Improve health, safety and well-being.
It sounds like a bullet point, but it marks something significant.
It’s a new goal on the U.S. Office of Disease Prevention and Health Promotion’s “Healthy People 2020,” which strives to create science-based national objectives to improve the health of Americans. “Improving health, safety and well-being” describes, for the first time, strategies to improve the health of individuals who are lesbian, gay, bisexual and transgender (LGBT). And it’s an indication that research priorities on health issues of LGBT individuals are changing.
“The last 15 years or so have seen a more focused effort in LGBT health research, but it is still in its relative infancy,” said Dr. Nathan Grant Smith, associate professor in the College of Education’s Department of Psychological, Health and Learning Sciences. “There is a good amount of research on HIV and LGBT mental health, but researchers are now starting to go beyond that.”
Smith is part of this emerging area of LGBT research. He and his research team — CORE: Coping and Resilience — explore issues of stress and coping in LGBT individuals, and the health consequences that result from stigma and discrimination—like contemplating suicide, smoking or sexual behaviors that increase HIV risk.
Smith’s collaborations with colleagues from other colleges and institutions has yielded research, for example, on the very high likelihood of transgender people attempting suicide, often because of the prejudice, transphobia and other stressors they may experience. His studies examined factors that may protect transgender adults from attempting suicide.
“Identifying factors that protect transgender people from suicide is critical,” he said. “Our research showed that social support, self-acceptance, and access to health care that affirms their gender identity, among other factors, were all protective against suicidality.”
Collaborating with colleagues from McGill University and The Argyle Institute of Human Relations in Montreal, Canada, their findings build on the available research on suicide protective factors in transgender adults and inform medical and mental health professionals who work with transgender clients. Organizations and practitioners who work with this population can use the information to develop specific prevention programs and mental health support for suicidal transgender individuals.
Currently, he and his team are examining how stigma and discrimination are related to tobacco use in LGB adults. About a quarter of LGB adults smoke, compared to less than 17 percent of heterosexual adults.
“Existing research has revealed a clear health disparity. Both LGB adults and adolescents are at an increased risk for tobacco use. However, very little research has examined why this disparity exists,” Smith said. He and his colleagues at the University of Houston are using innovative methods, including examining physiological markers of stress, to pinpoint the factors that increase risk for smoking among LGB adults.
His new research is focused on increasing the health and well-being of gay and bisexual men by reducing their risk of contracting HIV. Bisexual men report engaging in more sexual risk behaviors than gay men, though there is not an abundance of research to explain why. In addition to identifying the unique stressors that increase bisexual men’s HIV risk, Smith has developed a program to help young gay and bisexual men better cope with stigma and discrimination and reduce HIV risk behaviors. His program titled Project PRIDE (Promoting Resilience In Discriminatory Environments) reduced substance use, unprotected sex, depression and anxiety among those who participated in it.
Smith’s research has been funded by the Canadian Institutes of Health Research. His research earned him recognition from the American Psychological Association, which named him a Fellow of the Association and of the Association’s Society of Counseling Psychology and Society for the Psychological Study of Lesbian, Gay, Bisexual, and Transgender Issues.
“LGBT people are increased risk for a variety of negative health outcomes. However, they also show remarkable resilience in the face of societal stigma and prejudice. This emerging area of research can help to foster the many strengths of the LGBT community and promote better health and well-being,” Smith said.