LGBTQ Breaking News Service

According to a new study from Brown, students who identify as lesbian, gay or bisexual (LGB) are more likely than their heterosexual peers to experience burnout.

Studies have shown that nearly half of all medical students in the U.S. report symptoms of burnout, a long-term reaction to stress characterized by emotional exhaustion, cynicism and feelings of decreased personal accomplishment. Beyond the personal toll, the implications for aspiring and practicing physicians can be severe, from reduced quality of care to increased risk of patient safety incidents.

Conducted in collaboration with researchers from Yale University, the new research is based on data from the 2016 and 2017 AAMC Medical School Graduation Questionnaire, a national survey that includes questions on everything from medical education to financial costs to clinical experiences. 

In the survey there are questions about negative experiences (such as mistreatment and burnout) and identity, including sexual orientation. Response options include “heterosexual or straight,” “gay or lesbian” and “bisexual.” The study combined the former into the category of LGB. Information about the gender identity of students who identify as transgender or genderqueer was not provided for analysis.

In the analysis of 26,123 total responses, 17% of LGB medical students reported high levels of burnout, compared to 11.1% of heterosexual students.

WHAT’S THE IMPACT?

Potential causes of burnout include the intensity of medical training, strained finances and unattainable expectations, the authors note in the study. Mistreatment is also a contributing factor, and there has been increased interest in examining its effects on trainees from racial and ethnic groups underrepresented in medicine. However, research had yet to focus specifically on LGB medical students.

LGB students also reported a higher frequency of perceived mistreatment. For example, 27% of LGB students reported being publicly humiliated, compared with 20.7% of heterosexual students. Some 23.3% reported perceived mistreatment specific to their sexual orientation at least once during medical school, compared with 1% of heterosexual students.

Mistreatment didn’t completely explain the emotional strain experienced by LGB medical students, who were 30% more likely to experience burnout, even after adjustments were made for reported experiences of mistreatment.

LGB students reporting frequent experiences of mistreatment related to their sexual orientation had an eight times higher likelihood of burnout compared to heterosexual students. This difference was dramatic when mistreatment occurred more frequently. At lower levels of mistreatment, the differences weren’t as extreme.

According to the authors, there are characteristics of medical training separate from individual experiences of mistreatment that lead to increased burnout among LGB trainees. Previous studies had shown that a high number of LGB medical students report concealing their sexual identity during medical school for fear of discrimination. They also report more depression, anxiety and low self-rated health compared with heterosexual students.

This can have far-reaching consequences, as the wellbeing of the healthcare workforce is strongly linked to the kind of care that providers are able to offer patients.

THE LARGER TREND

Physicians across the board are feeling burnt out, with a recent Medscape survey finding that although burnout rates were stable from the previous year, at 42% overall, the level in women increased from 48% to 51% during the pandemic, while burnout in male physicians overall remained unchanged from 2019.

Burnout and the stress of the pandemic – including factors such as personal risk, social distancing and financial uncertainty – appeared to diminish physicians’ overall work life happiness, with only 49% reporting they were happy in 2020 versus 69% pre-pandemic. More than one-third (34%) reported feeling unhappy last year, compared with 19% in 2019.

Nearly 80% of physicians said they felt burned out prior to the pandemic, but one in five said their burnout emerged only last year. Critical care (51%), rheumatology (50%) and infectious disease specialists (49%) ranked among the highest in reporting burnout for the first time since Medscape began surveying on the issue in 2013.
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com

Affirmations may act as powerful tools to center your energy and mend your mental health, but standing in front of a mirror and looking yourself square in the eyes while repeating phrases that you might not believe — or even just writing them down — can seem like a difficult task. And, they can feel downright awkward at first, something model Ashley Graham knows all too well.

“It’s awkward because a lot of the time what you’re saying feels like a lie,” Graham told POPSUGAR — if you are reciting affirmations aloud, your voice might be shaky, too, she added. “I was raised with the understanding that your words have power, and they will choose your destiny. And I knew that I needed to make affirmations for myself.”

