Exploring LGBT Health Disparities and Interventions

The provided assignment is a compilation of research papers and studies related to LGBT (Lesbian, Gay, Bisexual, Transgender) health disparities and interventions. The documents cover various aspects, including elder abuse, HIV testing, cervical cancer prevention, and staff clinical knowledge in long-term care settings. The research papers and studies were published in reputable journals such as the Journal of the American Association of Nurse Practitioners, BMC Public Health, and Clinical Gerontologist. The assignment appears to be related to a course or program focused on LGBT health disparities and interventions, possibly for healthcare professionals or students in the field of public health.

Health Care Provision and
Service

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
1. 1 Sexual Minority in Hong Kong and in Germany.................................................................1
1.2 Culture belief in Hong Kong and Germany.........................................................................1
1.3 Historical event.....................................................................................................................2
2. Health care policies and service provision for Hong Kong and Germany..................................2
2.1 Health issues associated with sexual minorities in both places............................................2
2.1.1 Public attitude to sexual minorities – Social exclusion.....................................................3
2.1.2 The need for mental health service ...................................................................................3
2.1.3 Risk factors – unprotected sex..........................................................................................4
2.2 Health care policies for sexual minorities in Hong Kong and Germany...................................5
2.2.1 How Health care polices impact sexual minorities in Hong Kong and Germany............5
2.2.2 What health service provision for Sexual Minorities people in Hong Kong and in
Germany......................................................................................................................................6
CONCLUSION................................................................................................................................6
REFERENCES ...............................................................................................................................7

INTRODUCTION
The Sexual minority constitutes of a small number of people who differs from the
majority of population in term of sexual preference identity which can be lesbian , gay, Bisexual
that are not accepted by the people (Rowniak and Selix, 2016). The health and care services for
sexual minorities in Hong Kong was published in a market-oriented economic matrix, which
gives a huge range of social protection and medical service system (Pulakka, Kawachi,and
Kivimaki, 2017). On the other side health care services in Germany for the sexual minority are
based on principles of self-governing, solidarity etc.
This report will address a comparison in sexual minority of Hong Kong to Germany on
the grounds of culture side,events of history and health issues that are related to sexual
minorities. Between the people of Hong Kong and Germany the perception based on sexual
minority is different from each other. It will also represent the policies and services provision for
sexual minorities of these countries.
1. 1 Sexual Minority in Hong Kong and in Germany
For Confucian values most Hong Kongers are affected by traditional philosophy. As the
people at Hong Kong are more traditional so the LGBT minority is still fighting for their rights.
However on the other side the treatment given to LGBT short for Lesbian, Gay, Bisexual and
Transgender at workplace is better than the Hong Kong (Jabson, Mitchell and Doty, 2016).
1.2 Culture belief in Hong Kong and Germany
The values of culture are needed to evaluate the behaviour of a person as patient and
what it means to be sick and particularly to be patient of hospital. Due to difference in cultural
aspect there may be issues in communication, rapport, physical examination and so on. From
culture to culture the perception of physical pain and psychological distress varies in both Hong
Kong and Germany (Peter, 2017). The hospital-based treatment and care are especially related to
religion beliefs and attitudes about death that may have many cultural variations. In Hong
Kong ,the linguistic and cultural translators are important. To reduce the health disparities it is
essential for the students and professional to understand the cultural diversity. As the
Confucianism have been established in Hong Kong so there is a concept of masculinity and
femininity over there so most of the LGBT population have to hide their identity to avoid
embarrassment among their families and friends (Donaldson and Vacha-Haase, 2016).
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The diverse cultural background of both Hong Kong and Germany can lead to creation of
different attributions of illness, health, disease, symptoms and treatment. The practitioners need
to be trained about the cultural-bound syndromes. In health care services of both countries social
factors like immigration, acculturation plays a major part. Different cultural aspects may result in
different expectations of how to meet the need of remedies of patients as in Hong Kong
individualistic belief is followed whereas in Germany social welfare oriented society is there
(Lukkerz, 2017).
1.3 Historical event
In 1883, Germany scientist discovered modern science based medicine which shaped
endless scientific discoveries. In the mid 1970 s various attempts were made by the German
health care community to control the growth of health cost. And in 1993 through the act of health
care structural reform new instruments were made to observe closely aces to medical
practice .Even though the law have been passed in 1995 in Hong Kong for protecting sexual
orientation but there is no such laws is followed over there (Jabson, Mitchell and Doty, 2016) .
