More than 34 million Americans have diabetes, the majority of them type 2, and another 88 million — over a third of the population — have前奶奶。但随着史塔哥ering as these numbers from theCenters for Disease Control and Prevention (CDC)are, the risk of糖尿病不是一个平等的。对于LGBTQ +社区，疾病负担和医疗质量差异是疾病负担和医疗质量的差异，意味着糖尿病和其他健康状况的风险增加心血管疾病andasthmaas well as greater barriers to diagnosis and treatment.
Minority stress is the reason for this difference, says劳伦海滩，博士是，西北大学Feinberg医学院的研究助理教授和伊利诺伊州埃文斯顿的埃文斯顿福祉和健康的编辑计划副主任。“由于他们所面临的耻辱，性别少数民族人类的心理健康状况不佳，这有助于糖尿病负担，”她说。
According to a2019 webinar by the Fenway Institute,糖尿病risk factorswith higher prevalence among LGBTQ+ people includedepression，吸烟，冒险饮酒，服用HIV爱滋病medication, and the disorder多囊卵巢综合征（PCOS）, which disproportionately affects lesbians.
它没有帮助差异在主流糖尿病资源中几乎看不见。Theresa Garnero，Cdces是一位认证糖尿病护理和教育专家，助理临床教授，加利福尼亚州萨克拉门托大学的助理临床教授和糖尿病证书课程主任，于2010年7月举行了这一闹钟美国糖尿病协会期刊糖尿病谱, revealing that, although there are more lesbian, gay, and bisexual (LGB) people with diabetes than there are totalpeople with type 1 diabetes，LGBTQ +数据被低估或阻止。最近的一个例子是美国卫生和人类服务部门的LGBTQ +人员从2018-2022战略计划中引人注目，该计划设定了原子能机构的目标，例如旨在预防和管理糖尿病等慢性条件的举措。Garnero论文超过十年，一些组织提供资源，如2019 National LGBT Health Education Center’s diabetes brief，但很少有更好的资源提到了风险。
The first LGB-focused studies hit the journals in 2014, but the available data sets didn’t include gender identity or expression until 2017, so scientists are only beginning to cover the LGBTQ+ spectrum. That may change, thanks to21世纪的治疗法案, signed December 2016, which authorized funding for the National Institutes of Health’s (NIH)性和性别少数民族研究办公室，这在2015年形成。他们的2021–2025 strategic plan侧重于增加代表LGBTQ +人的临床研究，特别是在患有慢性病的糖尿病和心脏病等时。该计划还强调支持在LGBTQ +社区和获得NIH资金的培训研究人员的研究人员。
A试点研究在4月2020年4月发表的问题Health Equitysuggests the value of training. First-year medical students who underwent a mandatory one-hour training on transgender health needs and disparities significantly changed their attitudes toward transgender patients. And that positive attitude and accurate knowledge remained with the medical students when the researchers followed up a year later.
For now, the stigma that’s making people sick also makes it tough to access healthcare. “The purpose of healthcare is to improve the health and健康of the patient, but that isn’t always what happens in the doctor's office,” says Dr. Beach. It’s a place where patients can feel “blamed and shamed” for body size or diabetes status on top of systemic issues like homo- and transphobia, racism, and ableism.
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How to Put Your Health First if You’re an LGBTQ+ Person Managing Diabetes
So, how can you take charge of your healthcare if you are part of the LGBTQ+ community?
找到你的医疗保健独角兽。“It's going to be a while before we get the medical establishment to behave as it should, and you can't let your health suffer while you're waiting,” saysJoshua Safer, MD, the executive director of the Center for Transgender Medicine and Surgery and a professor of medicine at Mount Sinai in New York City. Find providers in theGay＆Lesbian Medical协会的数据库或者World Professional Association for Transgender Health (WPATH) directory。你也可以要求推荐your local LGBTQ+ centerorPlanned Parenthood。
Learn to read lab results.糖尿病screening means bloodwork, and lab results are tricky. Brush up on your knowledge with theAmerican Diabetes Association's explainer或者UCI Health blog。
相信你的肠道。如果有一些医疗保健提供者感到沮丧，你就不必回去 - 甚至完成访问。“你是自己的权威，”Ann Williams, PhD, RN, CDCES,a retired research assistant professor at Case Western Reserve University in Cleveland. “You're the one who can say, ‘Is this emotionally okay for me or not?’” she says.
依靠你的社区。Williams recommends taking a support person to your appointment if you expect to have trouble advocating for yourself. You can also offer to call healthcare providers and vet them for LGBTQ+ siblings who face more barriers.
Give feedback.很难告诉医生他们可以做得更好，但直接沟通 - 无论是来自你还是支持人员 - 都可以帮助医疗保健提供者改善。考虑移位医疗保健提供者2019年美国糖尿病教育家协会提示表or hooking them up with the国家LGBT健康教育中心的资源。
Focus on yourself as an act of pride.The LGBTQ+ legacy is resistance, and stigma is just another barrier begging to be knocked down. One way to live this out is by doing what makes you feel good, Beach says — including锻炼, getting plenty ofbob ios下载
,要治疗,和爱你自己和你的people. “Being healthy and well in a society that’s making you sick is a radical act,” she says. “Wellness and happiness and joy in a society that traumatizes you and your community is fighting back.”
