Beyond pride month: supporting LGBTQ+ health year round

As pride month ends, we reaffirm our year round commitment to offering the best possible care to everyone and making sure every member of our community, especially those who identify as LGBTQ+, feels heard, seen, and well-cared for.

Inclusive and affirming healthcare is essential for everyone’s well-being and overall health. However, the LGBTQ+ community often faces unique and difficult challenges when accessing care. They experience health disparities and higher risks of mental health concerns, substance use, and other chronic conditions. LGBTQ+ individuals often encounter discrimination, bias, and stigma in their lives that compound these health conditions. In healthcare settings, the biases against LGBTQ+ people can lead to avoidance of care and negative health outcomes. Offering affirming and comprehensive care helps build trust between healthcare providers and LGBTQ+ people, ensuring they receive the support and services they need to support their health.

Almost half (47%) of LGBTQ+ people report that they have an ongoing health condition that requires regular monitoring, medical care, or medication–a higher share than for non-LGBTQ+ people. In addition, a larger share of LGBTQ+ people report having a disability or chronic disease that keeps them from participating fully in work, school, housework, or other activities than non-LGBTQ+ people (21% v. 14%). When it comes to preventive care and screenings, trans and non-binary people are less likely to have appropriate exams for certain types of cancers. While LGBTQ+ people have many of the same health needs as anyone, there are a variety of ways to accommodate them more comprehensively and compassionately:

• Inclusive language. Using gender-affirming language, such as asking for and sharing pronouns and using gender-neutral terms, creates a welcoming environment for LGBTQ+ patients. Patients may want to avoid visits that are unnecessarily gender-labeled (such as “well woman exams”), as an example.
• Culturally-competent providers. Healthcare professionals should receive training on LGBTQ+ health issues, cultural competency, and the unique needs of this community. This training helps providers understand the specific challenges faced by LGBTQ+ individuals and equips them with the knowledge to deliver appropriate care.
• Safe spaces. Creating a safe and inclusive environment is essential. Welcoming people of all sexual orientations and genders contributes to a sense of safety and acceptance.

Barriers

LGBTQ+ individuals unfortunately encounter various barriers when accessing healthcare. Most significantly, stigma, discrimination, and other negative attitudes can lead to people feeling unwelcome or judged. These biases can cause them to delay or avoid seeking care altogether. Despite being a younger population that would typically be expected to be in better health, LGBTQ+ people more commonly report that their health is fair or poor than non-LGBTQ+ people (23% v. 14%), who are more likely to report good or excellent health (86% v. 77%).

Research findings indicate that LGBTQ+ people are more likely to encounter certain negative experiences with healthcare providers when compared to their non-LGBTQ+ counterparts. Specifically:

• Doubt regarding truthfulness: LGBTQ+ individuals reported instances where providers did not believe their accounts of health-related issues at a rate of 16%, whereas non-LGBTQ+ individuals reported a lower rate of 8%.
• Personal blame: Among LGBTQ+ individuals, 13% indicated that providers suggested they were personally at fault for their health problems, while the corresponding figure for non-LGBTQ+ individuals was 8%.
• Assumptions without inquiry: LGBTQ+ individuals reported cases where providers made assumptions about them without seeking clarification, with a higher rate of 21% compared to the 11% reported by non-LGBTQ+ individuals.
• Disregarding concerns: In terms of dismissing their concerns, 29% of LGBTQ+ individuals experienced this behavior from providers, whereas the rate was 16% for non-LGBTQ+ individuals.

Overall, the data reveals that over one-third (36%) of LGBTQ+ individuals reported encountering at least one of these negative experiences with a healthcare provider, whereas the figure for non-LGBTQ+ individuals was fewer than one in five (22%).

Many healthcare providers may have limited knowledge about LGBTQ+ health issues, leading to inadequate or inappropriate care. The absence of specific training can perpetuate health disparities within this community. For example, healthcare providers must be aware of the privacy needs of their LGBTQ+ patients. A patient who comes out to their provider may not feel safe with that information shared with their family members. LGBTQ+ patients also face higher risk of unsafe housing and substance use issues. Healthcare providers with proper training can bring up these topics compassionately to provide support and resources to these patients.

In terms of systems, discriminatory laws and policies can hinder access to essential healthcare services for LGBTQ+ individuals. Examples include restrictions on gender-affirming care or denial of services based on sexual orientation or gender identity. There can also be inequities in health insurance coverage, such as exclusions for gender-affirming care or same-sex partner coverage, which can create financial barriers to care.

Specific healthcare conditions

Several healthcare conditions and treatments are particularly important for the LGBTQ+ community:

• Mental health. LGBTQ+ people face higher rates of depression, anxiety, and suicide. In fact, LGBTQ+ individuals are three times as likely to experience a mental health disorder in comparison to individuals that identify as straight. Access to LGBTQ+-affirming mental health services is crucial to address these disparities and provide support.
• Sexual health. Conversations about sex with providers can be uncomfortable even without the additional layer of feeling “different” if a patient has a different sexual orientation than their provider. Regular screenings for sexually transmitted infections (STIs) and access to inclusive sexual health education and resources are vital.
• Substance abuse. Statistics show that LGBTQ+ adults are more than twice as likely as their heterosexual counterparts to use illicit drugs and almost twice as likely to suffer from a substance use disorder. LGBTQ+ individuals with addiction may hesitate to seek help from traditional treatment facilities due to fear of discrimination. However, these facilities often lack support for their unique needs, including coping with social isolation, family issues, homophobia, and violence.
• Gender-affirming care. Just like cisgender patients may seek gender-affirming care like eyelash growth or treatment for male pattern baldness, transgender and gender-nonconforming individuals may also seek gender-affirming treatments such as hormone therapy or surgical interventions. Access to competent and affirming healthcare providers is essential for safe and comprehensive care.
• General preventive health. Emerging studies suggest that LGBTQ+ people are less likely to receive certain health screenings, including those for the early detection of cancer. This is despite a higher risk of developing certain types of cancer in LGBTQ+ populations. There are social factors, such as delaying care due to fear of discrimination, and lack of education and research. It’s important that healthcare providers educate themselves and their patients on what screenings are appropriate.
• Reproductive health. LGBTQ+ people may require reproductive health services, including fertility assistance, family planning, or access to reproductive health screenings. Offering these services without judgment or bias is critical.

For a more inclusive and equitable healthcare system, we must take collective action. This includes: recognizing the shortcomings in traditional healthcare for LGBTQ+ patients, providing appropriate accommodations, addressing unique barriers to care, and caring for the specific health conditions this community faces. Creating a safe, respectful, and knowledgeable environment for LGBTQ+ individuals enhances their access to quality care and improves overall health outcomes. It is essential for healthcare providers, policymakers, and society as a whole to work together to ensure that LGBTQ+ individuals receive the compassionate and affirming care they deserve.

Hello Alpha emphatically believes that everyone deserves high-quality, compassionate, affordable healthcare regardless of gender, race, sexual orientation, or any other element of a person’s identity.