Discrimination in LGBTQIA+ Health Care

Navigating the health care system isn’t easy. With complicated insurance terms, overworked doctors and year-long wait times to get appointments, seeing your doctor can be challenging. This difficulty increases tenfold for specific marginalized communities — such as the LGBTQIA+ community.

LGBTQIA+ patients face blatant discrimination in health care, including access to fewer providers and uninformed doctors. To reach a place of equitable health care for LGBTQIA+ individuals, much work still needs to be done. Proper training for doctors and medical staff and putting laws in place that protect the rights of LGBTQIA+ privacy are some ways health care can be improved.

In this guide, we’ll look at some LGBTQIA+ patients' struggles, review equitable health care improvements and solutions and provide various resources for finding care.

Although a few positive strides have been taken recently, LGBTQIA+ individuals often encounter prejudice and bias when seeking medical care. This takes the form of outright refusal of care to more subtle forms of discrimination, such as inappropriate questioning or a complete lack of understanding regarding LGBTQIA+-related health questions. These discriminatory practices severely compromise the LGBTQIA+ community’s right to access necessary — and often lifesaving — health care services.

As an LGBTQIA+ person, turning on the nightly news can be a depressing experience. State governments limit access to necessary primary health care daily, creating headlines such as “Missouri lawmakers pass gender-affirming care ban for minors and anti-trans sports bill.” These bills encourage a blatant refusal of care or impose serious penalties for doctors and parents who do provide or seek out care.

LGBTQIA+ individuals may encounter refusal of care when seeking services such as hormone replacement therapy, gender-affirming surgeries or even routine primary care. In fact, in a study by American Progress, 7% of respondents reported that their provider wouldn’t give them the necessary health care because of their perceived sexual orientation.

This discrimination violates health care professionals’ ethical duty and creates significant barriers to accessing necessary care. This lack of care can have devastating health consequences.

LGBTQIA+ health care has recently gained traction. Not long ago, doctors received next to no training (or at least accurate training) on LGBTQIA+ health needs. Unfortunately, this reflects in the medical community, where many health care professionals lack the correct language and understanding of medications. This leaves care in the hands of patients rather than doctors.

The absence of LGBTQIA+-inclusive care can contribute to mistrust and discomfort, ultimately deterring individuals from seeking health care services altogether.

There are places with strong medical support for the LGBTQIA+ community, but there are just as many, if not more, that don’t have the necessary care available. Communities with higher rates of discrimination against LGBTQIA+ people often have few doctors willing to administer crucial medications such as hormone therapy, mainly because those places are rural areas where health care may already be limited anyway.

According to a study by American Progress, 23% of LGBTQIA+ adults didn’t seek the medical care they needed due to this fear of discrimination. Within this group, 27% were LGBTQIA+ people of color, 32% were LGBTQIA+ people with disabilities, 37% were trans and 50% were intersex.

The LGBTQIA+ community (transgender individuals specifically) often face limited reproductive health options within the current health care system. According to the same American Progress study, more than 1 in 5 trans respondents were denied the reproductive care they sought.

Additionally, traditional reproductive health care services are typically designed with cisgender, heterosexual individuals in mind, contributing to the same lack of education on trans issues mentioned above. For instance, lesbian couples or transgender individuals may encounter challenges when seeking fertility treatments or access to assisted reproductive technologies.

Insurance is complicated and only grows more complex for many members of the LGBTQIA+ community. Many insurance policies have exclusions or limitations targeting LGBTQIA+ individuals, denying coverage for essential health care needs such as gender-affirming surgeries or hormone therapy.

Transgender, nonbinary and intersex individuals deal with these issues most often. The outdated and discriminatory exclusions fail to recognize the medical necessity and well-established standards of care for transgender individuals. As a result, LGBTQIA+ patients have to take on that financial burden themselves.

LGBTQIA+ patients encounter various obstacles when getting the care they deserve. Trans patients often have to deal with incorrect pronouns and names on health insurance and patient forms or a lack of coverage for gender-affirming care. Lesbians and gay men don’t always have ready access to the LGBTQIA+-friendly reproductive options they need. And the list goes on.

It’s not always easy, but some solutions can help propel the community toward a more inclusive future.

Since almost a quarter of all LGBTQIA+ adults face discrimination as medical patients, this is a serious issue preventing individuals from seeking care. This can lead to poorer health outcomes, lack of transgender hormone therapy and gender-affirming care and increased risks of suicide if patients are unable to get the care they need.

Navigating the challenges of discrimination and rejection as an LGBTQIA+ individual can be daunting, but practical strategies and resources are available to help overcome these obstacles.

With health insurance coverage being a complex topic for many members of the LGBTQIA+, medical bills often become a personal responsibility rather than being covered by insurance. This can put a lot of pressure on a person, especially considering LGBTQIA+ individuals already face a wage gap that puts them at an income disadvantage.

