LGBT health research, once seen as ‘disposable,’ gets a boost at NIH

It wasn’t too long ago that including “LGBT” in a health research funding proposal could get it thrown out, said LGBT health researcher Kellan Baker.

“LGBT health has traditionally been treated as disposable,” said Baker, a senior fellow at the Center for American Progress.

But a recent announcement from an institute within the National Institutes of Health shows a shift in that attitude, and lends federal recognition to the health challenges faced by those who identify as lesbian, bisexual, gay, transgender, or otherwise outside of traditional gender norms.

The National Institute of Minority Health Disparities (NIMHD) this month classified sexual and gender minorities as a health disparity population — that is, a group whose health is significantly worse than the general population in terms of disease and mortality. Baker, who regularly meets with the NIH on issues of LGBT health policy, said that the Center for American Progress has been pushing for this classification for almost a decade.

Though it does not allocate any additional funding, the classification means that LGBT research will now be eligible for health disparity funding from any institute within the NIH. The NIMHD also offers grants and fellowships — but its budget is much smaller than some of the other NIH institutes. It also sends a strong signal to scientists that the field is important, and will hopefully drive an increase in funding applications that ask questions about LGBT populations, said Karen Parker, the director of the Sexual and Gender Minority Research Office at the NIH.

“I did a little happy dance in my office,” said John Blosnich, who works on LGBT health at the Department of Veterans Affairs. “It’s huge. We’ve known for decades that there are a lot of health disparities areas for the LGBT population, but for one reason or another, they were never included as a health disparity group.”

Studies have found that women who have sex with women are less likely to receive Pap smears and mammograms; that lesbian, gay, and bisexual kids are at higher risk of suicide; that gay and bisexual men have higher rates of depression; and that transgender individuals struggle to find health care.

“Mounting evidence indicates that [sexual and gender minority] populations have less access to health care and higher burdens of certain diseases, such as depression, cancer, and HIV/AIDS,” wrote Dr. Eliseo J. Pérez-Stable, director of the NIMHD, in his message announcing the decision. “But the extent and causes of health disparities are not fully understood.”

The announcement follows from the 2011 release of an NIH-commissioned report on LGBT health issues, which led to the creation of the Sexual and Gender Minority Research Office within the NIH.

The majority of research on LGBT health to date has been connected to HIV and AIDS — that was where the funding was. Scientists had to sneak other questions in.

“The scientists were very savvy,” said Blosnich. “They were able to say, we collected this on HIV, but we also asked about smoking behaviors, or something else.”

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The NIH decision will allow direct focus on other health issues, said Ricky Hill, a research program coordinator at the Institute for Sexual and Gender Minority Health and Wellbeing

“I definitely think that it’s something that’s really going to change the research landscape over the next three to five years,” Hill said. “It’ll pull the other health disparities that sexual and gender minorities face up into the open.”

Hill hopes to see more research on the long-term effects of hormone replacement therapy for trans individuals, for example, and more work on intimate partner violence in the LGBT population. For his part, Baker is anxious for more studies on the intersections of sexual and gender identity with race and ethnicity, and more systematic collection of LGBT health data.

What the NIH classification does, says Baker, is centralize research on these issues.

“This provides a home for LBGT health research,” he said.