Institute of Medicine calls for expanded federal support for LGBT health research
By Howard S. Kurtzman, PhD
The Institute of Medicine (IOM) has released a report on The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. The report, which was commissioned by the National Institutes of Health (NIH), provides a comprehensive overview of current research on the physical and mental health of LGBT populations, identifies research gaps and opportunities, and makes recommendations for how NIH and other federal agencies can strengthen research on LGBT health. The IOM is the health arm of the National Academies, located in Washington, D.C.
The report was prepared by a 17-member committee that included five psychologists (Walter Bockting, University of Minnesota; Brian de Vries, San Francisco State University; Gregory Herek, University of California, Davis; Charlotte Patterson, University of Virginia; and John Peterson, Georgia State University) as well as other behavioral scientists, medical researchers, and clinicians. The group was chaired by Robert Graham, professor of family medicine at the University of Cincinnati.
The chief recommendations of the report are:
NIH should implement a research agenda designed to advance knowledge and understanding of LGBT health. This agenda would include research questions in such areas as demographics, family and interpersonal relations, health services, preventive and treatment interventions, and transgender-specific issues. The report emphasizes the need to examine health at all stages of the life course.
Data on sexual orientation and gender identify should be collected in federally funded surveys concerned with health and social and economic conditions.
Data on sexual orientation and identity should be collected in electronic health records, with appropriate privacy and security protections.
NIH should support the development and standardization of sexual orientation and gender identity measures and other methodological research relevant to LGBT health.
NIH should support training on LGBT health research for graduate students, scientists, and NIH staff.
NIH should encourage grant applicants to address explicitly the inclusion or exclusion of LGBT populations in their samples.
At a March 31 press conference in Washington, Graham and other committee members pointed out that most areas of LGBT health are lacking in research altogether or require additional research. They noted that most research until now has been conducted with gay men and lesbians, while less has been carried out with bisexual and transgender populations; that most research has focused on adults, with less on adolescents and very little on elders; and that research has not adequately examined subpopulations, such as those defined by race, ethnicity, socioeconomic status, and geography. The committee members stressed that research must consider the social contexts of LGBT people, including the roles of prejudice and discrimination.
Responding to the report, NIH director Francis Collins issued a statement that said, in part, “The report makes it clear that there are significant gaps in our understanding of the health issues confronting LGBT people. Effective methods for systematic collection of data from research participants about sexual orientation or gender identity are needed, and are not currently available. In response, NIH will collaborate with the National Center for Health Statistics, a component of CDC [Centers for Disease Control and Prevention], to address and improve the methodology for collecting survey data on sexual orientation and gender identity. I have asked the NIH LGBT research coordinating committee to consider the report’s recommendations carefully, and to suggest strategies for how the NIH Institutes and Centers can support research to generate the knowledge base needed to promote the health of the LGBT community.”
The Secretary of Health and Human Services, Kathleen Sebelius, has also indicated support for the report, particularly the recommendation regarding inclusion of sexual orientation and gender identity questions in federal health surveys.
The report incorporates the major recommendations offered by the American Psychological Association (APA) in its invited testimony at the IOM panel’s initial public meeting in February 2010. The APA Science and Public Interest Directorates will monitor the long-term responses of the NIH, CDC, and other federal agencies to the report, and they will facilitate the work of the NIH staff coordinating committee established by Dr. Collins by keeping it informed about the evolving directions and needs of LGBT research and by arranging meetings between scientists and the committee. The APA directorates’ government relations offices will also continue their longstanding efforts to advocate for support of LGBT health research to members of Congress and other federal officials.
Howard Kurtzman is Deputy Executive Director for Science at APA.
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