“In 2016, the LGBTQ+ community was identified as a “health disparity population” by the National Institute on Minority Health and Health Disparities, partly because individuals who identify as part of this group have less access to health care.”
This is a statement that simply shouldn’t be a truth in the age we live in.
What is more shocking is that a survey conducted in 2017 shows that doctors turned away 1 in 10 LGBTQ people from needed health resources for what they perceived or knew to be the sexual orientation. At the same time, doctors turned away 3 out of 10 transgender people due only to the gender presentation.
The Hippocrates Oath says that a doctor’s job is to treat the sick to the best of their ability and to maintain their privacy. Why does discrimination need to play into this?
Please bear with me, as I share something from my past.
Passing of a loved one
I have mentioned in other posts that my first boyfriend, Shawn, passed away on February 28th, 2003. That I came home to him taking his last breaths and held him in my arms as he passed. What I haven’t shared, to my knowledge, are the events right after that moment.
It is important to point out that at this time, Shawn had stopped taking his meds for HIV. He became tired of how the cocktail of drugs affected him. How advanced his symptoms were was something he kept to himself…
I reached for the phone and called 911.
As the paramedics arrived, they pushed me out of the room and started trying to resuscitate him. I explained to them that he was HIV-.
I am sobbing heavily over him dying and the paramedics talked to one another about how “someone needs to calm HER down.” They assumed I was female, based on my emotional response to the situation.
They were unable to revive him and pushed him through the living room and into the ambulance without telling me where they were taking him. Remember, this was 2003 and gay marriage wasn’t a thing yet nor were hospital rights. I didn’t have any information about where he went or how to find him. Thankfully, I had also called a friend who showed up to console me. She asked me to identify the ambulance. She said she knew where they went and took me to the hospital.
I get there and explain, through tear-stained eyes and sobbing breaths, why I am there. They identified he had been brought there but that I was not allowed to see him. Her response was that I was gay and had no family rights to view him. I fell to the floor in disbelief and desperation.
I sat there crying. A nurse came out and asked me if I was okay. I explained the situation and how they wouldn’t let me back to see him. She looks around, grabs my hand, and says come with me. She took me to see him one last time.
The tube they used to resuscitate him was still in his mouth and it appeared they had left him in a hall. She said that she could only give me ten minutes. I thanked her for her kindness and held his hand sobbing for as long as I could. Thirty mins later, she came back and said she was going to have to escort me out.
I share this story to show how health care disparities are a real issue.
Yes, we are in a better place than we were in 2003. Yet, if a doctor turns away someone who needs help, only because of their perceived orientation or their gender presentation, then we haven’t progressed that far.
Why is do we have less access to healthcare
Maybe you are wondering why we have less access than our straight counterparts. There are many contributing factors to that answer. Many LGBTQ people live in a more impoverished environment, whether from parents kicking out their queer kids or even from losing their housing due to discriminatory landlords. There is also the factor of having to deal with discriminatory healthcare providers or discriminatory social environments.
These types of situations create negative health impacts and can lead to what’s called minority stress – stress associated with experiencing both institutional and interpersonal stigmas because of one’s sexual orientation or gender identity.
Like my experience with the hospital when my lover died, many LGBTQ people feel like they are also pushed away for being who they are. Imagine the kind of fear that a transgender person must feel when they have to go to a new doctor and explain what’s going on. Will that doctor be understanding of who they are or will they have to worry about harassment.
These fears force us into a position of not wanting to go visit a healthcare provider and ultimately have serious negative impacts on our health.
LGBTQ Health Disparities
While there are many disparities that LGBTQ people face, there are six that are the most common among each of us.
Obesity and Eating Disorders
A study conducted in 2019 showed that lesbian and bisexual women had a much higher chance of being obese than women identifying as heterosexual. The why’s of these findings isn’t clear. There are researchers who have talked with lesbians who believe that being this is part of a societal construct of a beauty image designed by men for men.
Gay and bisexual men, on average, do not seem to have the same issues with being overweight. Gay and bisexual men are more prone to eating disorders and body image issues. This isn’t a surprising one with all the images we are surrounded with about having a perfect body.
Sexually Transmitted Infections
Gay, bisexual men, and men who have sex with other men are the most affected by Human Immunodeficiency Virus (HIV). Adolescent and adult gay and bisexual men were 69% of the 37,832 new HIV infections in 2018, according to the CDC. By now, it should be no shock that anal sex is the riskiest type of sex for transmitting or getting HIV. It also should be no surprise that many men still engage in unprotected anal sex, without a condom or medicine like PreP to prevent the spread of HIV.
