All people need health care at some point, and most expect good-quality care. But, not all people have the same access to care or the needed treatments. When some groups of people have less access than others to health care, it results in worse health.
Health disparities or inequities can happen when one group gets lower-quality care than others. The LGBTQIA+ community may face more challenges in getting adequate health care than the broader population.
The LGBTQIA+ group includes people who are:
- Another gender identity or sexual orientation.
LGBTQIA+ health disparities can affect the health of LGBTQIA+ people. They may be more likely to have or die from certain diseases. And there are ways to reduce these differences and improve health care for all.
What Are LGBTQIA+ Health Disparities?
Health disparities are when disease, injury, or violence affects one group more than others. That’s according to the Centers for Disease Control. This tends to occur to marginalized groups, meaning they may have more disadvantages than others.
Many things can prevent LGBTQIA+ people from getting high-quality health care, according to a 2016 article in the journal LGBT Health.
Some issues that LGBTQIA+ people face in getting high-quality health care include:
- They are less likely to have access to primary health care than others, according to the Journal of Clinical Oncology. Almost one out of three transgender people does not have a regular doctor. That’s according to the organization Services and Advocacy for Gay, Lesbian, Bisexual, and Transgender Elders (SAGE).
- They are less likely to know which health screenings they need. They are less likely to have cancer screenings like mammograms, cervical Pap exams, or prostate exams. That’s according to a 2022 study in the journal Cancer Causes and Control.
- They are less insured than others, according to the U.S. Department of Health and Human Services, and they worry about the cost of care. They are twice as likely to delay care, according to a 2019 study in the journal Preventive Medicine Reports. Twenty-nine percent of LGBTQIA+ people said they could not pay for health care in a 2020 Center for American Progress survey.
- One in eight LGBTQIA+ people lives in a state where a doctor can refuse to treat them. That’s according to a survey by the Movement Advancement Project.
- Some health care workers do not know as much about treating people who are LGBTQIA+. That includes doctors, according to the Journal of Clinical Oncology in 2019. Also, nurses, according to a review in Nurse Education Today in 2017. And pharmacists, according to Pharmacy Practice in 2020.
- Older LGBTQIA+ adults are more likely to have a disability than other older adults, according to SAGE. Trans adults are more than twice as likely to get poor health care and unfair treatment. That’s according to the 2019 study in Preventive Medicine Reports.
Never Miss a Beat!
Subscribe to Our HealthBeat Newsletter!
Thank you for subscribing!
You are already subscribed.
Sorry, an error occurred. Please try again later.
Get Healthy Tips Sent to Your Phone!
What Factors Stop LGBTQIA+ People from Accessing Skilled, Safe, Readily Available Care?
There are several reasons that people who are LGBTQIA+ might receive worse health care. That’s according to the National Academies of Sciences, Engineering, and Medicine.
One reason is that people in this group are a minority — there are fewer LGBTQIA+ people than straight people. Only 3.5 % of Americans identify as lesbian, gay, or bisexual. And 0.3% identify as transgender. That’s according to a 2017 study in the journal Cureus.
Some LGBTQIA+ people also need care that differs from what the broader population gets. Experts that provide this care can be few and far between.
Some health care workers may not have training in treating LGBTQIA+ people. For instance, many schools that train doctors do not teach how to care for trans people. That’s a 2022 study in the journal Advances in Health Sciences Education.
Many primary care doctors are also not prepared to answer questions about LGBTQIA+ health. That’s according to another study in 2018 in the Journal of Homosexuality.
There is also less research on the health issues of LGBTQIA+ people. That’s according to a 2011 review by the National Academies of Science, Engineering, and Medicine. That means data on how to care best for LGBTQIA+ people may not exist. Without this research, doctors rely on knowledge that may be inadequate or inappropriate for the care of LGBTQIA+ people.
LGBTQIA+ health disparities and bias are the biggest reasons these have trouble getting safe and skilled health care. Many have had negative experiences with health care workers.
The 2020 Center for American Progress survey found many stigmas and poor treatment of LGBTQIA+ people by health care workers. These include:
- One in five LGBTQIA+ people didn’t visit the doctor to avoid bias.
- Fourteen percent said their doctor seemed uneasy because of their sexual orientation.
- Eight percent of LGBTQIA+ people said a doctor used harsh or abusive speech with them.
- Eight percent said a doctor ignored their family member on purpose.
- Seven percent said they had unwanted physical contact from a doctor.
The same survey found even more bias against transgender people. This includes:
- 28% of trans people said a doctor refused to see them because they were trans.
- 29% of trans people said a doctor used harsh or abusive speech toward them.
- One out of three trans people said a doctor refused to give them health care linked to gender transition.
- 38% of trans people said a health care worker was rough or abusive while treating them.
- About half of trans people said their doctor seemed uneasy treating them.
- Almost half of trans people said their doctor called them the wrong gender on purpose.
Another barrier to good-quality health care includes access to health insurance coverage. According to the Movement Advancement Project, in 27 states, there are no laws to ensure that LGBTQIA+ people can get the same insurance as others. Actually, according to Bloomberg Law, several states block coverage of gender-affirming care for young people.
Finally, according to the American Psychiatric Association, LGBTQIA+ people do not have as much social support as other people. Feeling lonely or isolated from other people can add to poor health.
How Does Low-Quality Care Affect the LGBTQIA+ Community?
Not having access to high-quality health care means the LGBTQIA+ community has higher risks for many health issues. They also have a higher risk of worse outcomes and even a higher risk of death for some diseases.
According to a 2011 report from the Joint Commission, LGBTQIA+ people have a higher risk of many health issues. These include:
- Smoking, alcohol use, and substance use.
- Depression and anxiety.
- Eating disorders and obesity.
- Heart disease.
- Sexually transmitted diseases, like HIV.
- Violence from a romantic partner.
- Violence from strangers.
- Bullying from students or coworkers.
What Can Reduce LGBTQIA+ Health Disparities?
Equitable health care for LGBTQIA+ people would improve their physical and mental health. Equitable care means that health care workers will sometimes need to do more for certain groups to get the desired outcome.
Equitable health care could help extend the average life expectancy of people in the LGBTQIA+ community. It would also lower health care costs and reduce the spread of diseases.
According to the Joint Commission, there are ways to increase equitable health care and improve the health of LGBTQIA+ people. These actions include:
- Teach health care workers how to treat LGBTQIA+ people.
- Research into LGBTQIA+ health needs and proper treatment of those needs.
- Make doctors’ offices more welcoming to LGBTQIA+ people, with rainbow flags and posters about LGBTQIA+ health.
- Pass local, state, and national laws to protect LGBTQIA+ people from poor treatment or denial of health care.
- Teach people that LGBTQIA+ people deserve fair treatment and respect.
- Pass laws against violence, bias, or unequal treatment of LGBTQIA+ people.
The UPMC Adult Congenital Heart Disease (ACHD) Center is a joint program between UPMC Children’s Hospital of Pittsburgh and UPMC Heart and Vascular Institute. We provide long-term care for adolescents, young adults, maternal patients, and adults with congenital heart disease. Our goal is to provide complete care from your childhood all the way through your life. Our team of experts has a wide knowledge of heart conditions.