Vector Volume 11 Issue 2 - 2017

Sexual health
LGBTQIA+ individuals may also experience poorer
sexual health. There is evidence to suggest that women
who have sex with women (WSW) are at higher risk for
cervical cancer.[32] Both patients and clinicians lack
awareness around sexually transmitted infection (STI),
specifically human papilloma virus (HPV), transmission
during cisgender woman to woman sexual contact.
Consequently, WSW are less likely to have Pap or other
cervical smears.[33]
Key LGBTQIA+ health issues
Besides issues of access, LGBTQIA+ individuals have
specific healthcare risks, needs and concerns. Pertinently,
LGBTQIA+ individuals have significantly poorer mental
and sexual health. They also have higher incidence of
certain chronic diseases such as cardiovascular disease,
asthma and diabetes.[30]
Mental health
Poorer mental health is one of the ways that stigma
affects LGBTQIA+ individuals’ wellbeing. Compared to
the general population, LGBTI people in Australia are
five times more likely to attempt suicide in their lifetimes
and more specifically, TGD-identifying individuals are
eleven times more likely.[31] LGBT people are also twice
as likely to be diagnosed and treated for mental health
disorders, and 24.4% of LGBT people aged 16 and over
currently meet the full criteria for a major depressive
episode.[31]
Reasons for poorer mental health are also based in
internalised, inter-personal, organisational and structural
stigma and discrimination.[31] These include: bullying at
schools, lack of bullying laws, ostracism from families
and faith communities, fear of employment and economic
stability, and inner conflict and internalised phobia
about their respective identities. LGBTQIA+ individuals
also have higher risk for poor coping mechanisms and
substance abuse.[32]
In addition, MSM have greater incidence of HIV. In
Australia, HIV transmission occurs primarily through
male-to-male sex with 68% of new HIV diagnoses in 2015
having been attributed to male-to-male sex.[34] Besides
the greater susceptibility of anal mucosa, this increased
incidence arises from the concentration of HIV within
MSM sexual networks in Western nations.[35] Receptive
anal intercourse in male-to-male sex may also increase
risk of hepatitis B, HPV and herpes.[32] In NSW, MSM
are also more likely to report ever having had an STI,
particularly chlamydia, pubic lice, genital herpes, syphilis,
anal warts and gonorrhoea.[36] As some of these STIs
are risk factors for anal cancer, MSM are also at greater
risk for anal cancer.[32] However, MSM are also more
likely than any non-MSM to be tested for STIs.[36]
Furthermore, poor data collection means that the
sexual health of TGD populations in Australia remain
poorly understood. The tendency to collapse TGD
experiences into a single ‘third gender’ category ignores
the vast differences in risk associated with different
gender identities, sexual orientations and partners. For
example, the Kirby Institutes’ 2016 annual report on
STIs recorded sex as ‘male’, ‘female’ and ‘transgender/
missing’.[37] This is particularly disappointing in the
context of trans women in particular being significantly
overrepresented in global HIV prevalence.[38]
Aging
Owing to Australia’s aging population, the issue of older
Key messages
• LGBTIQA+ people face barriers to healthcare access,
historically influenced by discrimination from the medical profession
• Health disparities exist between LGBTIQA+ individuals and
the general population, particularly in the areas of mental health,
sexual health and chronic disease
• Further research and education, a collective effort to treat
LGBTIQA+ people with individual respect, and a willingness to learn,
will help to reduce health inequalities
*In certain parts of this article, terms to refer to the sex, sexuality and gender diverse individuals may change dependent
on the groups of people being researched in the various research articles cited.
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