Germany in comparison to Hong Kong is more open minded and also the same sex
marriage is allowed. It is also encouraging and motivating other laces for providing equal rights
to the minority section.
In Hong Kong with the help of WHO and support of the health minister in china control
of over infectious disease was controlled. And the Primary health care(PHS) was possible due to
support of government ,health professionals that achieved its full potential. Many society
contribute towards the development of health and human care (Victor and Nel, 2017).
2. Health care policies and service provision Hong Kong and Germany’s
sexual minorities
2.1 Health issues associated with sexual minorities in both places.
In Germany, equal rights are given to all under the policy of government and other
guiding principles. Since the laws of homosexuality is adopted and practised in Germany and
there is a disobedience in rights for members of sexual minorities which can enhance the risk of
HIV infection. This can increase the spread of virus. This is the condition where an individual
will contract a particular disease or illness. According to past reports the main cause of this
transmission among people in Germany is homosexuality (Champion, Young and Rew, 2016).
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The LGBT people commit suicide as they face formidable issues. The LGBT people in both the
places are suffering from depression.
In Hong Kong, people are also affected by HIV due to having sex with the same sex. The
cases of HIV in Hong Kong are on the high peak as the younger generations are infected by it
(Jabson, Mitchell and Doty, 2016). HIV is affecting both heterosexuals and homosexuals .The
gay people living in the country are more getting affected by it now.
In both these place the numbers of HIV numbers are increasing due to enhance in the
number of homosexuality there are about more gay men who are infected by it. A HIV is a
human immunodeficiency virus,is a type of infection that weakens the immune system of human
beings (Hines, Draucker and Habermann, 2017).
2.1.1 Public attitude to sexual minorities – Social exclusion
Even though various laws have been made in order to accept the homosexuality in both
Hong Kong and Germany .The government of these countries are trying to adapt and accept gay
and lesbian marriages in order to provide them equal rights but the public attitude towards these
minorities is not so good. They consider these minorities as untouchables they still are not able to
accept these people as equal to them. In 2013 a poll was conducted in Hong Kong university
where major part of population opposes the same sex couples.
Though as the times is passing and more awareness and laws are impose for the rights of
homosexuality there have been increase in numbers in Germany who are considering these
minorities as equals. They do not consist these people as minority according to them they all are
same. In Germany various pub and bars have been opened up over last decades for the gay men.
In Germany about major population believed that homosexuality need to be accepted by society.
In may 2015 a LGBT social network have been made in which over 120 countries gay men
were asked about their feeling about society's view on homosexuality and their satisfaction over
there lives (Pulakka, Kawachi and Kivimaki, 2017). The various organization that work for
LGBT rights protested in Hong Kong on the street to provide equal rights to them at
workplace .Once their identities have been found they cannot take part in social, traditional life.
Hong Kong is unable to protect sexual minorities due to private ordinance and equality
opportunity ordinance over there. The condition is better in Germany as compared to Hong
Kong.
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2.1.2 The need for mental health service
In fast moving cities like Hong Kong stress and anxiety are common for people .In order
to help them to enjoy life and maintain good relationship knowing how to remain physiologically
healthy and dealing with stress is important (Acker, 2017). Tension in families,
examination ,heavy workload can be the main cause of the stress. The stress can have positive
effect on the performance of work but it can lead to various issues related insomnia that lasts too
long. In Hong Kong there is a 24-hour hotlines for people who need help with issues of mental
health. Mental health services are targeted at different groups such as men, women and youth in
number of government and non-governmental organization (Fung and Fung, 2017). But for the
LGBT people in Hong Kong there is no specific provision have been provided for mental health
services. On the other hand in Germany the government is concerned for the LGBT people
mental health service.
In Germany various steps are also taken in order to pay attention on the need of mental
health services appropriate tasks have been done in order to provide funds. Thus the potential
savings from long investment is important .The employment can be the main cause of mental
illness in employment. So, more and more employment needs to be given in Germany. The
reason behind mental illness can be same sexual relations among people are criminal offence in
major countries and in five countries and two regions it is punishable by death (Hines, Draucker
and Habermann, 2017).
