{"id":3975,"date":"2021-06-28T15:26:00","date_gmt":"2021-06-28T15:26:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=3975"},"modified":"2025-09-04T12:25:59","modified_gmt":"2025-09-04T20:25:59","slug":"a-discussion-around-lgbtq-health","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/a-discussion-around-lgbtq-health","title":{"rendered":"A Discussion Around LGBTQ+ health"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_80 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/a-discussion-around-lgbtq-health\/#Dont_ask_Dont_tell_%E2%80%93_No_more\" >Don\u2019t ask, Don&#8217;t tell &#8211; No more!<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/a-discussion-around-lgbtq-health\/#A_deep_dive_into_LGBTQ_medicine\" >A deep dive into LGBTQ+ medicine<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/a-discussion-around-lgbtq-health\/#Pre-exposure_prophylaxis_PrEP\" >Pre-exposure prophylaxis (PrEP)&nbsp;<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/a-discussion-around-lgbtq-health\/#Sexually_Transmitted_Infections_STIs\" >Sexually Transmitted Infections (STIs)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/a-discussion-around-lgbtq-health\/#The_lesbian_community\" >The lesbian community<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.osmosis.org\/blog\/a-discussion-around-lgbtq-health\/#The_bisexual_community_and_their_unique_concerns\" >The bisexual community and their unique concerns&nbsp;<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.osmosis.org\/blog\/a-discussion-around-lgbtq-health\/#The_transgender_community_and_hormone_therapy\" >The transgender community and hormone therapy&nbsp;<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/www.osmosis.org\/blog\/a-discussion-around-lgbtq-health\/#LGBTQ_Fellowship\" >LGBTQ+ Fellowship<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/www.osmosis.org\/blog\/a-discussion-around-lgbtq-health\/#References\" >References<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><strong><em>When the topic of specific medical care for LGBTQ+ patients comes up, people often ask \u201cWhy?\u201d. Why is there a need for this specification? Why are there special clinics for LGBTQ+ people in Tel Aviv, New York, and Berlin? These are all cities with a very high population of people from the community, therefore with high awareness and sensitivity to that community.<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>This blog is a summary of the webinar&nbsp;<\/em><\/strong><a href=\"https:\/\/youtu.be\/rh5uduy94Tk\" target=\"_blank\" rel=\"noreferrer noopener\"><strong><em>\u201cA discussion around LGBTQ+ health\u201d<\/em><\/strong><\/a><strong><em>, led by Dr. Zucker, an Infectious diseases specialist and the first to specialize in LGBTQ+ medicine at Icahn School of Medicine at Mount Sinai, New York.<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The term LGBTQ+ is an umbrella term for&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Sexual_orientation_and_gender_identity\" target=\"_blank\" rel=\"noreferrer noopener\">Lesbian, Gay, Bisexual, Transgender, Queer<\/a>. Over the years, many more terms have fallen under this colorful umbrella which is why the plus sign has been added.&nbsp;<strong>The term LGBTQ+ medicine means medical care that specifically revolves around that community, their specific needs, and raising awareness within that community.&nbsp;<\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Dont_ask_Dont_tell_%E2%80%93_No_more\"><\/span>Don\u2019t ask, Don&#8217;t tell &#8211; No more!<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">When the topic of LGBTQ+ specific medical needs comes up, there are many who ask why there&#8217;s a need to be aware of the patients\u2019 sexual orientation and gender identity. Why is there a need for a specialization focusing on LGBTQ+ health? The answer to this is split into two.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>First, the LGBTQ+ community is less likely to seek out medical care.<\/strong>&nbsp;This may relate to their fear of &#8220;coming out&#8221; to medical staff. These people will often seek medical attention only once the symptoms are so severe that they usually need to be taken to the hospital. Even in \u201cgay-friendly\u201d cities like New York and Tel Aviv, it only takes one bad encounter with someone less accepting to make people more hesitant to seek medical care the next time.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>The second part has more to do with the future of medicine and where it is headed.\u00a0<\/strong>Medicine is becoming more and more personalized. In the past, we had only general specializations such as orthopedics and cardiology. Nowadays, orthopedics might continue to specialize in spinal surgery and cardiologists may specialize in Interventional cardiology. The same approach should and is being applied to LGBTQ+ health. Medical providers administrating hormonal treatment to a transgender patient should be able to adjust the patient\u2019s HIV prevention and treatment plan accordingly to minimize any drug-drug interactions and adverse effects. The medical provider should be also able to take into consideration possible substance issues, vaccinations and more. Until recently, there was never a structured syllabus and specialization for this kind of medical care.