Graham suggests going to the root of what you’re struggling with. “What are the things that you may not even be able to tell yourself? There is no right or wrong answer here. This is truly for you, made by you, and something to only better your life.” For her, these affirmations were, at first: I am bold. I am brilliant. I am beautiful. I am worthy of all. I love you.

Graham recalled that, at 17 or 18 years old, she needed to tell herself “I am bold” because she was new to the modeling industry and had just moved to New York City. She was diagnosed with ADD and dyslexia growing up, so “I am brilliant” speaks to the people who always used to tell her she wouldn’t be able to go anywhere due to those diagnoses.

As for “I am beautiful,” Graham explained, “I’m in an industry that has told me that I’m everything from good, bad, ugly, pretty, tall, short, fat, skinny. I needed to know what beautiful was in my terms, not the world’s terms.” Next, “I am worthy of all” is another reminder to give herself grace and accept what comes her way, and “I love you,” she noted, is the most difficult of affirmations. “A lot of people, the first person that they need to forgive is themselves. The first person they need to love is themselves. It can be a really tough one to say at the end of it all.”

Most importantly, Graham advised to be realistic about the affirmations that you want to rehearse and live by. For example, if words rooted in body positivity don’t seem genuine to you, focus on body acceptance or body neutrality — this is something Graham learned from Demi Lovato when she was interviewing the actress and singer on her podcast, Pretty Big Deal. Plus, if you don’t want to look at yourself in the mirror while you state affirmations, write them down or record them on your phone instead (Graham does this, and plays back her recordings on occasion).

Self-affirmations, self-care, and overall wellbeing are the topics that Graham will discuss in her new Airbnb Online Experience, “Loving Yourself in 2021,” taking place Feb. 5 at 5 p.m. ET. There are 10 spots available, and bookings open on Feb. 3 at 5 p.m. ET. Sales will go to the Anti-Recidivism Coalition.

Self-care, Graham said, has to be emotional, physical, mental, and spiritual. “I always try to challenge myself in all of those areas,” she explained, noting that she turns to reading, prayer, and fitness. “Self-care is deeper than a massage or a bubble bath because those sometimes just feel like Band-Aids,” she said.

Everyday rituals, Graham noted, are definitely needed, but self-care can also be “a heart change.” Sometimes, she said, “it’s a mind change, and it’s a word change. And those are hard.” You have to start somewhere. Dig deep, and find the affirmations that speak to you.

Kevin Whitt speaking at a rally before participating in the insurrection (via YouTube)

The Texas Republican Party has fired ex-gay Dallas resident Kevin Whitt. On Nov. 20, 2020, he was hired by the Republican Party to be a field organizer, according to the Texas Tribune. Yes, the election was over, so we’re not sure what he was hired to organize.

In 2019, Whitt organized the protest against Drag Queen Story Hour at the Grauwyler branch library in Dallas. You remember that protest when they showed up at the wrong library on the wrong day. Obviously not the most talented field organizer.

Whitt is seen in a video recorded in D.C. speaking to, well, no one, claiming to be an ex-transgender, ex-drag queen, ex-prostitute who had been the victim of sexual abuse as a child. He claims he wasn’t the victim of a reparative therapy scam. Just got invited to church and got saved. Here’s the video:

What was he doing in D.C.? Why taking part in the insurrection at the Capitol. Although he was on the steps, he isn’t accused of being among those who broke into the building.

While in D.C., he visited the pizzeria that’s known for the Pizzagate conspiracy that alleged Democrats were running a child sex-trafficking ring out of the restaurant. In the pizzeria, he was shouting at employees that they were pedophiles and refused to leave when asked.

Texas Tribune reports that Whitt said of his firing, the Republican Party is “canceling conservatives, obviously.”

In the video, he claims to have had “probably 50,000 sexual partners.” Well, we are impressed. We imagine that’s slowed down, though since coming out as straight.

— David Taffet

Folx Health launched out of stealth mode in December as the first major queer and trans-venture-backed company to offer virtual care and prescriptions for hormone replacement therapy and sexual health.