Managing expensive medical bills can seem like a never-ending endeavor. You can do things to decrease debt or erase it.

Medical transition, encompassing hormone therapy, gender-affirming surgeries and various other procedures can present unique obstacles when seeking reliable health care. Thankfully, support networks and resources can assist you in your journey towards gender-affirming care.

When you need help affording medical transition, make sure to:

When your health care provider can’t answer basic medical questions, the whole experience can be a little disheartening. This knowledge gap can lead to inadequate care and misdiagnosis.

While undertrained doctors aren’t your fault, there are still steps you can take to help them understand your needs.

From hate crimes to harassment and bullying, the LGBTQIA+ community continues to face disproportionate levels of violence. By exploring preventive measures, support networks and advocacy efforts, we can all work toward a future where all individuals are free to express their identities without fear of violence or harm.

We can all take steps to promote the safety of the LGBTQIA+ community by doing the following:

Caring, helpful providers exist for the LGBTQIA+ community — it’s just a matter of finding them. Various strategies and resources can help you identify and connect with providers who prioritize inclusivity and understand the specific health concerns faced by the LGBTQIA+ community.

To find LGBTQIA+-friendly health care services in your area, find your state below to see the closest options.

Source: Centers for Disease Control and Prevention

Several organizations are dedicated to providing health services to LGBTQIA+ patients. These resources can help LGBTQIA+ individuals connect with supportive health care providers:

• GLMA (Health Professionals Advancing LGBTQ Equality): GLMA promotes LGBTQIA+-inclusive health care by providing a directory of LGBTQIA+-friendly health care providers. They also offer education for health care professionals looking to improve their understanding of LGBTQIA+ health issues.
• LGBTQ+ Health Care Directory: A comprehensive online directory that allows you to search for LGBTQIA+-friendly health care providers in your area.
• Out2Enroll: An organization that focuses on helping LGBTQIA+ individuals navigate health insurance enrollment, providing information and assistance finding inclusive coverage.
• The Human Rights Campaign (HRC), "My Body, My Health:" In the absence of reliable care, HRC created the “My Body, My Health” initiative, which helps the LGBTQIA+ community (and other marginalized communities) have a better understanding of their bodies, HIV and sexual health.
• The Trevor Project: A well-known organization, the Trevor Project provides emergency mental health counseling for LGBTQIA+ youth. This also includes a directory of mental health professionals specializing in LGBTQIA+ care.

Despite significant advancements in LGBTQIA+ rights, health care disparities still exist. That doesn’t mean we shouldn’t celebrate our victories, though, and there have been numerous victories, including:

While these are actions on the federal level, it’s important to note that the landscape of health care access for the LGBTQIA+ community varies across states. Some states have implemented laws that protect LGBTQIA+ individuals from discrimination, while others have set forth some that do the opposite.

Ongoing efforts are still necessary to get equitable care for every LGBTQIA+ American. This includes continued advocacy for comprehensive nondiscrimination policies, expanded provider education and education on the financial barriers that limit health care access for many LGBTQIA+ individuals.

Understanding your options, advocacy, support and legal rights is crucial. The following resources can help you find the information and guidance you may need when navigating the health care system as an LGBTQIA+ individual.

1. GLAAD: A nonprofit organization advocating for LGBTQIA+ acceptance through positive media, engagement within the community and education services throughout the country.
2. CenterLink: A network of global LGBTQIA+ community centers offering educational resources, support and services to the LGBTQIA+ community.
3. National LGBTQ+ Task Force: An advocacy organization helping to advance the rights of the LGBTQIA+ community, specifically in the areas of reproductive justice, government representation and policy.
4. National Center for Transgender Equality (NCTE): An organization advocating policy change and social justice for the transgender and gender nonconforming communities.
5. Lambda Legal: A nonprofit organization fighting for LGBTQIA+ legal rights — specifically for those living with HIV — and advocating for equal legal treatment.
6. Trans Lifeline: A hotline and resource center offering support to transgender individuals in crisis. They also offer microgrants for gender-affirming care and name changes, plus LGBTQIA+ migrants.
7. PFLAG: A national organization that provides support, education and advocacy for LGBTQIA+ individuals, their families and community allies.
8. National LGBTQIA+ Health Education Center: A resource center offering educational materials and training programs to enhance LGBTQIA+ health care inclusivity.
9. SAGE: An organization dedicated to improving the lives of older LGBTQIA+ adults through advocacy, inclusive housing, a hotline and more.
10. The National Queer and Trans Therapists of Color Network: A directory of queer and trans therapists of color looking to promote mental health resources for the entire LGBTIA+ community.
11. Transgender Legal Defense & Education Fund (TLDEF): A nonprofit organization offering the Trans Health Project, which offers education on legal rights for the LGBTQIA+ community and leads the movement toward equitable care for trans patients.