Health Disparities

A multitude of articles discuss the health disparities that are present within the LGBT communities and it is our responsibility as physicians to understand these health disparities and from where they stem. Due to factors like high levels of stress from life-long harassment, low rates of health insurance coverage, and a lack of cultural competency in the healthcare system, LGBT people are at a higher risk for many diseases.

LGBT people are more likely than their heterosexual/cisgendered peers to:

*Have poorer access to care

*Be uninsured

*Have worse health outcomes

*LGBT families are twice as likely to be impoverished

*Ten times as many hate crimes (physical assault) according to LGBT status than race/ethnicity

*40% of homeless youth are LGBT

Many LGBT people face substantial barriers to receiving care, a survey of almost 5,000 LGBT people found:

73% of Trans AND

29% of LGB respondents

==> Believed they would be treated differently by medical personnel.

52% of trans AND

9% of LGB respondents

==> Believed they would be refused medical services because they are LGBT.

27% of Trans AND

8% of LGB

==> Actually have been denied care (the most frequent setting was in a physician's private office).

Our LGBT neighbors are less likely to receive quality, culturally sensitive care for the same diseases that they are more likely to be afflicted by. Social marginalization can lead to employment difficulties which makes it difficult to maintain medical insurance or adequate housing. “Right now in 29 states, there is no state law protecting a gay, lesbian or bisexual person from being fired just because of who they are – and the same is true in 34 states for transgender people.” (citation: Human Rights Campaign)  It is stressful enough to support oneself and family members, but what if you could be fired for who you love or how you identify? The added stress could lead to heart disease, cancer, depression and myriad other illnesses related to stress. This disparity between the quality of healthcare provided to heterosexual and cisgendered citizens and LGBT citizens is a human rights issue and a civil rights issue. It is our duty as physicians to work to provide equitable, sensitive care for all people, regardless of sexual orientation or assignment.

As we can see, this endemic discrimination leads to tangible, but preventable negative health effects. Furthermore, this discrimination does not only affect adults within the LGBT community, but individuals at all stages of life. “Recent, highly-publicized cases of suicide among teenagers bullied for being gay, lesbian, bisexual or transgender have shed light on the violence and victimization experienced by LGBT groups. Indeed, gay, lesbian, and bisexual high school students are more likely than their heterosexual counterparts to be injured in a fight, threatened or injured with a weapon while at school, experience dating violence, be forced to have sexual intercourse, and avoid school because of safety concerns.”- Fenway Institute “Improving the Healthcare of Lesbian, Gay, Bisexual, and Transgender people: Understanding and eliminating Health disparities”