Various attempts were made in Hong Kong to compare the status of mental health of
local youth and immigrant and evaluate the impact of social competence on the health of local
youth. The data was collected through the use of structured questionnaire. This analyse
concluded that the local youth of the country have better health than the immigrant youth (Victor
and Nel, 2017).
2.1.3 Risk factors – unprotected sex
The risk factors are the circumstances or the behaviour that enhance the likelihood of an
individual to contract a specific disease or illness. These risk factors can be related to smoking,
alcoholic, illicit drug abuse etc. The unsafe sex is among the top risk factors to health in the
terms of cause of disease it causes. The reason behind the unsafe sex ranks is so high is due to
HIV/AIDS. It has affected various countries like Hong Kong and Germany has taken over more
than 40% lives in last 10 years (Fung and Fung, 2017).
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The main reason behind is the minority population of these countries as they feel sexually
undesirable and get engage in a risky sexual behaviour. There are high chances of risk for
sexually transmit infections, unplanned pregnancy (Dong, 2017). Young people and adults are at
higher risk than adults. People may be at high risk as they may be not be aware about STI and
how they can be transmitted. They haven't discusses the safer practices of sex with their partner .
They are not prepared or are not able to understand the protective measure use to prevent STI.
In the Carribean men who have sex with men and people of bisexual orientation have a
particular high risk (Acker, 2017). This is because the traditional gender roles that is there often
does not allow people to open up about their sexuality.
Due to unprotected sex there can be high chances of falling prey to infectious or sexually
transmitted diseases. The recent survey conducted states that gay men are in the highest group
for several of the most serious diseases (Pulakka, Kawachi and Kivimaki, 2017). Both in Hong
Kong and Germany the risk factors are increasing due to unprotected the homosexuality
population and this have led to increase in the number of HIV .More and more preventive
measures need to be taken in terms to reduce the impact of unprotected sex and awareness need
to be made among the population.
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Illustration 1: LGBT population
(Source: LGBT people across globe, 2017)

2.2 Impact of Health care policies on sexual minorities in Hong Kong and
Germany
As the perception and the degree of acceptance of sexual minority is different in both
Hong Kong and Germany so the health care policies and services is different.
2.2.1 How Health care polices impact sexual minorities in Hong Kong and Germany
The various health care policies have been made by Germany for the population of sexual
minorities. To help to reduce the stigma in a surrounding the problem and increase the
knowledge of how to protect them from HIV infections the regional HIV program that is funded
by BMZ provide knowledge and education on this topic (Tang, 2017). It also encouraged the
people to be open up about their sexual orientation and also enhance the availability of condoms
and lubricants. Various attempts are made by German Federal Ministry for Economic
Cooperation and Development (BMZ) to support the community of LGBTI. To bring together
youth organizations and organizations engaged in the field of HIV the civil society initiative
“Youth in the real world” has been made (Chan, 2017). As result of this an organization of
transgender sex workers has been created.
Under this prevention information and services to transgender women is provided. To
promote a comprehensive sexuality education the German development cooperation also extends
to area of education where continuous efforts are made. Efforts are also made to support and
strength the organization that are concerned with combating with discrimination, that sexual
minorities are facing and demanding they need to be involved in the strategies (Pulakka,
Kawachi and Kivimaki, 2017) .
In Hong Kong various committees were formed to address the existence of discrimination
against people on the grounds of homosexuality. Over period of time, these subcommittee would
arrange a meeting to discuss on the areas related to discrimination from education to housing,
from medical and health system to marriage. With this committee it had enhance the levels of
tolerance and awareness among the general people. The legal reforms was made in three field
such as on the commencement of anti-discrimination bill that covers sexual orientation, and
equal rights in terms of minimum age of consent. For promoting long term goal of acceptance of
sexual diversity continuous efforts in public education and social awareness remain important
strategies (Dong, 2017). The few LGBTQI organizations in Hong Kong aggressively opened and
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discussed the issues of health care services for themselves. In terms of keeping their sexual
orientation secret both the places LGBT people behaviour are same.
2.2.2 What health service provision for Sexual Minorities people in Hong Kong and in Germany
The Tongzi movement was dominated by social networking and friendship building
events like sports events and social gatherings. This group was developed for the sexual minority
population. Under this group it was illegal to have sex in same sex under 21. The rights that
Tongzi had was similar to the people residing in Hong Kong. The equal opportunity Bill was
introduced but was voted down twice (Pulakka, Kawachi and Kivimaki, 2017). This bill provides
equal opportunities to people but due to support it was divided into three bill to enhance the
likelihood of passage. The HKSAR government at Hong Kong have put in efforts to provide
better health services to LGBT population by conducting various surveys. A program named
PriSM ( Prevalence and Risk Behavioural Survey of Me) ,its goal is to how to represent HIV.