<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/www.osmosis.org\/plans\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_fcef23.png\" alt=\"Learn more and forget less create an osmosis account.\" class=\"wp-image-3979\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_fcef23.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_fcef23.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"A_deep_dive_into_LGBTQ_medicine\"><\/span>A deep dive into LGBTQ+ medicine<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">This blog\u2019s purpose isn\u2019t to just explain the \u201cwhy\u201d, but also the \u201cwhat\u201d and \u201chow\u201d. We cannot cover all of the topics in one blog post. Instead, we will focus on a few main topics that were introduced in the&nbsp;<a href=\"https:\/\/youtu.be\/rh5uduy94Tk\" target=\"_blank\" rel=\"noreferrer noopener\">webinar<\/a>. The main goal is to open our eyes and help all of us cultivate a more understanding mindset when seeing a patient from the LGBTQ+ community.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Pre-exposure_prophylaxis_PrEP\"><\/span><strong>Pre-exposure prophylaxis (PrEP)&nbsp;<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">According to the Centers for Disease Control and Prevention (CDC), an antiretroviral medication (containing&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Nucleoside_reverse_transcriptase_inhibitors_(NRTIs)\" target=\"_blank\" rel=\"noreferrer noopener\">tenofovir&nbsp;<\/a>and emtricitabine) will&nbsp;<a href=\"https:\/\/www.cdc.gov\/hiv\/effective-interventions\/prevent\/prep\/index.html#:~:text=The%20Centers%20for%20Disease%20Control,who%20inject%20drugs%20(PWID).\" target=\"_blank\" rel=\"noreferrer noopener\">reduce the chances of contracting HIV via sexual contact by 99%<\/a><sup>[1]&nbsp;<\/sup>if taken as prescribed. It is important to note that, yes, it does require a prescription, but any health care provider licensed to write prescriptions can prescribe PrEP.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">According to the \u201cGlobal PrEP Network\u201d, oral PrEP use is increasing globally, with a 70% increase in usage from 2017 to 2018 alone!<sup>[2]<\/sup><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Unfortunately, not everyone who might benefit from this drug receives it. For instance, In the USA it is estimated that out of the 1.1 million potential candidates, only 8% are receiving PrEP<sup>[3]<\/sup>. This disparity might be because of the patient\u2019s lack of knowledge or because the patient might need to \u201cout\u201d themselves to their medical provider to receive the prescription.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Sexually_Transmitted_Infections_STIs\"><\/span><strong>Sexually Transmitted Infections (STIs)<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">When speaking about&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Sexually_transmitted_infections:_Clinical_practice\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>STIs<\/strong><strong>&nbsp;<\/strong><\/a>we mainly refer to&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Treponema_pallidum_(Syphilis)\" target=\"_blank\" rel=\"noreferrer noopener\">syphilis<\/a>,&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Chlamydia_trachomatis\" target=\"_blank\" rel=\"noreferrer noopener\">chlamydia trachomatis (LGV &amp; non-LGV)<\/a>,&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Neisseria_gonorrhoeae\" target=\"_blank\" rel=\"noreferrer noopener\">neisseria gonorrhoeae<\/a>, and&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Sexually_transmitted_infections:_Clinical_practice\" target=\"_blank\" rel=\"noreferrer noopener\">mycoplasma genitalium<\/a>. As a healthcare provider, if a heterosexual male asks you for an STI test, you will be usually correct in sending him for a urine and blood test. Would you medically treat men who have sex with men (MSM) the same way?&nbsp;<strong>The correct answer is no.<\/strong>&nbsp;Both chlamydia and gonorrhea, are \u201csite-specific\u201d infections, meaning if the patient had oral sex we will do a pharyngeal swab and if they had anal sex we will do a rectal swab. Even now, in many countries, the guidelines for STI screening don\u2019t acknowledge the difference between patients from the LGBTQ+ community. The best approach in this case is to explain these tests and openly ask your patient about their sexual encounters to determine the screening tools that will provide the most accurate results.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The increased use of PrEP led to a decrease in the use of condoms which might increase the risk of contracting an STI<sup>[4,5]<\/sup>. This combined with the lack of knowledge of many medical providers regarding the appropriate screening tests to order, has led to many people thinking they are healthy because of a negative urine test. In actuality, a rectal or pharyngeal swab would have indicated otherwise.