Strokes can be life altering — or even life ending, with often a stroke of luck being the difference between life and death. These medical emergencies are the No. 5 cause of death and a leading cause of disability in the U.S. While strokes were the No. 4 leading cause of death in the past, advances in treatments impacted higher survival rates. The American Stroke Association (ASA) states, “The right care — done the right away — can save both lives and quality of life.”
May is National Stroke Awareness Month, and an ideal time to remind ourselves and our peers of risk factors and effects. AMA suggests that folks use the letters in “FAST” to identify a stroke in others: “F” for face drooping, “A” for arm weakness, “S” for speech difficulty, and “T” for time to call 911.
Patents may encounter a range of symptoms as defined by the ASA, such as:
- Numbness or weakness, often on one side of the body
- Trouble speaking or understanding
- Trouble seeing
- Trouble walking
- Severe headache
Strokes occur when the blood flow to the brain is interrupted. Much like the patients who experience them, though, strokes are not “one size fits all” and they come in different forms.
Types of strokes include:
- Ischemic Stroke (clots)
- Hemorrhagic Stroke (bleeds)
- TIA (Transient Ischemic Attack): also called a mini-stroke
- Cryptogenic Stroke: the cause is not determined through testing
- Brain Stem Stroke: often impacting both sides of the body
According to the ASA, 80 percent of strokes are preventable, and understanding risk factors can be the first step to prevention. Leading causes of stroke cited by the CDC include high blood pressure, high cholesterol, smoking, diabetes, and obesity – and a healthy diet and exercise can help lower risk. However, practitioners should be mindful of the unique risk factors that may impact LGBTQ+ patients with strokes and other cardiovascular or neurological conditions.
Implications for LGBTQ+ Community Care
According to a scoping review by Rosendale, Wong, Flatt, and Whitaker, higher rates of stroke impact lesbian, bisexual, and transgender women. “It is evident that there are many disparities that exist for LGBTQ+ patients within neurology; however, there is still so much we do not know,” said Dr. Sarah Friedman in the Neurology.org blog. “Why do these disparities exist? While the answer is likely multifactorial, further studies are needed to explore various contributors, including psychological stressors, minority stress, and hormonal differences.”
USA Today reports statistics from an Oct. 2020 American Heart Association scientific statement, citing that 56% of LGBTQ adults experienced discrimination from clinicians, increasing to 70% of transgender or gender non-confmorming patients. This discrimination inculdes abusive language, and this often deters patents from receiving routine care, identifying health risks early on, and/or receiving medication to lower blood pressure or cholesterol.
Stroke risk for the LGBTQ population can potentially be offset by proper social support, studies suggest. Michelle Martin shares in USA Today, “Researchers urge health care professionals to ask patients about their exposure to discrimination and whether they have adequate support to deal with the stressors.”
Dina Proto International delivers training, consulting, and professional development opportunities to help providers and their teams understand disparities our LGBTQ+ patients face, helping to foster safe spaces and intentionally inclusive care for patients. Instead of relying on a stroke of luck for our LGBTQ+ patients’ positive outcomes, we can take calculated action to become better support systems — and ultimately save lives.
American Heart Association, (2020, Oct. 8). Discrimination contributes to poorer heart health for LGBTQ adults. Retrieved from https://newsroom.heart.org/news/discrimination-contributes-to-poorer-heart-health-for-lgbtq-adults
American Stroke Association. (n.d.).About Stroke. Retrieved from https://www.stroke.org/
American Stroke Association. (n.d.). Stroke Symptoms. Retrieved from https://www.stroke.org/en/about-stroke/stroke-symptoms
American Stroke Association. (n.d.). Types of Stroke. Retrieved from https://www.stroke.org/en/about-stroke/types-of-stroke
Centers for Disease Control and Prevention. (n.d.). Stroke Facts. Retrieved from https://www.cdc.gov/stroke/facts.htm
Friedman, S. (2021, June 14.) Current State of LGBTQ+ Disparities in Neurology and Neurologic Training. Retrieved from https://blogs.neurology.org/rf/current-state-of-lgbtq-disparities-in-neurology-and-neurologic-training/
Martin, M. (2021, June 23). American Heart Association reveals disparities in LGBTQ heart health. Retrieved from https://www.usatoday.com/story/sponsor-story/american-heart-association/2021/06/23/american-heart-association-reveals-disparities-lgbtq-heart-health/7771175002/
Rosendale N, Wong JO, Flatt JD, Whitaker E. (2021, Feb. 22). Sexual and Gender Minority Health in Neurology: A Scoping Review. Retrieved from https://jamanetwork.com/journals/jamaneurology/article-abstract/2776784