The startup has now raised $25 million in new financing led by Bessemer Venture Partners and with participation from existing investors Define Ventures and Polaris.

“Our partnership with Folx is a historical moment. It’s challenging to articulate how transformative Folx is for our community. We do so mindful of the brilliant and brave queer and trans people who fought for this moment to happen,” said Morgan Cheatham of Bessemer Venture Partners in a statement.

Folx Health also announced the availability of its hormone replacement therapy for testosterone or estrogen with monthly plans starting at $59 a month. Folx Health will also begin releasing its sexual health and wellness offerings starting with erectile dysfunction (ED) treatment, soon to be followed by at-home STI testing and treatment, all customized for the specifics of queer and trans bodies, the company said.

RELATED: Queer and trans healthcare provider Folx banks funding from Polaris Partners

All services will include unlimited on-demand clinical support with at-home lab testing, for most plans, and home-delivered medications. Upon launch, Folx Health’s services will be available in California, Connecticut, Delaware, Florida, Illinois, Massachusetts, North Carolina, New York, Texas, Virginia, and Washington.

The company will leverage its new funding in order to drive national expansion and expand its offerings in sexual health and family creation later in 2021 and early 2022.

A.G. Breitenstein, an investor, entrepreneur, and queer health advocate, founded Folx Health as a telehealth platform designed specifically for the queer and transgender community. The company combines access to a specialized network of queer and trans clinicians with a tailored focus on clinical offerings that are typically marginalized in traditional health settings. 

The startup works like a One Medical for the LGBTQIA+ (lesbian, gay, bisexual, pansexual, transgender, genderqueer, queer, intersexed, agender, asexual and ally) community, Breitenstein told Fierce Healthcare.

There are a growing number of digital health companies tackling health issues for the LGBTQIA+ community. Queerly is an online marketplace where LGBTQ people can connect with vetted and trained providers, telehealth tools and concierge health. Violet is a mental healthcare startup run by and for the LGBTQ+ community, and Plume is a digital health service focused exclusively on the transgender community and has expanded into employee benefits. 

RELATED: Aetna grows coverage for gender-affirming surgeries for transgender women

These companies are tapping into a community that historically has been underserved in the healthcare market. About 4.5% of U.S. adults—11 million people—identify as LGBT; about 1.4 million people identify as transgender. Among the 18-34 population, about 20% identify as LGBTQ, according to a GLAAD survey. Folx is targeting an addressable market that’s nearly 39 million people in the U.S., Breitenstein said.

As part of its mission to demystify health care and build a queer and trans- centric health service, the company also launched a content hub to serve as a free resource for all things queer and trans health.

Written by Folx clinicians, the content hub will fill a need for accessible queer and trans-focused health content that is informative, accessible, and compelling, the company said. The library addresses questions and concerns ranging from an overview of the expected physical changes with hormone replacement therapy to how to navigate the health system.

“As a non-binary lesbian and healthcare industry veteran, I have seen and experienced firsthand just how broken the current system is for the queer and trans community,” Breitenstein said in a statement. “Whether it’s HRT, PrEP, sexual health, or family creation, health care is essential for us to be who we are. It’s about time we build a platform for ourselves, so queer and trans people feel seen, heard, and celebrated.”

PROVIDENCE, R.I. [Brown University] — Studies have shown that nearly half of all medical students in the U.S. report symptoms of burnout, a long-term reaction to stress characterized by emotional exhaustion, cynicism and feelings of decreased personal accomplishment. Beyond the personal toll, the implications for aspiring and practicing physicians can be severe, from reduced quality of care to increased risk of patient safety incidents.

According to a new study published on Tuesday, Feb. 2, in JAMA Network Open, students who identify as lesbian, gay or bisexual (LGB) are more likely than their heterosexual peers to experience burnout.

“The health and well-being of trainees is intimately linked to the quality of patient care, physician retention, and is key to reducing care inequities,” said lead author Dr. Elizabeth Samuels, an assistant professor of emergency medicine at the Warren Alpert Medical School of Brown University. “Understanding how the current medical training environment impacts lesbian, gay and bisexual medical students is critical for improving their training experience, building and retaining a workforce of LGB physicians, and also delivering optimal care to all patients — especially those who also identify as LGBTQI+.” 