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_lesbian_community\"><\/span><strong>The lesbian community<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">The word LGBTQ+ represents many different groups of people. Assuming that they all share the same problem is a mistake. Each group has its own unique features.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The lesbian community suffers higher rates of breast and cervical cancer than their heterosexual counterparts. One of the main reasons for this is the low rates of lesbian women who undergo prevention and screening tests compared to their heterosexual counterparts<sup>[6,7]<\/sup>. In addition, evidence shows that the lesbian community suffers more from obesity, substance abuse, and smoking<sup>[8]<\/sup>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_bisexual_community_and_their_unique_concerns\"><\/span><strong>The bisexual community and their unique concerns&nbsp;<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">As my bisexual identifying friend always tells me, just because they enjoy both worlds doesn\u2019t mean they don\u2019t have their own unique problems. According to one study, bisexual people have higher rates of mental health issues and suicide when compared to the other members of the LGBTQ+ community<sup>[9]<\/sup>. Additionally, they experience body image issues, eating disorders, and substance abuse. According to studies, in the USA more than half of the LGBTQ+ community identifies as bisexual<sup>[10]<\/sup>.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_transgender_community_and_hormone_therapy\"><\/span><strong>The transgender community and hormone therapy&nbsp;<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">When interacting with a transgender patient (or any patient) for the first time, don\u2019t be afraid to ask what pronouns to use when addressing them. This simple question will make both of your lives easier and less awkward. Avoid the term \u201cbiological gender\u201d. Instead, ask about their assigned gender at birth and ask them about their current gender identity. If this information wasn\u2019t noted before, add it to their file to better prepare the next medical provider.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">According to a study conducted in the USA, less than 1% of Americans identify as transgender<sup>[10]<\/sup>. Despite the general misconception, most transgender people do not undergo gender reassignment surgery<sup>[11]<\/sup>. Some of them choose only to take hormones. There are many discussions regarding the age a person can start undergoing hormonal therapy. If they do start during puberty, the medical provider will administer reversible therapy with a&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Puberty_and_Tanner_staging\" target=\"_blank\" rel=\"noreferrer noopener\">gonadotropin-releasing hormones agonist<\/a>. The medical provider will administer&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Testosterone\" target=\"_blank\" rel=\"noreferrer noopener\">testosterone<\/a>&nbsp;based regimen for transgender men, and&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Estrogens_and_antiestrogens\" target=\"_blank\" rel=\"noreferrer noopener\">estrogen<\/a>&nbsp;based regimen for transgender women. For transgender women who are taking estrogen, there is an associated risk of venous thromboembolism; to reduce this risk, androgen lowering agents (e.g.&nbsp;<a href=\"https:\/\/www.osmosis.org\/learn\/Androgens_and_antiandrogens\" target=\"_blank\" rel=\"noreferrer noopener\">spironolactone<\/a>) may be added which will allow reducing the estrogen dose.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For more info on how to interact and communicate better with a transgender patient, check out my previous blog post&nbsp;<a href=\"https:\/\/www.osmosis.org\/blog\/2020\/08\/17\/how-to-provide-lgbtq-patients-with-the-best-care-possible\" target=\"_blank\" rel=\"noreferrer noopener\">\u201cHow to Provide LGBTQ+ Patients With the Best Care Possible\u201d<\/a>&nbsp;and check out&nbsp;<a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMcp1903650\" target=\"_blank\" rel=\"noreferrer noopener\">this article&nbsp;<\/a>published by the New England Journal of Medicine.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"LGBTQ_Fellowship\"><\/span>LGBTQ+ Fellowship<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">In 2015&nbsp;<a href=\"https:\/\/www.facebook.com\/zuckeroy\" target=\"_blank\" rel=\"noreferrer noopener\">Dr. Zucker<\/a>&nbsp;was sent to Berlin to conduct research in Cardiology. During his visit, he stumbled upon his first LGBTQ+ medical center. The Berlin medical center took care of 25,000 people. Once back in Israel, he started taking more interest in transgender health, HIV, STDs and preventative care. He joined the Gan Meir LGBTQ+ clinic in Tel Aviv in 2017. His interests led him to specialize in infectious diseases. Nowadays, Dr. Zucker is the first medical provider in the world sub-specializing in LGBTQ+ medicine at Mount Sinai hospital in New York. In addition, Dr. Zucker started a program called \u201cParty Keepers\u201d in Israel. The program trains non-medical people in how to correctly provide first aid to someone who has overdosed during a party. He is now starting a similar program in New York.