1869, Karl-Marie Kertbeny: homosexual definition irt anti-sodomy laws, then carried over into medical health by Kraffft-Ebing
late 1800s: bisexual co-opted to reference peoples’ sexual orientation as well as(?) hermaphroditic plants in botany
early 1900s: intersex co-opted from biology; was synonymous with homosexual
continued pathologization of queerness; “heterosexual-homosexual rating scale” adopted and applied to individuals’ sexual behavior and psychic reactions (thoughts, feelings, fantasies)
1960s, gay rights movement: distrust of medical establishment, rejection of most health care providers and attempts to find affirming providers
early 1950s: medical transition of Christine Jorgensen (woman of the year awd; celebrity)
late 1960s/early 1970s: homegrown self-help books, including with content on alcohol safety, STIs, and prohibited vulnerable health topics (Our Bodies, Ourselves and other works published by feminists in a major movemeent)
1965: first study of gender-affirming/sex reassignment surgery → Johns Hopkins University, Baltimore
ended in 1978 due to transphobic research and resumed recently in modernity
1981-: AIDS epidemic reports and increased stigmatization of gay men and queer communities
healthcare and advocation via metropolitan grassroots organizations: NY Gay Men’ss Health Crisis, Tidewater AIDS Crisis Taskforce, AIDS Coalition to Unleash Power
21st century medical awareness
widespread attempts to obtain gender-affirming surgery, esp. w/ health insurance vs. out-of-pocket
medical theory
early theories (1800s) viewed sexual variance as pathological
homosexuality as innate theory
innate sexuality co-opted from Greco-Roman belief; third sex, social tolerance
degeneracy theory
homosexuality and bisexuality comparable to criminality, alcoholism, and drug addition
deviance resulted from the modern exhaustion of the gene pool via life, vice, and indulgence
Darwinian theory
non-stem dogwhistle incoming
“me when i hear about darwin in biology and evolution: YEAHHHH LETS GO / me when i hear darwin anywhere else:”
homosexuality and bisexuality were reversal-of-state evolutions and primitive
yeah there it is
psychoanalytic theory
Freudian postulations
infantile perversion
pleasure was shaped by society into “productive heterosexuality”, but trauma and conflict caused regression
homosexuality was psychosexual immaturity, not a disease
talk therapy
behaviorism
“learned behavior” of sexual orientation
reward and punishment psychology (operant conditioning), gay conversion therapy
modern institutionalized views of LGBTQ+ health view it under four lenses:
minority stress model
marginalization and minority identity produces personal and group stress that induces psychological and physiological effects
distal vs. proximal: external victimization vs. concealment and internal psychology
life-course perspective
intersectionality perspective
intersectionality for LGBTQ+ identifying individuals
considering all demographics in health issues, a holistic identity
social ecology
modern changes
increased documentation, awareness, and treatment for LGBTQ+ people and LGBTQ+ unequal issues
family support
STI and HIV prevention; HIV research
destigmatizing legal medical fields for LGBTQ+ people
removing barriers towards transgender and GNC healthcare, including towards insurance, medical discrimination, preventive health
better determination/review of LGBTQ+ statistics; incidence vs. prevalence and masking transgender and gender dysphoric identities
increasing therapeutic options for transgender and GNC patients
transitioning
changing legal names and markers
psychotherapy
peer support groups
speech/voice/communication therapy
hair removal treatment
support for unequal LGBTQ issuees
HPV, HIV/AIDS, other STIs
certain cancers (breast/gynecological, prostate, anal, colon)
illicit injectable silicone
self-advocacy for LGBTQ+ individuals and awareness in the health care community, hc providers
inclusive education for medical and nursing students
important organizations:
Human Rights Campaign,
Gay and Lesbian Medical Association
National LGBT Health Education Center
public, free resources
American Psychological Association
The Trevor Project
CA Health Education and other statewide centers
regional reources for CA
concerns over HIV infection, mental illness, substance abuse, homelessness, disinclination to reach out to preventative health, hormone use
gender-affirming hormone therapy
individualized programs
require psychosocial assessments for documented dysphoria, fully informed consent, 18+, control of health concerns
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