Access to healthcare is more difficult for LGBTQIA+ people over 50 years old.

Brazil Agency - A study reveals that people aged 50 and over who belong to the LGBTQIA+ community receive worse healthcare than those in the same age group who are not part of this community. The situation is the same in both private and public healthcare systems (SUS), reveals a study by researchers from Hospital Albert Einstein, the Faculty of Medicine of the University of São Paulo (USP), and the University of São Caetano do Sul, published in the scientific journal [name of journal missing]. Clinics.

Researchers highlight that 31% of the LGBTQIA+ group are in the worst range of healthcare access in the country, while the proportion among the population that is not in this group is 18%. To arrive at the results, the team analyzed the responses of 6.693 people from all over Brazil in an online questionnaire, which could be completed anonymously. In total, 1.332 of the participants identified as LGBTQIA+.

By comparing the responses, it was observed that 74% of heterosexual women reported having had at least one mammogram in their lifetime. At the same time, the proportion of women with a gender identity or sexual orientation that fits within the LGBTQIA+ acronym was only 40%, which highlights the disparity in relation to health care and may also indicate difficulties for this group in undergoing examinations.

A similar disparity can be observed in another statistic: preventive screening for cervical cancer among people who identify as cisgender women. The percentage of heterosexuals who underwent the examination was 73%, compared to 39% of LGBTQIA+ individuals.

Regarding preventive bowel cancer screening, even among cisgender women, the discrepancy is smaller, but it exists. In total, 57% of women stated that they had undergone the examination at some point, a number that drops to 50% among LGBTQIA+ individuals.

According to the authors of the study, a relevant finding is that more than half (53%) of the group does not believe, or does not know, that doctors are able to deal with the particularities of their health. Furthermore, 34% of those who answered the questionnaire believe that the professionals who treated them did not know their gender identity or sexual orientation, a fact that may show how there are still taboo subjects relevant to diagnosis and treatment.

"From the moment we become aware of this reality, it reinforces the importance of eliminating inequalities and barriers to access," says Milton Crenitte, one of the authors of the research and a geriatrician at the Albert Einstein Israelite Hospital. The hospital has already been developing specific protocols and actions for LGBTQIA+ patients since the creation of the Medical Assistance Group focused on this population.

According to Crenitte, one of the misconceptions that most influences how healthcare professionals specifically view this group is limiting care to sexually transmitted infections (STIs). This is explained by the stigma from the 1980s, when the stereotype associating homosexuality with HIV began, a stereotype that persists to some extent today.

"Often, LGBT health has only been addressed in policies for the prevention of HIV and other STIs. So, what I think geriatrics has to contribute in this area of ​​LGBTQIA+ aging is understanding that it goes beyond that. It is necessary to welcome these people, to bring them into our practice settings, into our health services, to treat high blood pressure, diabetes, to do physical activity, to address mental health, and also to talk about HIV and AIDS," says the geriatrician.

Crenitte points out that an important fact in today's HIV scenario is that science has changed a lot and advanced significantly in treatment. "But one thing that remains, after 40 years of the HIV epidemic, is serophobia. A space that also needs to be discussed is that of serophobia, which is prejudice against those living with the virus."

The fear of becoming targets of LGBTQIAphobia in clinics or hospitals even leads many people to forgo regular check-ups and preventive exams, which can result in the diagnosis of diseases already in an advanced stage, with little chance of effective treatment. "This is real. Many people in the LGBTQIA+ community, out of fear of discrimination or due to previous negative experiences or other access barriers, which are numerous, fail to seek out the service," says Crenitte.

The doctor also highlights a finding from the research showing that how the user perceives the availability of the service will impact their decision to leave home to seek help or not. "Many people, instead of seeking preventative care, avoid it and only access healthcare in emergencies, which is much worse."