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HEALTH CARE NEEDS OF

SAME SEX PARTNERSHIPS


DR O.A. SHOLOTAN
DR K.M.KUTI
26/1/11
OUTLINE
INTRODUCTION
SEXUALITY AND SEXUAL RIGHTS
DEFINITION
EPIDEMIOLOGY
HEALTH CARE CONCERNS
LITERATURE REVIEW
HEALTH CARE NEEDS
PRIMARY CARE MANAGEMENT
GAY RIGHTS VS DOCTORS RIGHTS
CONCLUSION

INTRODUCTION
1
The health care of gay, lesbian, bisexual and
transgender (GLBT) patients may not be a
component that family physicians are prepared
for or incorporate into their practice.
The AAFP asserts in its policy on patient
discrimination that discrimination in any form
including sexual orientation and gender identity
is unethical.
Family physicians should be prepared to offer a
standard of treatment that is inclusive of
heterosexual men and women or those in the
GLBT community.




Importance

Homosexuality is not a western issue .

March 11 2009, Openly gay people
stormed the National Assembly in Abuja
seeking for legislation that will guarantee
the protection of what they termed their
right to determine their sexual orientation.
Importance
2

According to an article by Chude Jideonwo in
the Next Article Color me Gay (June 1 2010) -
the ED of International centre for Sexual
Reproductive Rights claimed to have 52
registered lesbian ladies
Same article also quotes an official of the group
Alliance Rights as having 2000 registered
homosexuals in the country.
If we as Family Physicians will provide holistic
care we must be aware of issues of sexuality.
HISTORY OF
HOMOSEXUALITY
3
Abrahamic times Gen 19: 1-11
Americas: Shamans and Mayans
East Asia: Shudo and Samurai
Europe: Sappho of Lesbos
Africa: Motsoalle in Lesotho, Azande
warriors, Northern Congo.
Middle East, South and Central Asia:
Koceks, Bachas, Sufi
South Pacific: Hetero and Marindanim.(1,2)

Sexual rights
4


Include the right of all individuals, free of
coercion, discrimination and violence, to the
highest attainable standard of sexual health,
including access to sexual and reproductive
health care services;
Seek, receive, and impart information related to
sexuality
Sexuality education
Respect for bodily integrity
Choose their partner
Decide whether or not to be sexually active
Consensual sexual relations


Terms
Sexuality
Sexual Identity
Sexual Behaviour
Gender Identity
Sexual Orientation
Sexuality
6
Sexuality is a central aspect of humanity
and encompasses sex, gender identities
and roles, sexual orientation, eroticism,
pleasure, intimacy, and reproduction.
Sexuality is experienced and expressed in
thoughts, fantasies, desires, beliefs,
attitudes, values, behaviours, practices,
roles, and relationships.

Sexual Identity
6
A multidimensional construct that :
includes sex identity (primary and secondary
sexual characteristics),
gender identity (the expected behaviours in a
cultural context according to biological sex at
birth),
socio-sexual identity (self-identification with a
particular social group), and
erotic identity (erotic attraction to a particular
gender)

Sexual Identity
Sexual identity describes how persons
identify their own sexuality.
This may or may not relate to their actual
sexual orientation.
7

Sexual Identities- Lesbian, Gay and
Bisexual (LGB), Heterosexual,
Homosexual




Sexual Behaviour
8
Defined as a persons actual sexual
practices
Gender Identity
Defined as gender identity (the
psychological sense of being male or
female),
Sexual Orientation
Sexual orientation is an enduring pattern
of emotional, romantic, sexual, or
affectional attraction toward others .
Refers to fantasies desires and longings
5
exists along a continuum that ranges from
exclusive heterosexuality to exclusive
homosexuality and includes various forms
of bisexuality .
Epidemiology
Prevalence differ based on the definiton of
sexual orientation used by reseachers
Generally more have same sex relationship
than identify as LGBT
US
Men Women
Self Identification 2.8% 1.4%
Same Sex attraction 7.7% 7.5%
Adolescents 3.2%
Epidemiology
Australia 2006 Study- 2-3% as
homosexuals and 20% with same sex
attractions.
9
Uk. 2005 6% of population self-
identified as gay.
10
Epidemiology
Estimates of the prevalence of gay, lesbian, and bisexual people in
the United States vary according to how they are defined (Pathelal
et al.,2006).

