Anxiety
Chronic, excessive worry and stress that can manifest itself in physical ways such as headaches and muscle tension and can lead to more intense symptoms.
LGBT Health
Quality healthcare for all
IU Health believes in providing the best healthcare to all our patients. Providing a safe environment for patients enables providers to deliver the best care.
Lesbian, Gay, Bisexual and Transgender (LGBT) patients are at a higher risk for certain health conditions. Knowing these in advance and communicating concerns with your provider can help you receive the best care. Being open and honest with your provider about your sexual orientation or gender identity is key to building a positive relationship to meet your health goals.
Lesbian and Bisexual Women’s Health
Like all patients, lesbians and women who have sex with women (WSW) need an annual physical exam – but they may be at an increased risk for certain health issues.
Breast cancer
Lesbians and WSW have risk factors for breast cancer and are often not very likely to get screening exams. This combination can sometimes mean lesbians and WSW may not be diagnosed early when the disease is most curable.
Depression and anxiety
Discrimination may cause you to experience constant stress. Needing to hide your orientation or if you've lost important emotional support because of your orientation can cause you to experience a worsened form of stress. This stress can lead to depression and anxiety.
Heart health
Heart disease is the leading cause of death for women with the biggest risk factors among lesbians and WSW being smoking and obesity. Yearly medical exams testing for high blood pressure, cholesterol problems and diabetes (Type 1 or Type 2) is something all lesbians and WSW need.
Gynecological cancer
Compared to heterosexual women, lesbians and WSW have a higher risk for certain types of gynecological (GYN) cancers. For early detection, you should have regular pelvic exams and pap tests.
Fitness
Compared to heterosexual women, lesbians and WSW are prone to being overweight or obese. This can lead to heart disease, cancers and premature death. Getting knowledgeable and helpful advice about healthy living and eating can be given to you through your healthcare provider.
Tobacco
Smoking has been connected with higher rates of cancers, heart diseases and emphysema – three major causes of death among women.
Intimate partner violence
You may experience violence in your intimate relationships. Talk with your healthcare provider if you’re concerned and get connected to the right resources.
Alcohol and substance use
Lesbians and WSW are commonly seen with heavy drinking and binge drinking habits. While one drink a day may be good for your heart, more than that can increase your risk of cancer, liver disease and other health problems. Drug use is also frequently seen and can be caused by stress from discrimination, sexism and/or homophobia.
Sexual health
Sexually transmitted infections (STDs) are transmitted through skin-to-skin contact, mucus membrane contact, vaginal fluids and menstrual blood.
What to Expect
Lesbian, Gay, Bisexual and Transgender (LGBT) patients are at a higher risk for certain health conditions. Knowing these in advance and communicating concerns with your provider can help you receive the best care. Being open and honest with your provider about your sexual orientation or gender identity is key to building a positive relationship to meet your health goals.
Lesbian and Bisexual Women’s Health
Like all patients, lesbians and women who have sex with women (WSW) need an annual physical exam – but they may be at an increased risk for certain health issues.
Breast cancer
Lesbians and WSW have risk factors for breast cancer and are often not very likely to get screening exams. This combination can sometimes mean lesbians and WSW may not be diagnosed early when the disease is most curable.
Depression and anxiety
Discrimination may cause you to experience constant stress. Needing to hide your orientation or if you've lost important emotional support because of your orientation can cause you to experience a worsened form of stress. This stress can lead to depression and anxiety.
Heart health
Heart disease is the leading cause of death for women with the biggest risk factors among lesbians and WSW being smoking and obesity. Yearly medical exams testing for high blood pressure, cholesterol problems and diabetes (Type 1 or Type 2) is something all lesbians and WSW need.
Gynecological cancer
Compared to heterosexual women, lesbians and WSW have a higher risk for certain types of gynecological (GYN) cancers. For early detection, you should have regular pelvic exams and pap tests.
Fitness
Compared to heterosexual women, lesbians and WSW are prone to being overweight or obese. This can lead to heart disease, cancers and premature death. Getting knowledgeable and helpful advice about healthy living and eating can be given to you through your healthcare provider.
Tobacco
Smoking has been connected with higher rates of cancers, heart diseases and emphysema – three major causes of death among women.
