Access to health care differs by sexuality
OTTAWA - A new study suggests that the use of the health-care system in Canada, and mental health services in particular, differs by sexual orientation.
A report published Wednesday by Statistics Canada sought to answer whether sexual identity had anything to do with having a regular doctor, consulting health-care providers, taking preventive screening tests and having any unmet medical needs.
“The theory is that disenfranchised groups might access (the health-care system) differently, might have difficulty accessing it, so we wanted to look at whether this is also the case for sexual orientation,” said the study’s author Michael Tjepkema.
“It is true that gays, lesbians, bisexual men and women do access different types of the health-care system differently from heterosexual Canadians,” he said of his findings.
The study is the first national picture of health care use by sexual orientation and it used data from the 2003 and 2005 Canadian Community Health Survey for adults aged 18 to 59. An estimated 346,000 survey respondents identified themselves as gay, lesbian, or bisexual.
Tjepkema controlled for factors such as health status, income, education and geography and found the differences between heterosexuals and gays, lesbians and bisexuals persisted.
“The striking example for me would be looking at lesbians and Pap smear testing,” said Tjepkema.
Less than two-thirds of lesbians reported having a Pap test within three years of the survey, well below the more than three-quarters of heterosexual and bisexual women who had the screening test.
“The lower screening rate among lesbians could be in response to past negative experiences with health-care providers, the belief that the test is not necessary, or not usually taking birth control pills, renewal of prescriptions for which can be an opportunity for doctors to discuss and administer the Pap test,” the study said.
Lesbians and bisexual women were also less likely to report having a regular family doctor than heterosexual women, the study found.
The study also determined that gay men, lesbians, bisexual men and women were more likely to access mental health services than heterosexuals. They had more frequent contact with counsellors, social workers and psychologists and were more likely to report attending self-help groups.
“It might be more acceptable to use those services in those populations, but our data didn’t speak to the reasons,” Tjepkema said.
Relatively large proportions of bisexuals reported mental health problems, the study noted. Bisexual men were more than twice as likely as heterosexual men to perceive their mental health as fair or poor and for bisexual women the proportion reporting fair or poor mental health was three times that of heterosexual women, the findings showed.
Cherie MacLeod, executive director of PFLAG Canada, a support and education organization, was not surprised by the findings on mental health.
“It is well known that there’s increased depression in the gay, lesbian, bisexual and transgender community because of dealing with widespread societal homophobia and transphobia,” she said. “The fact that our community is looking to obtain these services is not surprising at all.”
The Statistics Canada report also determined that bisexuals of both sexes reported having unmet medical needs more often than heterosexual Canadians, another finding that MacLeod expected.
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