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>If you have reached this far in the blog I hope you will agree that even if in 10, 20, or 30 years, being queer will be so normal it\u2019s boring. The medical attention given to the LGBTQ+ community should still be specific and targeted to provide the best medical care possible.&nbsp;<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>About Omer<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Omer Rott is a fourth-year medical student at&nbsp;<\/em><a href=\"https:\/\/www.muni.cz\/en\" target=\"_blank\" rel=\"noreferrer noopener\"><em>Masaryk University<\/em><\/a><em>, Brno, located in the Czech Republic. A Regional Lead in the&nbsp;<\/em><a href=\"https:\/\/www.osmosis.org\/omef\" target=\"_blank\" rel=\"noreferrer noopener\"><em>Osmosis Medical Education Fellowship program<\/em><\/a><em>, he is interested in Pediatrics. During his free time, Omer enjoys reading, baking, photography, and playing board games with his friends.&nbsp;<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>_________________________<\/em><\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><a href=\"https:\/\/www.osmosis.org\/plans\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_78ea40.png\" alt=\"Osmosis sign up ad\" class=\"wp-image-3980\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_78ea40.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/09\/image_78ea40.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Try Osmosis today! Access your\u00a0<a href=\"https:\/\/www.osmosis.org\/login?type=create\" target=\"_blank\" rel=\"noreferrer noopener\">free trial<\/a>\u00a0and find out why millions of current and future clinicians and caregivers love learning with us.<\/em><\/strong><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span>References<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Cottrell ML, Yang KH, Prince HMA, et al. A Translational Pharmacology Approach to Predicting Outcomes of Preexposure Prophylaxis Against HIV in Men and Women Using Tenofovir Disoproxil Fumarate With or Without Emtricitabine. J Infect Dis. 2016;214(1):55-64.<\/li>\n\n\n\n<li><a href=\"https:\/\/www.who.int\/news-room\/feature-stories\/detail\/global-data-shows-increasing-prep-use-and-widespread-adoption-of-who-prep-recommendations\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.who.int\/news-room\/feature-stories\/detail\/global-data-shows-increasing-prep-use-and-widespread-adoption-of-who-prep-recommendations<\/a><\/li>\n\n\n\n<li>Siegler AJ et al. Distribution of active PrEP prescriptions and the PrEP-to-need ratio, US, Q2 2017. 25th Conference on Retroviruses and Opportunistic Infections (CROI 2018), Boston, abstract 1022LB, 2018.<\/li>\n\n\n\n<li>Kojima, N., D.J. Davey, and J.D. Klausner, Pre-exposure prophylaxis for HIV infection and new sexually transmitted infections among men who have sex with men. AIDS, 2016. 30(14): p. 2251-2.<\/li>\n\n\n\n<li>Nguyen, V.K., et al., Incidence of sexually transmitted infections before and after preexposure prophylaxis for HIV. AIDS, 2018. 32(4): p. 523-530.<\/li>\n\n\n\n<li>Dana L. Brandenburg PsyD, Alicia K. Matthews PhD, Timothy P. Johnson PhDM &amp; Tonda L. Hughes PhD and RN and FAAN (2007) Breast Cancer Risk and Screening: A Comparison of Lesbian and Heterosexual Women, Women &amp; Health, 45:4, 109-130, DOI: 10.1300\/J013v45n04_06<\/li>\n\n\n\n<li>J. Kathleen Tracy, Alison D. Lydecker, and Lynda Ireland.Journal of Women&#8217;s Health.Feb 2010.229-237.<a href=\"http:\/\/doi.org\/10.1089\/jwh.2009.1393\" target=\"_blank\" rel=\"noreferrer noopener\">http:\/\/doi.org\/10.1089\/jwh.2009.1393<\/a><\/li>\n\n\n\n<li>Weisz, V. K. (2009). Social justice considerations for lesbian and bisexual women&#8217;s health care. Journal of Obstetric, Gynecologic &amp; Neonatal Nursing, 38(1), 81-87.<\/li>\n\n\n\n<li>Chan RCH, Operario D, Mak WWS. Bisexual individuals are at greater risk of poor mental health than lesbians and gay men: The mediating role of sexual identity stress at multiple levels. J Affect Disord. 2020;260:292-301. doi:10.1016\/j.jad.2019.09.020<\/li>\n\n\n\n<li>Gates, G. J. (2011). How Many People are Lesbian, Gay, Bisexual and Transgender? UCLA: The Williams Institute. Retrieved from\u00a0<a href=\"https:\/\/escholarship.org\/uc\/item\/09h684X2\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/escholarship.org\/uc\/item\/09h684X2<\/a><\/li>\n\n\n\n<li>Table 1, Nolan, I. T., Kuhner, C. J., &amp; Dy, G. W. (2019). Demographic and temporal trends in transgender identities and gender confirming surgery. Translational andrology and urology, 8(3), 184\u2013190.\u00a0<a href=\"https:\/\/doi.org\/10.21037\/tau.2019.04.09\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/doi.org\/10.21037\/tau.2019.04.09<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>When the topic of specific medical care for LGBTQ+ patients comes up, people often ask \u201cWhy?\u201d. Why is there a need for this specification? Why are there special clinics for LGBTQ+ people in Tel Aviv, New York, and Berlin? 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