maximize sleep efficiency with stimulus control

      Pedram Navab, DO | Conditions
    • The Iranian diaspora’s fight for liberty: Overcoming challenges in the largest women’s rights movement of our century

      Montreh Tavakkoli, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Treating LGBTQ youth affected by violence: Here’s what you should know
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...