The provisions of health service are given to sexual minority in Germany and Hong Kong
have been evolved significantly over period of time. There is recognition of the same sex couples
in Germany. Since 2001,the registered life partnership have been introduced which give rights
for the same sex couples and obligation in areas such as health insurance, alimony, name change
etc. This law was again amended in 2005 in order to register the same sex adoption rights
(Acker, 2017). The health ministers also announced that the ban on gay and bi men to donate
blood is to be lifted replacing it with one year of deferral period.
Currently in Hong Kong these is no laws that regulate discrimination on the grounds of
sexual orientation.
CONCLUSION
By summarizing the above report it can be concluded that equal rights and recognition
need to be given to equal minority population in both places Hong Kong and Germany. They
need not to be considered as untouchables by the local public of these countries. The LGBT
people at Hong Kong are facing more pressure due to Confusion value. Various measures need
to be taken for the up-liftment of health services for the homosexuality population and they need
to be made aware about the risk factors that are involved in unprotected sex. More and more of
policies and programs need to be made for their benefits and rights. The condition over Germany
is better than Hong Kong as the protection of LGBT people by ordinance.
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REFERENCES
Books and journals
Acker, G. M., 2017. Transphobia among students majoring in the helping professions. Journal of
homosexuality. pp.1-19.
Champion, J. D., Young, C. and Rew, L., 2016. Substantiating the need for primary care–based
sexual health promotion interventions for ethnic minority adolescent women
experiencing health disparities. Journal of the American Association of Nurse
Practitioners. 28(9). pp.487-492.
Chan, K. K., 2017. Family and Homosexuality in Chinese Culture: Rights Claims by Non-
heterosexuals in Hong Kong. Sexuality & Culture. 21(3), pp.845-859.
Donaldson, W. V. and Vacha-Haase, T., 2016. Exploring staff clinical knowledge and practice
with LGBT residents in long-term care: A grounded theory of cultural competency and
training needs. Clinical Gerontologist. 39(5). pp.389-409.
Dong, X. ed., 2017. Elder Abuse: Research, Practice and Policy. Springer.
Fung, M. S. and Fung, M. S., 2017. An IMB model testing via endorser types and advertising
appeals on young people's attitude towards cervical cancer prevention advertisement in
Hong Kong. Young Consumers. 18(1), pp.1-18.
Hines, D. D., Draucker, C. B. and Habermann, B., 2017. HIV testing and entry to care among
trans women in Indiana. Journal of the Association of Nurses in AIDS Care.
Jabson, J. M., Mitchell, J. W. and Doty, S. B., 2016. Associations between non-discrimination
and training policies and physicians’ attitudes and knowledge about sexual and gender
minority patients: a comparison of physicians from two hospitals. BMC public health.
16(1). p.256.
Lukkerz, J., 2017. An Empty Arena–Attitudes and Experiences of Sexuality Education Among
Special School and Habilitation Service Staff in Sweden. The Journal of Sexual
Medicine. 14(5), p.e315.
Peter, T., 2017. Mind the gap: predicting the positive mental health of adult sexual minority
Canadians. Health promotion international. p.dax016.
Pulakka, A., Kawachi, I. and Kivimaki, M., 2017. Distance From Home to the Nearest Tobacco
Outlet May Not Reflect the True Accessibility Reply. JAMA internal medicine.
Rowniak, S. and Selix, N., 2016. Preparing nurse practitioners for competence in providing
sexual health care. Journal of the Association of Nurses in AIDS Care. 27(3). pp.355-361.
Tang, D. T., 2017. Youth work in a changing society: A case study of Hong Kong youth service
providers. Qualitative Social Work. p.1473325016680283.
Victor, C. J. and Nel, J. A., 2017. Developing an affirmative position statement on sexual and
gender diversity for psychology professionals in South Africa. Psychology in Russia.
State of the Art. 10(2).
Online
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LGBT people across globe. 2017. [Online]. Available through: <https://76crimes.com/76-
countries-where-homosexuality-is-illegal/>. [Accessed on 28th August 2017].
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