Many LGBT people avoid seeking medical care out of fear of being refused service or experiencing discrimination from staff members who are not aware of what to do when treating them. The LGBT community faces unique challenges and obstacles when seeking adequate health care. For example, transgender people often face discrimination and harassment by medical professionals and even other patients in hospitals (Qureshi et al., 2018). This is largely due to the lack of awareness among providers about transgender health issues, including their special preventive needs like HIV treatment and PrEP. In a recent healthcare survey, gay men and lesbians noted that they would confide in health providers, but less than one-third of them did so (Romanelli et al., 2017). Stigma, violence, lack of health insurance by some health insurers, rejection by families, and prejudice are among the obstacles experienced by LGBT persons at every point of engagement with the health care system, beginning with the initial contact with a provider.
According to the Centers for Disease Control and Prevention, stigma towards LGBT people while accessing health care is a major factor that is preventing them from getting adequate health care services. Stigma has the effect of encouraging the LGBT community to hide the facts regarding their sexual orientation, which they perceive as being associated with illness and poor treatment (Jennings et al., 2019). For instance, gay and bisexual men are five times less likely to discuss their sexual risks with a healthcare provider than heterosexual men (Qureshi et al., 2018). This reluctance to disclose private details of sexual orientation is based on the subjective perception that disclosing it would have negative consequences for the individuals, such as discrimination or loss of medical care (Korpaisarn et al., 2018). This is the reason behind the higher rates of HIV infection among gay and bisexual men.
Moreover, LGBT people do not feel that they can get adequate health care without fear of being discriminated against. For instance, 20 percent of the LGBT community are uncomfortable with discussing their sexual orientation with a physician; and 25 percent of them are extremely uncomfortable or feel threatened by an LGBT patient in the waiting room (Jennings et al., 2019). For many LGBT people, the lack of sufficient health care is a major reason for not disclosing their sexual orientation to healthcare providers. Also, 54 percent of the LGBT community say that they avoid seeking medical care because of fear of being denied services or discriminated against by healthcare staff (Qureshi et al., 2018). A majority of them say that they have been turned away from various medical facilities because of their sexual orientation and 47 percent were turned away from hospitals.
Another main barrier to accessing adequate health care for the LGBT community is the lack of health insurance. Many insurance companies refuse to cover the cost related to the treatment of HIV or AIDS for their LGBT customers because they consider them a high-risk group (Qureshi et al., 2018). Many other times, health insurance companies do cover the cost for this community, but the majority of them do so only if the customer does not disclose a history of HIV infections or AIDS within the family (Romanelli et al., 2017). This makes it difficult for this community to easily access healthcare coverage and essential medical treatments. Many healthcare insurance policies limit coverage for transgender medical interventions such as healthcare procedures and hormonal treatments, often called “sex reassignment”. Transgender individuals may be rejected from health insurance plans because their sex has been legally changed, at which point they are no longer covered by the insurer (Korpaisarn et al., 2018). As a result of this policy, many transgender people face financial barriers and are unable to access necessary medical treatment.
Also, LGBT persons have less inclination to discuss their sexual orientation and symptoms of illness with a healthcare provider because they do not want to be rejected by their family. For example, 22 percent of the LGBT community report that they have given up on seeking medical care because their families would not accept them (Korpaisarn et al., 2018). A major reason for this is the lack of support from their families and lack of awareness due to which they feel the need to hide the fact that they are homosexual. This lack of acceptance from their family may also be because of the attitude of the health provider and staff members toward LGBT patients (Romanelli et al., 2017). The fear of discrimination and harassment among LGBT patients is a common reason for not disclosing their sexual orientation to healthcare providers, even though 21 percent say that they would disclose it if they could get adequate medical care.
LGBT persons face great difficulty in accessing adequate health care and medical treatment because of the fear of discrimination, humiliation, harassment, and rejection by many health care providers. The discrimination they face at every level affects their willingness and ability to seek medical help, which also explains why there is a higher risk of contracting HIV among them. Creating awareness among healthcare providers is therefore recommended. Along with this awareness, it is also important to make sure that the LGBT community has access to health care and is allowed to access it in a non-discriminatory manner. This would drastically lower the infections of HIV and AIDS among the LGBT community, and increase their life expectancy.
Jennings, L., Barcelos, C., McWilliams, C., & Malecki, K. (2019). Inequalities in lesbian, gay, bisexual, and transgender (LGBT) health and health care access and utilization in Wisconsin. Preventive Medicine Reports, 14, 100864. https://www.sciencedirect.com/science/article/pii/S221133551930049X
Korpaisarn, S., & Safer, J. D. (2018). Gaps in transgender medical education among healthcare providers: A major barrier to care for transgender persons. Reviews in Endocrine and Metabolic Disorders, 19(3), 271-275. https://link.springer.com/article/10.1007/s11154-018-9452-5
Qureshi, R. I., Zha, P., Kim, S., Hindin, P., Naqvi, Z., Holly, C., … & Ritch, W. (2018). Health care needs and care utilization among lesbian, gay, bisexual, and transgender populations in New Jersey. Journal of Homosexuality, 65(2), 167-180. https://www.tandfonline.com/doi/abs/10.1080/00918369.2017.1311555
Romanelli, M., & Hudson, K. D. (2017). Individual and systemic barriers to health care: Perspectives of lesbian, gay, bisexual, and transgender adults. American Journal of Orthopsychiatry, 87(6), 714. https://psycnet.apa.org/doiLanding?doi=10.1037/ort0000306