Author: Simona Hausleitner
It’s 2020. And the LGBTQ+ community is still facing significant discrimination in the healthcare field. Despite the commonly-held view that doctors are obligated to give the best standard of care to every patient, LGBTQ+ citizens frequently have less access to medical treatment. Although we have made progress in advancing LGBTQ+ rights in the political,
social, and economic spheres, one area that is still lacking is the healthcare industry. It is important to recognize the disparities that LGBTQ+ people face when seeking medical care and health insurance so that we can effectively work on eliminating this societal problem.
There are three main reasons for the LGBTQ+ community’s reduced access to healthcare: lack of health insurance, discriminatory treatment by healthcare providers, and the inability of doctors to address the unique needs of the LGBTQ+ community.
Medical research has found that LGBT people are at heightened risk for physical and mental health problems, including psychological distress and drug abuse/overdose. Lesbian and bisexual women are at heightened risk of having multiple chronic conditions (arthritis, asthma, a heart attack, a stroke, angina pectoris, or cancer), and homosexual and transgender people in the United States are more likely to be overweight, depressed, report cognitive difficulties, and forego treatment for health problems.
The health issues that LGBTQ+ people experience are often exacerbated by the discrimination they face in society. Researchers have identified a range of harms related to “minority stress," or the added stressors that individuals face because they belong
to a stigmatized group. Studies have concluded that minority stress processes are related to an array of mental health problems, including depressive symptoms, substance use, and suicide attempts. This means that individuals in the LGBTQ+ community are more prone to have certain health issues, but they are also more likely not to seek treatment for these problems due to the fear of discrimination.
When it comes to healthcare access, LGBTQ+ individuals are less likely to have health insurance, less likely to fill prescriptions, more likely to use the emergency room or delay getting care, and more likely to be refused health care services. Many people also experience harassment or verbal abuse from the doctors who should be helping them. LGBT
individuals are twice as likely to be uninsured as non-LGBT individuals and many have difficulty finding providers who will treat them without passing judgment on their sexual orientation or gender identity. Many providers also cannot offer the services they need, particularly in rural areas.
LGBT people also have unique needs related to their sexual orientation and gender identity. Same-sex couples who decide to have children, for example, may seek out fertility specialists or utilize assisted reproductive technologies as part of the process. Gay and bisexual men and transgender women may be more in need of HIV-related health care, including treatment and access to preventive care such as pre-exposure prophylaxis (PrEP), a daily pill that significantly lowers the risk of HIV infection. Transgender people who medically transition may seek access to puberty blockers, hormone replacement therapy (HRT), or gender-affirming surgeries as part of their transition. However, LGBT people often face significant verbal abuse, discrimination, and judgment, both from healthcare providers and from bystanders. Thus, they are much less likely to seek medical treatment.
There are three main causes for these disparities: a lack of specific education and training for health care workers, restrictive health benefits and outdated laws that legalize discriminatory treatment, and LGBTQ+ people’s fear due to stigma, discrimination, and institutional bias in the health care system.
Despite the discrimination and lack of access experienced by the LGBT community, there are many ways that we can solve these problems. Every state should require that medical schools include LGBTQ- specific topics in medical education. In a 2018 survey sent out to 658 students at US medical schools, around 80 percent of respondents said they felt "not competent" with medical treatment of gender/sexual minority patients. By informing doctors and spreading awareness, we will be able to create a more accepting and inclusive environment. In addition, we can lobby legislators to pass laws banning discrimination based on gender identity & sexual orientation.
By spreading awareness of these problems, we can ensure that the LGBTQ+ community receives the same access to healthcare and the same quality of medical treatment as the rest of the population.
Sources:
"Anti-LGBT Discrimination in US Health Care | HRW." 23 Jul. 2018, https://www.hrw.org/report/2018/07/23/you-dont-want-second-best/anti-lgbt-discrimination-us-health-care.
"Unhealthy Attitudes | LGBTQ discrimination in healthcare ...." 15 Jan. 2019, https://www.headstuff.org/topical/lgbtq-discrimination-healthcare/.
"Access to health services by lesbian, gay ... - NCBI - NIH." 14 Jan. 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4714514/.
"Anti-LGBT Discrimination in US Health Care | HRW." 23 Jul. 2018, https://www.hrw.org/report/2018/07/23/you-dont-want-second-best/anti-lgbt-discrimination-us-health-care.
"Unhealthy Attitudes | LGBTQ discrimination in healthcare ...." 15 Jan. 2019, https://www.headstuff.org/topical/lgbtq-discrimination-healthcare/.
"Access to health services by lesbian, gay ... - NCBI - NIH." 14 Jan. 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4714514/.
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