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LGBT+ people take fewer preventive exams than heterosexual cisgender individuals

Study looked at data from 6,693 Brazilians aged 50 or over from all macro-regions of the country

Efe Godoy

A study published in January 2023 in the science journal Clinics points out that LGBT+ people tend to undergo fewer preventive exams than heterosexual, cisgender individuals. The study analyzed data provided by 6,693 Brazilians aged 50 or over—of which 1,332 were LGBT+—from every region of the country. The respondents completed a confidential online questionnaire during the period from August 2019 to January 2020. Just over two-thirds of the participants were women. While 74% of heterosexual women who participated in the survey reported having had at least one mammogram during their lifetime, only 40% of lesbians and bisexuals said they had had the exam. The proportion of LGBT+ women who underwent preventive tests against cervical cancer, such as the Pap smear, was also lower than among the non-LGBT+ group, 39% versus 75%, respectively. This same trend was observed with those completing tests to detect colorectal cancer: 50% of LGBT+ participants versus 57% of respondents not belonging to this group had undergone this screening.

Geriatrician Milton Crenitte, coordinator of the Elderly Sexuality Outpatient Clinic at the Hospital das Clínicas of the University of São Paulo (USP), says that healthcare professionals are often unaware of LGBT+ patients’ healthcare particularities. “The elderly population demands more careful attention in the area of health, such as preventive exams. But many LGBT+ people avoid seeking healthcare services, either because they’ve had some previous negative experience or because they’re afraid of discrimination,” explains the physician, who is the study’s lead author.

A study published in 2018 in the journal Epidemiologia e Serviços de Saúde points out that women who have sex with women were less likely to have an annual consultation with a gynecologist. Through an online questionnaire, 582 women fitting this profile participated in the study, coordinated by gynecologist Andréa Cronemberger Rufino, from Piauí State University (UESPI). According to Rufino, research participants who did consult periodically with a doctor received less guidance regarding sexually transmitted infections from these healthcare professionals than is recommended.

The gynecologist points out that, by not seeking health services, LGBT+ women miss a window of opportunity for diagnosing several preventable diseases, such as cervical, endometrial, breast, and ovarian cancers. “In addition, they fail to control important risk factors for the onset of cardiovascular diseases, such as smoking, obesity, and alcohol consumption, and don’t have access to care for mental health issues,” comments Rufino.

Furthermore, as regards how professionals approach LGBT+ people, psychologist Breno de Oliveira Ferreira, from the Federal University of Amazonas (UFAM), cites various obstacles to patient access and the assistance offered by healthcare services. He coordinated a qualitative study that recorded oral reports from 32 professionals who work in local Health System Clinics (UBS) in Teresina, Piauí. According to Ferreira, who published the study in 2021 in the journal Interface – Comunicação, Saúde, Educação, health professionals appeared unprepared to deal with the specificities of the LGBT+ population, despite some of them having long experience in their fields.

“Some professionals lowered their heads, changed the subject, or pretended they hadn’t heard when a patient talked about non-normative sexual practices. Others didn’t even write this topic down in their medical records,” the psychologist says. “These issues, which are so important, end up being neglected and the medical attendance is not humanized.”

With the aim of ensuring greater equity in Brazil’s Unified Health System (SUS), in December 2011 the Ministry of Health instituted the National Policy for Comprehensive Health for Lesbians, Gays, Bisexuals, Transvestites, and Transsexuals. Crenitte, however, argues that, after almost 12 years, there are still numerous difficulties in implementing this initiative, at various levels. One of the few institutions dedicated to the care of elderly LGBT+ people in Brazil, the nongovernmental organization EternamenteSOU was founded in 2017 in São Paulo, offering services and projects aimed at psychosocial care for this group.

Data from the Pride Survey released in 2022 by the Datafolha Institute, in partnership with the Havaianas company and the NGO All Out, shows that there are more than 15.5 million people in Brazil’s LGBT+ community, equivalent to 9.3% of the population over 16 years old. Of this contingent, 12% are aged 60 or over. Despite the achievements made in recent years, this group tends to suffer a double prejudice in receiving healthcare, due to age and sexuality.

Scientific articles
CRENITTE, M. R. F. et al. Transforming the invisible into the visible: Disparities in the access to health in LGBT+ older people. Clinics. Vol. 78. Jan. 2023.
FERREIRA, B. O. and Bonan, C. Vários tons de “não”: Relatos de profissionais da Atenção Básica na assistência de lésbicas, gays, bissexuais, travestis e transexuais (LGBTT). Interface — Comunicação, Saúde, Educação. No. 25. 2021.
RUFINO, A. C. et al. Práticas sexuais e cuidados em saúde de mulheres que fazem sexo com mulheres: 2013-2014. Epidemiologia e Serviços de Saúde. Vol. 27, no. 4. Nov. 2018.[/bibliografia]