Introduction
There is ample evidence suggesting that lesbian, bisexual and transgender women experience unequal treatment by health care providers (Zuzelo, 2017). Taking into consideration the fact that nurses are on the frontline of the delivery of health care services to marginalized communities, they have to be able to use the most recent resources and tools in order to “assess and positively transform health care environments to ensure high-quality care for LBT women” (Zuzelo, 2017, p. 520). The aim of this paper is to review a case study of 45 years old lesbian woman who seeks treatment for depression and to discuss the biophysical, psychological, sociocultural, health system, and behavioral factors that have to be taken into consideration by a health care professional interviewing her.
Analysis
Betty reported during an interview with a community health care nurse that “she is tired of living the old way, and she is now involved with women and considers herself a lesbian” (Case Study, n.d., p. 1). Moreover, she revealed that during the last three years, she has been going through the bisexual phase of her sexual life (Case Study, n.d., p. 1). Taking into consideration the fact that the patient is 45 years old, it can be argued that she has entered the new stage of her sexual development at a fairly advanced age (Case Study, n.d., p. 1). It means that she might not be familiar with the health risks that are specific to lesbian women.
Her unwillingness to receive a pap smear supports this assumption. The following psychological and biophysical factors operate in this situation: greater risks of anxiety, stress, and depression as well as higher morbidity rates due to breast, colon, and uterine cancers among others (Hayman, Wilkes, Halcomb, & Jackson, 2013). Lesbian, bisexual, and transgender (LBT) women are also known to be more prone to heart diseases. On the behavioral level, LBT women have a higher proclivity for risky health behaviors such as drinking, smoking, and misusing drugs. Heteronormative health care services and refusal of services are the main health system factors affecting sexual minorities. On the sociocultural level, LBT women are more likely to be subjected to stigmatization, discrimination, and homophobia than heterosexual women (Hayman et al., 2013).
In order to provide LBT patients with more sensitive and effective care, it is necessary to remember that therapeutic relationships should be based on inclusiveness and individualized, patient-centered approach to the delivery of health care services. Therefore, health care professionals should take active steps in order to remove barriers caused by heterosexual assumptions during all interactions with their patients. Nurses have to remember that by presuming vulnerable populations to be heterosexual, it is possible to severely damage their psychological health and marginalized them even further (Hayman et al., 2013). It is also necessary to avoid inappropriate questioning and reveal undue curiosity during interviews with LBT patients.
It is clear that depression and marginalization are major concerns of the woman. In order to provide her with quality care, the community health nurse should play the role of the patient’s advocate who is willing to listen and use preferred terminology and pronouns while referring to her.
Conclusion
The paper helped to understand that LBT women experience significant levels of victimization and marginalization. Therefore, the community health nurse has to be cognizant of all biophysical, psychological, sociocultural, health systems, and behavioral factors affecting such patients in order to deliver safe and efficient health care services.
References
Case Study (n.d.)
Hayman, B., Wilkes, L., Halcomb, E. J., & Jackson, D. (2013). Marginalised mothers: Lesbian women negotiating heteronormative healthcare services. Contemporary Nurse, 44(1), 120-127.
Zuzelo, P. R. (2017). Improving Nursing Care for Lesbian, Bisexual, and Transgender Women. Journal of Obstetric, Gynaecologic & Neonatal Nursing, 43(4), 520-530.