There is also an increase in other STIs like gonorrhea, syphilis, and chlamydia., among gay and bisexual men.
Human Papillomavirus infections are also on the rise in the LGBTQ community. Gay, bisexual men, and men who have sex with other men are 20% more likely to develop anal cancer, which is linked to HPV infections. HPV is also a leading cause of cervical cancer among women. It is also linked to causing cancer in both the head and neck due to transmission through oral sex.
These are conversations we should be having with, both, our doctors and our partners.
Mental Health Conditions
Let’s face it, it is no shock that LGBTQ people are more prone to depression, anxiety, suicide, eating disorders, and substance abuse. These conditions are in direct correlation to systemic oppression. It is also no surprise we are seeing attention deficit disorder and depression increasing rapidly in transgender and gender non-conforming youths. Until 1973, homosexuality was still listed as a mental disorder. Today’s transgender youths face similar problems. For them to receive the needed life-saving and affirming, they have to be diagnosed with gender dysphoria. That is only the tip of a bigger iceberg.
Imagine being a transgender man who needs to schedule a pap smear. You are faced with having to find a health care provider then having to explain your situation to them. Imagine the amount of mental trauma this can cause. In many cases, you may have to go further and educate your doctor about what it is like to live as a transgender man.
Substance Usage and Abuse
Having to deal with the effect of depression, anxiety, and other mental conditions, that are often a part of being LGBTQ, can easily lead to an increase in substance use. Many times it becomes a coping mechanism for what they are forced to live through on a daily basis
In 2016, National Health Interview Survey released data that showed 20% of adult LGBTQ people smoked compared to 15% of heterosexual adults. Smoking is tied to heart disease, lung cancer, possibilities of stroke, and other health conditions.
Gay men and lesbians are also twice as likely to have a severe drinking problem, where bisexuals are three times as likely.
Breast and Cervical Cancer
Unfortunately, many LGBTQ people do not go to the doctor regularly. And of those that do, many of them do not self-identify as being LGBTQ, out of fear of harassment and refusal of service. This can lead a lot of studies not having correct information about issues that may be prevalent in our community.
Breast and cervical cancer studies are some of them
In 2000, an analysis of data of more than 93,000 women between the ages of 59-70 showed that lesbian and bisexual women had higher rates of breast and cervical cancer than the heterosexual counterparts. What isn’t known was if any of these women were prescreened, had predispositions to either, used alcohol excessively, or were overweight or obese.
It was later concluded that the only way to have accurate findings in these matters is to have collected information about the person’s sexual orientation.
Heart disease has many contributing factors; age, race, family history, as well as diet addictions. Many studies have shown that lesbians, gay men, and bisexuals are at higher risks for cardiac disease and heart problems than heterosexuals. Sexual minority groups, such as lesbians, gays, and bisexuals, are also more prone to be smokers and have poorly controlled blood sugar. This could be an effect of not eating properly and/or other factors.
Heavy drinking is also more common among LGBTQ people. Heavy drinking can have a direct effect on cardiovascular health. As with the lack of data on breast and cervical cancer, there have not been enough studies conducted to see the effect of long-term heavy drinking in LGBTQ people
Sleep is another contributing factor to overall cardiovascular health and studies are starting to show that LGBTQ men and women are not getting adequate sleep duration and quality of sleep. More studies are needed. For more information on this, check out “Assessing and Addressing Cardiovascular Health in LGBTQ Adults: A Scientific Statement From the American Heart Association.”
Why better access is needed
No LGBTQ person should have to fear being denied access to needed healthcare because of who they are. Just as it is important that we have access to see our spouses in the hospital. Healthcare is important for our quality of life, as much as it is for our survival.
The Hippocratic Oath says that doctors are supposed to treat the sick to the best of their abilities. LGBTQ people deserve the same access to healthcare as our heterosexual counterparts. No one should have to feel shame or fear when they need to see a doctor. Because of this fear, many of the contributing factors to our well-being have not been fully documented. This can cause misleading statistics about how environmental and psychosocial stressors affect our well-being.
We need more information on how LGBTQ health disparities affect our overall health and well-being. We need healthcare providers that will treat us as people and not our sexual orientation or gender identity.