Pride in practice: Equality in access to health services for the LGBT community in a third-world country

This article was exclusively written for The European Sting by Mr. Mabel Guerrero and Ms. Claudia Suero, two second-year medical students at the Iberoamerican University (UNIBE) in Santo Domingo, Dominican Republic. They are affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

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The LGBT community, also called the gay community, includes the lesbian, bisexual, gay, transgender and subcultures that are joined together by common social movements and culture. This community celebrates sexuality, individuality, pride and most important, the diversity. LGBT has been associated with many symbols that reflect what they really are and want to express, including rainbows and rainbow flags. They represent the diversity, a rage of different things, ideals and social acceptance in spite of the sexual orientation. The diversity of this community has led this population to face discrimination, violence and other human rights transgression worldwide because of their sexual orientation and gender identity. All of these partisanship are influenced largely by the stigma that some people still have against them, and the lack of acceptance that regardless of the sexual orientation we all have inalienable rights. Despite that fact that all individuals have the right to health, this community is confronting different situations where their rights have been interrupted. Today, they are still fighting for this rights on different areas that include good services, equal employment opportunities, registered partnerships for couples, children adoption and last but not least, the right to have the same access to medical care and treatments (1). Even though health is a human right, this community has been afflicted by the marked exclusion and violation of fundamental human rights, especially for Lesbians, Gays, Bisexuals, and Transgenders (LGBT) community present in many counties, particularly those known as third-world nations. This situation is reflected in the lack of access to health services by that population of this minority social group. Nowadays, over one third of LGBT individuals reported experiencing bias or discrimination from a healthcare provider, and about a third also reported that they do not discuss their sexual identity with their healthcare provider, resulting in a additional medical risk factor (2). On account of the Dominican Republic, an underdeveloped country, a public opinion study on Gender Inequality, Reproductive Health and Discrimination against Sexual Minorities and People with HIV, conducted by UNAIDS in 2015 indicates that 85% have been discriminated in healthcare centers. Some examples of conduct of rejection and discrimination listed included denial of services, speak contemptuously, teasing, and public humiliation. Furthermore, the reduction in attendance and the subsequent search for assistance by the LGBT community is a result of the marginalization in health services which reduces the chance of developing educational a preventive health work for them, which will limit the approach to certain diseases that are very common in this group, such as syphilis, hepatitis B, depression, anxiety, and HIV (3). For this reason, it is necessary to train the healthcare personnel to properly address patients in the LGBT community through guidelines on how to use an inclusive language that respects different sexual orientations and gender identities, and to be aware that patients may have been subjected to unequal treatment throughout their life, due to financial, social and health situations. These considerations must be implemented nationwide, especially in countries known to have a strong conservative culture, and where the healthcare personnel may be predisposed to this population, making it difficult to deliver proper health services. Finally, we consider that it is vital for physicians to remember that all people have the right to quality health services, regardless of their sexual preferences, ideals or appearance. References

1. Whitman L. The State of LGBT Human Rights Worldwide [Internet]. Amnesty International USA. 2019 [cited 28 June 2019]. Available from: https://www.amnestyusa.org/the-state-of-lgbt-rights-worldwide/
2. Richards, S. (2012) Gay and bisexual men ‘neglected’ by primary health services. Practical Nurse, 42 (8), 7.
3. Milles A. Problemas de salud de los jóvenes homosexuales [Internet]. HealthyChildren.org. 2019 [cited 28 June 2019]. Available from: https://www.healthychildren.org/spanish/ages-stages/teen/dating-sex/paginas/health-concerns-for-gay-and-lesbian-teens.aspx

About the author Mabel Guerrero is a second-year medical student at the Iberoamerican University (UNIBE) in Santo Domingo, Dominican Republic. She serves as an active member of Standing Committee on Sexual and Reproductive Health and Rights including HIV and AIDS (SCORA) of IFMSA-Dominican Republic (ODEM). She has a profound passion for volunteering, medicine and science. She also is an active member of the UNIBE Gynecology and Obstetrics Interest Group (GOING). Claudia Suero is a second-year medical student at the Iberoamerican University (UNIBE) in Santo Domingo, Dominican Republic. She serves as an active member of the Standing Committee of Professional Exchanges (SCOPE) of ODEM-Dominican Republic. Since a year ago she is part of the Biology area at UNIBE as a monitor. She is passionate about helping other people and teaching medicine.