Why Inclusion Matters: LGBTQ+ Health Disparities in the U.S

What Are the Disparities?

Among other things, both violence and victimization towards the LGBTQ community have long-lasting effects on physical and mental health.  Research has found that discrimination against LGBTQ+ persons has been associated with high rates of psychiatric disorders, substance abuse, and suicide. A lack of education geared towards LGBTQ-centered healthcare within society has also lead to inequalities. 

The Center for Disease Control and Prevention data (2014) revealed that gay and bisexual men accounted for 83% of the new diagnoses of HIV among males, aged 13 years and older. Lesbians and bisexual women are at an increased risk of breast, ovarian, and endometrial cancers due to fewer full-term pregnancies, fewer mammograms and obesity. 

 LGBTQ youth are 2 to 3 times more likely to attempt suicide than their heterosexual counterparts.  

Reducing Inequalities

Education and research are some of the most promising avenues for reducing health inequalities among the LGBTQ population. Recent health surveys that collect information on sexual orientation and LGBTQ healthcare have begun to emerge over the last couple of years. The data from these surveys is essential to creating a foundation from which educational material can springboard. 

Fifty-six percent of LGBTQ individuals report having experienced some form of healthcare discrimination.[1]  Education continues to address issues such as discrimination through patient-provider interaction and culturally competent care. Other important factors to consider in reducing these health disparities are language and legislation. 

Learn better with LGBTQ inclusive education

Many of the statistics regarding LGBTQ disparities show a lack of inclusive sex education for both LGBTQ youth and healthcare professionals. Unfortunately, a mere fifteen percent of PCPs claim they have received focused training regarding LGBTQ patient care. So, from the very beginning of puberty and sex education, disparities between LGBTQ and their counterparts arise. 

For clinicians who did not receive specialized training, The National LGBT Center for Health Education offers continuing education credits on LGBTQ specific healthcare for doctors and nurses. Advocates of the LGBTQ community can encourage healthcare workers to select these types of Continuing Education Credits to decrease inequalities. 

Another resource for education focused on schools is Advocates For Youth, which has both inclusive sex education material and training for sex education teachers. This organization also provides great online resources for individuals to educate themselves on sexual orientation and gender identity. 

It will take advocacy from both local individuals and communities, to advocate for more inclusive sex education. This type of education will decrease the number of STIs among the LGBTQ population as well as other related disparities. 

LGBTQ inclusive language makes a difference

Various social media and online communities are filled with personal accounts from LGBTQ patients discussing how heterosexual assumptions made by the healthcare workers affect their care. These assumptions, and the incorrect pronouns that follow, often cause LGBTQ patients to feel ostracized; leading to a decrease in proper medical care. 

The healthcare community needs to create a system that caters more specifically to the LGBTQ patient, thereby providing more complete and accurate information. Even the small change in asking the generic question: “Are you sexually active?” to such options as, “Are you having sex with a female or male?” would begin to address these issues. 

Legislation and Insurance Coverage

Unfortunately, the current administration recently reversed a rule from the Obama administration that protected sexual orientation and gender identity against sex discrimination in healthcare and insurance companies?[2] However, the populous at large is generally unaware. These types of threats contribute significantly to the disparities felt in LGBTQ centered healthcare. Until both legislation and insurance coverage are created and provided with LGBTQ specific coverage in mind, these institutions will remain biased toward heterosexual Americans. 

How to find Inclusive Care

The CDC has a comprehensive state-by-state guide, with LGBTQ facilities in each state, along with other resources, such as hotlines and referral services that focus on LGBTQ centered healthcare. OutCare and GLMA provide nationwide directories of healthcare centers that support the LGBTQ+ community. In some states, there are also community-driven directories such as the LGBTQ+ Directory of Clinical Care Services (DoCCS) in Illinois. These directories are nowhere near comprehensive, but they continue to emerge and grow each year. 

Another great way to find inclusive care is through local LGBTQ communities. Word of mouth can be a huge advantage in locating a physician who is LGBTQ competent and friendly. 

Be a Self-Advocate

It is important to remember that an individual can and should seek out healthcare providers who respect them. Seeking for LGBTQ-centered healthcare includes this type of self-advocacy where individuals find caring physicians. While this form of self-advocacy is vital, individuals should not forget to also seek out community advocacy that will affect them in the long term.

Effective community-based advocacy requires knowledge of current legislation and action towards better future legislation. Within these broader strokes are pockets of advocacy actions such as fundraising, petitioning, and community events to name a few. These actions may go beyond an individual’s advocacy, but decreasing disparities for the LGBTQ community as a whole. 

The National LGBTQ Task Force is a great resource for advocacy information on understanding legislation and getting involved. This site also contains a sign-up tab for notifications on the latest updates that affect LGBTQ-centered healthcare. Another great resource is the United Nations’ Human Rights Campaign, the largest LGBTQ advocacy organization in the world. They provide easy sign up for petitions and ways to follow both national legislation and state events affecting the LGBTQ community.

The Supreme Court ruled in June 2020 that sex discrimination protections apply toward sexual orientation and gender identity, preventing LGBTQ individuals from being fired or not hired based on their sexual orientation and/or gender identity.[3] Successes such as this ruling for the LGBTQ community are achieved through advocacy, and every person is needed to make this world a better and safer place for us all.

[1] https://www.thetaskforce.org/new-report-reveals-rampant-discrimination-against-transgender-people-by-health-providers-high-hiv-rates-and-widespread-lack-of-access-to-necessary-care-2/

[2] https://nurse.org/articles/culturally-competent-healthcare-for-LGBTQ-patients/