Stanford program helping address marginalization of LGBTQ+ health needs

LGBTQ community affected by high healthcare barriers

According to the latest study by the American Cancer Society, LGBTQ+ individuals experience discrimination and minority stress that may lead to elevated cancer risk.

The study showed that people in the LGBTQ+ population have a higher prevalence of smoking, obesity, and alcohol consumption, which contribute to the cancer burden. The study concluded that health systems need to systematically increase awareness of the unique needs of the community to help mitigate the risk for these types of disease.

 But many health institutions are not informed, or equipped, to handle the unique health care needs. For Rey Luna, he knows what it's like to be marginalized by medicine. Luna started his transition five years ago when he was 27 years old, but his journey to this point started much earlier. As a young child, he knew typical gender stereotypes just didn't fit.

"I felt uncomfortable, I felt ashamed, I felt embarrassed and just all around sad," Luna said.

He had never heard the term gender dysphoria, until a therapist suggested he do a little research, and something clicked.

"It was just mind-blowing. I literally just cried and like was happy, and then, I was like, 'Dang, this looks like it's going to be hard," Luna recalled.

The first challenge was finding the right medical team, but the transition didn't start and end with hormones. He knew he still had to take care of all areas of his medical care. And that included getting a pap smear, but a doctor turned him away.

 "I just kept experiencing stuff like that where people were just looking at me wild. And it just felt like a lot of people were uncomfortable with it and having that prejudice," Luna said.

Dr. Benji Laniakea is the chief of the Stanford LGBTIQ+ adult clinical program.

"We have to remember that until 2013 having gender affirming care was actually pathologized as having gender identity disorder, and until the 1970's even just being gay was identified as having a homosexual disorder rather than recognizing these as distinct identities and communities that had distinct health care needs," Dr. Laniakea told KPIX.

Dr. Laniakea said there are nuances to medical care for LGBTQ+ patients that often isn't covered in most medical schools. They make the curriculum for training future doctors at Stanford.

"Our patients may not necessarily have bodies that align with their legal sex or their sex assigned at birth even, right. So, making sure that we are able to do things like cancer screening appropriate for the body parts that are available. Transmasculine individuals that have had top surgery which is male chest reconstruction to reduce chest tissue and to create a more masculine appearance. Removing a lot of tissue that would normally have been screened for breast cancer. Not all of this tissue may not be removed so the nuance needs to be there and the appropriate screening afterwards. Our transfeminine patients who develop breast tissue often later in life compared to their cis gender peers will need breast cancer screening, but at an interval that may differ from their cis gender peers who develop breast tissue in puberty," Dr. Laniakea explained.

Luna eventually found his medical team that was able to provide the right gender affirming care. But his transition is still a journey of discovering his true self, that's more than just a pronoun.

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