In 2015, roughly 300,000 individuals from the LGBT community received social services from LGBT organizations. There have been several studies conducted, with researchers seeking to understand why and how people in the LGBT community go about accessing health care and other social services. However, time and time again, the answer is unknown. Researchers often focus on health care nationwide, and neglect to hone in on the LGBT community (Matros, Wilson, & Meyer, 2017).
LGBT or GLBT are acronyms used in reference to those who are non-heterosexual or non-gender conforming. LGBT stands for Lesbian, Gay, Bisexual, and Transgender—and serves as an umbrella term. Queer—like dyke and other words—was once used derogatorily towards the LGBT community, but has been reclaimed in recent years and now serves as an umbrella term as well. When talking about the LGBT community, it is more of an “imagined” community. This acronym groups together various collections of people, but this does not necessarily mean that all lesbians are unified or all bisexuals are all unified. Rather this term is used more so for its quick reference to vast groups of diverse individuals in the academic and political arenas (Wooten, 2014).
Tin and Redburn (2008) use the Concise Oxford Dictionary, to define homophobia as: “An extreme and irrational fear aversion to homosexuality and homosexuals” (p. 11). Homophobia, much like the word queer, umbrellas various phobias pertaining to the LGBT community. It is explained by Erdley, Anklam, and Reardon (2014), that most queer adults experience homophobia and heterosexism—which is: “a belief system that values heterosexuality as superior to and/or more ‘natural’ than homosexuality.” Which explains why homophobia and heterosexism often go hand-in-hand. For LGBT individuals, facing discrimination in potentially any facet of their daily lives, the likelihood of outreach from this community—most especially in terms of access to social services— is less likely to occur (Erdley, Anklam, & Reardon, 2014).
While discrimination manifests from the many of the isms and phobias, there are not many studies aimed at discrimination in relation to sexual identity or gender identity. Discrimination is defined as: “a socially structured and sanctioned phenomenon, justified by ideology and expressed in interactions, among and between individuals and institutions, intended to maintain privileges for members of [certain] groups at the cost of deprivation of others” (Krieger, 2000 as cited in Bostwick, Boyd, Hughes, West, & McCabe, 2014, p. 35-36). Many LGBT adults are less apt to seek-out social services because they fear being discriminated against.
In relation to the discrimination of LGBT individuals, is stigma. As defined by Whitehead, Shaver, and Stephenson (2016), discrimination towards non-heteronormative individuals, primarily because they break the social norm. Stigma presents itself in three variations: anticipated (future possibilities of encountering discrimination), internalized (weak sense of self), and enacted (experiences where discrimination is present) stigma. It plays a role in a LGBT persons “outness”—whether or not someone discloses their gender/sexual identity to others (Whitehead, Shaver, & Stephenson, 2016). By knowing this, professionals can interact with LGBT persons with a sense of knowledge and competence.
LGBT Historical Significance
In 1869, an advocate by the name of K. M. Berny first used the word many LGBT persons were referred to, homosexual—“those with a ‘healthy love for their own sex’” (Erdley et al., 2014). Homosexual soon after was used by others, to discuss LGBT persons, and to deem those LGBT-identifying as diseased or sick. The term homosexuality was also listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM) for a 100 years, until it was removed by the American Psychological Association in 1974, disregarding the evidence that showed homosexuality was not a cause of psychological anomalies.
With the AIDS epidemic and the Stonewall Riots, came lots of hysteria amongst the LGBT community. Acquired Immune Deficiency Syndrome (AIDS), the most severe level of Human Immunodeficiency Virus (HIV), catapulted what is known today as the AIDS epidemic. The AIDS epidemic began in the 1980s and took the lives of many, but was believed to only affect “homosexuals.” Thousands of lives were lost, due to the lack of education on the syndrome and discrimination towards LGBT persons. In some way, most individuals from the LGBT community have been impacted by this epidemic—either from watching loved ones die, having survivor’s guilt, contracting HIV/AIDS themselves, etcetera. Another factor that is important to note when discussing the AIDS epidemic is the silence of President Ronald Reagan. He does not speak up about AIDS until several years after the epidemic began, and his responses are generic and refer to the youth needing to be “abstinent” and being taught values (Erdley et al., 2014; Fredriksen-Goldsen, Hoy-Ellis, Goldsen, Emlet, & Hooyman, 2014; “What are HIV and AIDS?”, 2018).
As for the Stonewall Riots, these took place midyear in 1969, starting in New York. These riots took place at the Stonewall Inn, during a time when police would often raid bars and such to arrest people they suspected to be LGBT. Outraged by the police raids, LGBT members retaliated with six days worth of demonstration, beginning the uprising of the gay rights movement (Faderman, 2016).
Due to the AIDS epidemic and Stonewall Riots being so influential in LGBT history, and the term homosexuality aligning with the heteronormative framework of the time, and staying that way for so long, only furthered implanted the stigma and discrimination that surrounds the LGBT community (Erdley et al., 2014).
Effects of Discrimination and Stigma on the LGBT Community
The impact of discrimination and stigma on an LGBT individual is detrimental in terms of their well-being. Bullying and harassment arise when an adult or youth differ from the heteronormative structure of society. For instance, Erdley et al. (2014) finds that: “… the risk of suicide, especially among the aging LGBT population, in comparison to heterosexual adults is roughly two to four times higher” (p. 363); and Lennon-Dearing and Delavega (2015) noted that: “… LGBT youths suffer from emotional distress, depression, self-harm, suicidal ideation, and suicide attempts at greater rates than heterosexual youths” (p. 414). Both studies show that barriers that contribute to the discrimination and stigma of LGBT persons are tend to have a significant relationship to discrimination or stigma.
Amongst the LGBT population, the risk of erasure has always been posed in some way or another. Whether it be within the community itself, like with the exclusion of transgender persons, or with the erasing of bisexuals. Although, currently with the Trump administration, the possible removal or sexual orientation from data inquiry is in question, as well as, the erasure of trans rights by trying to change the definition of gender to one that is more binary. And while this is not the first time trans rights or LGBT rights in general, have been threatened, still after countless hardships, LGBT people and their allies, have to continue fighting for their civil and human rights (Loewy, 2017).
Being that many older LGBT adults face social isolation, they usually have support networks that typically consists of friends or chosen family. Though, to obtain these social supports, poses difficult, especially to those living in rural areas or alone (Loewy, 2017, p. 1217). Isolation can be further triggered with stress from factors like, economic status, discrimination, and more. Erdley et al. (2014), states that: “… isolation in older LGBT adults can lead to negative social and individual outcomes, including poor medical and mental health” (p. 371). To rid LGBT adults of isolation, starting within agencies and programs to be inclusive of LGBT persons and serve with cultural competence is seen as beneficial (Erdley et al., 2017; Loewy, 2017; Frost, Meyer, & Schwartz, 2016).
Mental and Physical Health
Taking into consideration how often discrimination takes precedence in LGBT lives is important because they are impacted by how others view them. Bias, discrimination, stigma, and more are attributed to whether or not LGBT persons have access to proper health care services. Like non-LGBT individuals, LGBT persons have mental and physical health issues. And along with these issues, there is the additional stigma to utilizing health care services too—with an emphasis on mental health services. Depression, suicide, substance abuse, physical and emotional abuse, tend to be at higher rates than non-LGBT mental health issues. In having discrimination present in many facets of their lives, access to health care or culturally competent programs/services furthers diminishes the mental and physical health of LGBT individuals (Hash & Rogers, 2013; Loewy, 2017).