Intimate partner violence
You may experience violence in your intimate relationships. Talk with your healthcare provider if you’re concerned and get connected to the right resources.
Alcohol and substance use
Lesbians and WSW are commonly seen with heavy drinking and binge drinking habits. While one drink a day may be good for your heart, more than that can increase your risk of cancer, liver disease and other health problems. Drug use is also frequently seen and can be caused by stress from discrimination, sexism and/or homophobia.
Sexual health
Sexually transmitted infections (STDs) are transmitted through skin-to-skin contact, mucus membrane contact, vaginal fluids and menstrual blood.
Gay and Bisexual Men's Health
Gay men and men who have sex with men (MSM) have the same health concerns as their heterosexual counterparts, however, they may be at an increased risk for certain health conditions. Gay men and MSM often fear rejection and embarrassment and can lead to a delay in the diagnosis of certain health conditions. The first step is to be open and honest with your provider in order for them to provide you the best care. By being open, this should lead your provider to ask specific questions about you and offer appropriate testing.
HIV/AIDS and safe sex
Gay men and MSM are at an increased risk of Human Immunodeficiency Virus (HIV) infection. If HIV positive, you need to be seen regularly by your provider in order to run appropriate tests as needed to ensure your medications are working. You should also be conscious of what to do in the event you are exposed to HIV by contacting your provider immediately to explore your options. You should also discuss options for prevention if you are in a relationship and one of you is positive.
Hepatitis immunization and screening
Hepatitis poses a bigger threat to gay men and MSM. Long term issues such as liver failure and liver cancer can be caused from hepatitis. Universal immunization for Hepatitis A and Hepatitis B is recommended for all MSM. Currently, the only means of protection for the very serious Hepatitis C is through safe sex practices.
Fitness
More commonly seen among gay men and MSM are problems with body image. Eating disorders such as bulimia or anorexia nervosa are also experienced by MSM. Substances such as anabolic steroids and certain supplements are known to be dangerous. Obesity also affects MSM and can lead to heart disease, diabetes, high blood pressure and other health conditions.
Alcohol and substance use
Gay men and MSM tend to use substances such as alcohol and drugs more frequently than the general population. Drugs such as marijuana, amyl nitrate ("poppers"), Ecstasy and amphetamines are all commonly seen. The long-term effects of many of these are unknown. Telling your provider about your drinking habits and substance use can help you get connected to the appropriate resources if you feel they are interfering with your work, school or relationships.
Depression and anxiety
Depression and anxiety affect gay men and MSM at a higher rate than the general population. For those who remain in the closet or do not have a sufficient social support system, the problem may be more severe. Because of this, adolescents and young adults may be at a higher risk of suicide. Mental health services that are culturally sensitive and targeted specifically at gay men may be more successful in prevention, early finding and treatment of these conditions.
STDs
Sexually transmitted diseases (STDs) occur in sexually active gay men and MSM at a high rate. Some STD infections have effective treatment and are curable (syphilis, gonorrhea, Chlamydia and pubic lice) while others can only be managed and not cured (HIV, Hepatitis, Human Papilloma Virus (HPV) and herpes). You should be screened more frequently each year if the number of partners you have increases.
Prostate, testicular and colon cancer
Gay men and MSM may be at a higher risk for death by prostate, testicular and colon cancer. You should be screened for these cancers regularly as recommended for the general population.
Tobacco
Tobacco use is at a much higher rate among gay men and MSM than the general population which can lead to lung cancer, heart disease, high blood pressure and other health conditions. You should be screened regularly for tobacco related issues and offered culturally sensitive prevention and cessation programs.
Human Papilloma Virus (HPV)
This virus is the cause of anal and genital warts. These infections have been thought to be playing a part in the increasing rates of anal cancer among gay men and MSM. Talk with your provider about being screened.
Transgender Health
Transgender patients like all patients need routine annual exams, but they may be at an increased risk of certain health conditions. Finding a provider who is knowledgeable and willing to treat transgender people is not simple. Once you find a provider, being open and honest is important in order to provide you with the best care. If your child is questioning their gender identity, the Gender Health Program at Riley Children's Health can provide both you and your child the appropriate resources.
