Understanding Barriers to Healthcare for LGBTQ+ Patients
1
DISCRIMINATION
One of the most prevalent factors creating a barrier for LGBTQ+ people in accessing healthcare is discrimination An estimated 1 in 5 LGBTQ+ individuals reported avoiding and/or delaying their healthcare because of mistreatment or discrimination by a provider; over 1 in 3 transgender individuals report the same (Medina & Mahowald, 2022)
Although general acceptance of LGBTQ+ identities has increased in recent years, implicit biases can still drive discrimination, leaving it to remain prevalent in the medical system. 1 in 3 LGBTQ+ adults report having been mistreated by a medical provider in the last year (Medina & Mahowald, 2022). Culturally-competent trainings for medical students and continuing professionals is necessary to improve these outcomes and better prepare providers to treat LGBTQ+ patients. Currently, medical students report that only 5 hours of their total medical education is dedicated to LGBTQ+ health (National LGBT Cancer Network).
2
COST
Another significant barrier to accessing healthcare for LGBTQ people is cost More than 1 in 3 LGBTQ+ people reported delaying care in the last year due to the cost More than 1 in 2 transgender or non-binary people reported the same (Medina & Mahowald, 2022)
Cost-related barriers may be a result of being uninsured or having discriminatory insurance policies that do not cover, or require high out-ofpocket costs for procedures (Medina & Mahowald, 2022). For example, in some states, insurance companies are permitted to deny coverage for gender affirming care (Movement Advancement Project). Additionally, general economic security may also contribute to cost-related barriers. Compared to non-LGBTQ+ people, LGBTQ+ individuals are more likely to be low-income which may contribute to the heavy burden of health care costs (Dawson, Long, & Fredericksen, 2023).
Another factor contributing to barriers to healthcare for LGBTQ+ people is policy. Although some states prohibit insurance discrimination on the basis of sexual orientation and/or gender identity, 26 provide no laws at all leaving an estimated 44% of the LGBTQ population living in a state with no insurance protections (Movement Advancement Project). Additionally, as mentioned, 2 states explicitly permit insurers to refuse to cover gender affirming care, creating significant barriers for these individuals residing here (Movement Advancement Project)
A greater number of states have policies that prevent transgender youth from accessing gender-affirming care Specifically, 23 states completely ban any medication or surgical form of gender-affirming care for youth; another bans only surgical care (Movement Advancement Project). In 5 of these states, the policy also makes it a felony if a healthcare professional provides this care (Movement Advancement Project). Such policies create systemic barriers for transgender individuals and also compound existing health inequities, including mental illness due to a lack of acknowledgement and acceptance of their identity in society.
REFERENCES
Dawson, L., Long, M., & Fredericksen, B. (2023). LGBT+ People’s Health Status and Access to Care. Kaiser Family Foundation. https://www.kff.org/report-section/lgbt-peoples-health-status-and-access-to-careissue-brief/
Medina, C. & Mahowald, L. (2023). Discrimination and Barriers to Well-Being: The State of the LGBTQI+ Community in 2022 https://www americanprogress org/article/discrimination-and-barriers-to-well-beingthe-state-of-the-lgbtqi-community-in-2022/
Movement Advancement Project [Year of access] "Equality Maps: Bans on Best Practice Medical Care for Transgender Youth " https://www lgbtmap org/equality-maps/healthcare/youth medical care bans
Accessed 04/17/2024
Movement Advancement Project "Equality Maps: Healthcare Laws and Policies " https://www.lgbtmap.org/equality-maps/healthcare laws and policies. Accessed 04/17/2024.
National LGBT Cancer Network (n.d.) Barriers to Health Care. https://cancer-network.org/cancerinformation/cancer-and-the-lgbt-community/barriers-to-healthcare/#:~:text=LGBT%20patients%20often%20face%20a,by%20a%20health%20care%20provider.