Providing Care for Lesbian, Gay, Bisexual, and Transgender Immigrants at Health Centers and Clinics

Coloniality and Ethnic Variation in Psychological Distress Among US Latinx Immigrants

To address ethnic variation and potential cross-cultural measurement error in diagnostic criteria, this study extends on the racialized ethnicities framework to examine how Latinxs' self-reported psychological distress differ among ethnic groups. Utilizing data from the National Health Interview Survey, logistic regression models and partial proportional odds models assessed differences in likelihood of self-reporting frequent anxiety, depression, and psychological distress among Mexican, Puerto Rican, Cuban, Dominican, and Central and South American immigrants. Membership in Caribbean Latinx ethnic groups, and the Puerto Rican ethnic group in particular, was significantly associated with higher predicted probabilities of frequent anxious and depressive feelings, and severe psychological distress, relative to membership in non-Caribbean Latinx ethnic groups. This work highlights the need for research on Latinxs to disaggregate among ethnic groups, and proposes the existence of a gradient of exposure to the psychosocial consequences of US coloniality that might explain some of these variations.

An Examination of Posttraumatic Stress Disorder-Related Symptoms Among a Sample of Latinx Sexual- and Gender-Minority Immigrants

Latinx sexual- and gender- minority (SGM) immigrants experience stress across multiple axes of identity, which can lead to negative health consequences. Using an intersectional-cultural theory of stress, the current study sampled 194 Latinx SGM immigrants to examine the association between intersectional discrimination (i.e., race- and sexual orientation-based), acculturative stress, symptoms related to posttraumatic stress disorder (PTSD), and somatic distress. We used moderated hierarchical linear regression analysis to determine whether social support moderated the associations among intersectional discrimination, acculturative stress, and PTSD symptoms. The results showed that after controlling for time in the United States, PTSD symptoms were associated with intersectional discrimination, β = .57, SE = 3.14, p < .001, and acculturative stress, β = .42, SE = 2.47, p < .001, at higher levels of social support. The variability in outcome explained by the variables of interest was approximately 47%. These findings offer important and timely data that can inform future research and clinical applications in this underserved and understudied community.

Queering nursing curricula: Understanding and increasing attention to LGBTQIA+ health needs

BACKGROUND

The LGBTQIA+ community has a long history of marginalization, disenfranchisement, and structural violence within the healthcare sector. Sexual and gender minority individuals may be wary of disclosing sexuality-related information to providers, and providers may not have received education on creating therapeutic relationships with these individuals.

PURPOSE

This paper explores factors that shape LGBTQIA+ individuals' daily lives and how these may influence care encounters. We argue for broadening nursing education to incorporate more specific and efficacious LGBTQIA+ education.

DISCUSSION

We propose that consideration of LGBTQIA+ care in nursing education is an important means of meeting the American Association of Colleges of Nursing (AACN) Essentials of Baccalaureate Education for Professional Nursing. We further suggest specific strategies for so doing.

CONCLUSION

Attending to the inclusion of LGBTQIA+ populations when developing and planning nursing education activities assures that newly-graduated nurses can be safe, effective, and nonjudgmental providers of care to a variety of populations.

"They feel empowered to discriminate against las chicas": Latina transgender women's experiences navigating the healthcare system

BACKGROUND

Transgender Women of Color are more likely to experience oppression at the hands of healthcare providers than their transgender White counterparts. However, there is a paucity of research on the experiences of Latina transgender women in the United States.

AIMS

Using an intersectionality theory framework, the present study aimed to investigate the factors that contribute to Latina transgender women's decision to seek or refuse healthcare services and Latina transgender women's experiences with healthcare providers in the United States.

METHODS

A community sample of 15 Latina transgender women at a large metropolitan city in Florida participated in a focus group to explore their experiences with seeking out and accessing healthcare services.

RESULTS

Thematic analysis revealed five themes: 1) experiences in seeking healthcare, 2) the effects of hormones on mental health, 3) resistance, 4) imparting collective knowledge, and 5) recommendations to healthcare providers.

CONCLUSIONS

Through collective dialog these women gave voice to their needs and pains in the context of healthcare while also positioning themselves as agentic, resistant, and aware of the power of collectivism in the process of healing. The current findings support and extend calls for training improvements related to transgender populations, giving voice not only to the need for training but specifying immigrant Latina transgender women's desire for such training. Also, elements related to Latinx cultural values (e.g., convivencia, familismo) must be considered when working with Latina transgender women.

“Things Are Different Now But”: Older LGBT Adults’ Experiences and Unmet Needs in Health Care

Background: Approximately 2.7 million U.S. older adults self-identify as lesbian, gay, bisexual, and transgender (LGBT). Many felt unsafe revealing their sexual orientation until relatively recently, and may still not be “out” to medical providers. The aim of this study was to increase understanding of the experiences and needs of older LGBT adults when accessing care. Method: Individual semistructured interviews were conducted with 10 individuals aged 65 years or older from a local LGBT community. Interviews were audio taped and transcribed verbatim. Transcripts were analyzed via thematic analysis. Results: Major themes were “Outness,” “Things are Different Now,” and “Additional Resources.” These describe participant comfort with being “out”; how treatment they received changed over time, and needed services or other options from the community. Conclusion: While many older LGBT adults are accustomed to navigating social mores to avoid negative experiences, nurses as well as other health care providers must be prepared to create trusting relationships with these individuals to provide truly comprehensive care.