Studies using representative school-based samples have found that
about 3% of students in grades 912 identify themselves as gay,
lesbian, or bisexual (Garofalo, Wolf, Kessel, Palfrey, & DuRant,
1998; Garofalo,Wolf, Wissow, Woods, & Goodman, 1999).

Data from the third wave of the National Longitudinal Survey of
Adolescent Health (Add Health), collected in 20012002, similarly
found that 3.2% of young adults aged 1826 described themselves
as mostly or exclusively homosexual or bisexual, with more females
(3.6%) than males (2.6%) using these labels (Silenzio,
Pena,Duberstein, Cerel, & Knox, 2007).


Epidemiology
One early representative survey of U.S.adults, the 1992 National
Health and Social Life Survey (NHSLS), reported that 2.8% of men
and 1.4% of women identified themselves as homosexual, slightly
lower than the 3% of men and 1.6% of women who reported current
sexual behavior exclusively with same-sex partners, and
considerably lower than the 7.7% of men and 7.5% of women who
indicated same-sex sexual attraction (Laumann, Gagnon, Michael, &
Michaels, 1994).

More recent studies of adults have generally confirmed these
figures and have consistently shown that more respondents indicate
same-sex sexual behavior, and especially same-sex attraction, than
identify themselves as gay or lesbian (Black,Gates, Sanders, &
Taylor, 2000; Pedersen & Kristiansen, 2008; Sell, 1997;Wells,
McGee, & Beautrais, 2010).

NATURE VERSUS NURTURE
11
Genes + Brain Wiring + Prenatal
Hormonal Environment = Temperament

Parents + Peers + Experiences =
Environment

Temperament + Environment =
Homosexual Orientation
NATURE VERSUS NURTURE
Absolutely not. From twin studies, we
already know that half or more of the
variability in sexual orientation is not
inherited. Our studies try to pinpoint the
genetic factors...not negate the
psychosocial factors." .. Dr Dean
Hammer( gay gene researcher)
12
HEALTH PROBLEMS
The Gay and Lesbian Medical Association,
the worlds largest and oldest organization
of GLBT health care professionals, notes
that there is still considerable ignorance
about GLBT health issues, with many
assuming that GLBT health involves only
HIV/AIDS.





HEALTH PROBLEMS
Common to both Gay men And
Lesbians
- Stigma and discrimination
- Depression
- Alcohol and Substance Abuse
- Suicide
- Homophobia
- HIV/AIDS
- STDs
-
HEALTH CONCERNS
Specific to Gay Men
-Anal Dysplasias
- Anorectal pain, anal incontinence, anal prolapse.
- Hepatitis A,B,C
- Parasitic infections
- Domestic violence
Specific to Lesbians
- Isolation
- Rape/Assault
Health Concerns
- General health issues
- myocardial infarction
- erectile dysfunction
- stroke
- eating disorders
- cancers
- cervical cancer
- breast cancer
- uterine fibroids


REFERRENCES

1.
2. Next Magazine online June 2010-Colour
Me Gay Part II.
3.
4.
5. Reiter L (1989). "Sexual orientation,
sexual identity, and the question of
choice". Clinical Social Work Journal 17:
13850.
6. Presentation by Dr. Olowokere on Sexual
Health and Well being 13/1/11.
7. Sexual Orientation and Homosexuality".
APAHelpCenter.org.
http://www.apahelpcenter.org/articles/article.php
?id=31. Retrieved 2007-09
8. "Sexuality, What is sexual orientation?".
American Psychological Association.
http://www.apa.org/topics/sorientation.html#what
is. Retrieved 2008-08
9. Sex in Australia: The Australian study of
health and relationships, Australian
Research Centre in Sex, Health and
Society. (Published as the Australian and
New Zealand Journal of Public Health vol
27 no 2.)
10. 3.6m people in Britain are gay - official
Denis Campbell, social affairs
correspondent.The Observer, Sunday 11
December 2005

11. Homosexuality 101:What Every
Therapist, Parent, And Homosexual
Should Know by Julie Harren, Ph.D.,
LMFT