Samuels, who is a practicing emergency physician at Rhode Island Hospital and The Miriam Hospital, has focused previous research on equity and diversity in the health care workforce and the care of transgender and gender non-conforming people. Data from Association of American Medical Colleges’ annual survey of graduating medical school served as the basis for the new study.

“The impetus for this study came out of my own personal experiences as a medical trainee and as a mentor to medical students, as well as a person dedicated to addressing health inequities and improving care for LBGTQI+ patients,” Samuels said. “When my collaborators and I learned that the AAMC had added questions about sexual orientation to their annual graduating medical student survey, we thought it would be a good opportunity to examine the experiences of LGB trainees generally, and more specifically, to examine whether medical student experiences of mistreatment and burnout varied by sexual orientation.”

The study, conducted in collaboration with researchers from Yale University, is based on data from the 2016 and 2017 AAMC Medical School Graduation Questionnaire, a national survey that includes questions on everything from medical education to financial costs to clinical experiences. In the survey are questions about negative experiences (mistreatment, burnout) and identity, including sexual orientation. Response options include “heterosexual or straight,” “gay or lesbian” and “bisexual.” The study combined the former into the category of LGB. Information about the gender identity of students who identify as transgender or genderqueer was not provided to the researchers for analysis.

In the study’s analysis of 26,123 total responses, 17% of LGB medical students reported high levels of burnout compared to 11.1% of heterosexual students.

Potential causes of burnout include the intensity of medical training, strained finances and unattainable expectations, the authors note in the study. Mistreatment is also a contributing factor, and there has been increased interest in examining its effects on trainees from racial and ethnic groups underrepresented in medicine. However, research has yet to focus specifically on LGB medical students.

“This is the first work that really looks at the relationship between sexual orientation and burnout and how that is mediated by mistreatment,” Samuels said.

In the study, LGB students also reported a higher frequency of perceived mistreatment. For example, 27% of LGB students reported being publicly humiliated, compared with 20.7% of heterosexual students; 23.3% reported perceived mistreatment specific to their sexual orientation at least once during medical school, compared with 1% of heterosexual students.

Samuels notes that mistreatment didn’t completely explain the emotional strain experienced by LGB medical students, who were 30% more likely to experience burnout even after adjusting for reported experiences of mistreatment.

The researchers found that LGB students reporting frequent experiences of mistreatment related to their sexual orientation had an 8 times higher likelihood of burnout compared to heterosexual students.  This difference was dramatic when mistreatment occurred more frequently, Samuels said. But at lower levels of mistreatment, the differences weren’t as extreme.

“I think this shows people’s resiliency — up to a point,” Samuels said.

Samuels asserts that there are characteristics of medical training, separate from individual experiences of mistreatment, that leads to increased burnout among LGB trainees. After all, previous studies have shown that a high of LGB medical students report concealing their sexual identity during medical school for fear of discrimination. They also report more depression, anxiety, and low self-rated health compared with heterosexual students.

“Layering concerns about homophobia and discrimination on top of the general intensity of medical training can lead not just to burnout, but also to truly deleterious mental health effects,” Samuels said.

This can have far-reaching consequences, she noted, as the well-being of the health care workforce is strongly linked to the kind of care that providers are able to offer patients. These findings, she said, underscore the need for continued, comprehensive support and mentorship for LGBTQ medical students, and the importance of institutional culture change to create healthy, diverse, inclusive medical school learning environments.

“Not only is that helpful for individual trainees, but building this workforce is a key strategy in addressing health inequities experienced by LGBTQI+ communities everywhere,” Samuels said. “This study gives us a sense of where we are now, and how far we still need to go.”

The study was conducted in cooperation with the Association of American Medical Colleges. It was funded by a Society for Academic Emergency Medicine Academy for Diversity and Inclusion Research Grant and the Northeast Group on Educational Affairs Research Grant Program.