Health history
Be open and honest with your provider from the beginning. This is a vital component for your provider to deliver you the best care by knowing what happened to you in the past.
Hormones
Talk with your provider about hormone treatment. If you are a transgender woman, ask about estrogen and blood clots, swelling, high or low blood pressure and high blood sugar. If you are a transgender man, ask about the blood tests that you will need to be sure your testosterone dose is safe. Only take the hormones that are prescribed by your provider.
Cardiovascular health
Hormone use, cigarette smoking, overweight, high blood pressure and diabetes put transgender persons at an enlarged risk for heart attack or stroke. Some transgender women may not report feelings of chest pain or trouble breathing out of fear their provider may make them stop estrogen. It is important you tell your provider if you have these feelings.
Cancer
Although it is rare to develop cancer due to hormone treatment, when you are seen for check-ups by your provider, you will be evaluated for the possibility of cancer. If your sex organs have not been removed, your provider will also check for possible signs of cancer in those areas as well.
STDs and safe sex
Transgender people, primarily young transgender people, may be participating in sexual activity. Transgender people may get a STD just like anyone else and practicing safe sex is important to prevent being infected with a STD or HIV.
Alcohol and tobacco
Transgender persons who drink alcohol may be drink too much and risk damage to the liver and other organs. When taken with together, hormones may become more dangerous. Many transgender people smoke cigarettes, resulting in an increased risk of heart and lung disease, especially in those taking hormones. Transgender persons should not smoke and should only drink small amounts, if at all.
Depression
You may become unhappy or experience depression at times. When someone is experiencing depression, you may be unable to be happy regardless of the circumstances. Talk with your provider or therapist openly and honestly if you are experiencing these feelings.
Injectable silicone
With the intent of looking feminine and beautiful without having to wait for the effects of estrogen, some transgender women expect injections of silicone to give them ‘instant curves.’ Silicone sold at ‘pumping parties’ by non-medical professionals may move around in the tissue and result in ugly scars years later. Silicone is dangerous and should not be used.
Fitness
Many transgender people are overweight and do not exercise. A frequent exercise routine and a healthy diet are just as important for transgender people as for anyone else. It is also necessary to be in good physical condition if planning to undergo surgery in order to help you do well and respond well during and after surgery.
Voice Services
Sometimes individuals’ gender identity may not match how they wish to speak. You may choose to have voice therapy to help your voice match more closely to your preferred gender expression.
Whether transitioning male-to-female or female-to-male, we understand the challenges that come with voice transition, so we have developed a program to help these patients with their speech.
Treatment Options
Many individuals benefit by working with our speech pathologists alone, but some alterations may need minor surgery to ‘reset’ the fundamental frequency.
- Voice therapy. Our therapists have an in-depth background and specific skill set to help improve pitch, inflections, prosody, and mannerisms. They work with you to adjust your pitch to be more comfortable and an appropriate pitch range.
- Laser treatments. More subtle elevations can be treated with laser treatments and topical anesthesia to the vocal folds.
Male-to-Female
- Anterior glottic webbing. Minimally invasive technique to shorten vocal folds and raise pitch.
- Feminization laryngoplasty. Same-day endoscopic procedure to shorten length of the vocal folds and elevate pitch.
- Laser bilateral cordotomy. Minimally invasive technique to tighten the vocal folds to raise pitch.
- Cricothyroid approximation. Open neck surgery to raise pitch. This is considered a cosmetic surgery and often not offered due to permanent effect.
- Thyroid shave. For patients with prominent laryngeal cartilage (“Adam’s Apple”). A minimally invasive procedure that can be performed at the same time as pitch-raising surgery.
Female-to-Male
- Fascia implantation. Minimally invasive technique to add fullness to vocal folds and lower pitch.
- Laryngoplasty (type 3 thyroplasty). Open neck surgery that alters cartilage framework around vocal cords, decreasing pitch.
Contact Us
At the IU Health Voice Center, we’re here to help you. We’ll answer any questions you might have about therapeutic or surgical management for your voice. We’ll explain the costs and logistics for each procedure.
If you’re local, please call 317.450.4180 to make an appointment. We will walk you through the billing and insurance process. If you are not local, please contact us so that we can ensure your questions are answered before making the commitment to travel to our center for a consultation.