Every June, pride month is celebrated with parades and marches across the country to celebrate diversity, promote dignity and equal rights, and increase visibility.
While the COVID-19 pandemic may have put parades and marches on hold for this year, it is more important than ever to celebrate and support community while also acknowledging that there is much work needed in overcoming health disparities in the LGBTQ+ (lesbian, gay, bisexual, transgender, queer, and the plus sign includes other identities) community.
The LGBTQ+ community has long faced discrimination, bias, stigma, substandard care, and often faces barriers accessing care within the health care system. Cases of discrimination or harassment, and negative experiences with doctors or nurses in the past may cause LGBTQ+ patients to not seek medical attention when a health concern arises.
Barriers to Care
In 2016, the LGBTQ+ community was identified as a “health disparity population” by the National Institute on Minority Health and Health Disparities (NIMHD), noting that mounting evidence shows that the LGBTQ+ “populations have less access to health care and higher burdens of certain diseases, such as depression, cancer, and HIV/AIDS.” Despite recent improvements to legal rights, including June’s landmark U.S. Supreme Court decision that ruled that employers can't fire workers for being gay or transgender, NIMHD reports that stigmatization, hate-violence, and discrimination are still major barriers to the health and well-being of LGBTQ+ individuals. The National LGBT Cancer Project says that LGBTQ+ people of color face even bigger barriers to health equity and access to cancer care due to the combined impact of poor adherence to cancer screening, barriers to adequate health care services, and engagement in cancer-promoting health risk behaviors.
Fear of discrimination is common among the LGBTQ+ community and becomes an even larger problem if their health care provider becomes the source of such discrimination. While the Affordable Care Act (ACA) had protected individuals from discrimination, earlier this month the Trump Administration released a final rule that undermines Section 1557 of the ACA, the law’s primary anti-discrimination provision, by removing explicit protections against discrimination of patients based on sex stereotyping and gender identity by providers and institutions. CSC joined 29 patient organizations in opposing the administration’s rule, as it has the potential to encourage discrimination in health care. Whitman-Walker Health, a CSC Health Care Partner, in conjunction with Lambda Legal and other LGBTQ groups, have sued the Trump administration, arguing that, among other things, the rule violates the Administrative Procedure Act, the Fifth Amendment’s guarantee of equal protection and due process, and the free speech and establishment clauses of the U.S. Constitution.
The need for a safe space inside the doctor’s office is critical to the wellbeing of the patient, yet this fear of discrimination can cause many LGBTQ+ people to avoid seeking healthcare. In a 2015 National Center for Transgender Equality Survey report, 23% of transgender respondents did not see a doctor when they needed to because of fear of being mistreated as a transgender person. A study from Lambda Legal showed that 56% of LGB people and 70% of transgender people reported experiencing discrimination by healthcare providers -- including refusal of care, harsh language, and physical roughness because of their sexual orientation or gender identity.
The National LGBT Cancer Network reports that because none of the large national cancer registries and surveys of cancer incidence collect data about sexual orientation or gender identity, we do not know nearly enough about cancer in the LGBTQ+ community.
It is important to understand how to close these gaps, as some studies have shown that the LGBTQ+ community has a higher risk of being diagnosed with some cancers than non-LGBTQ people. According to a 2017 study published in The Journal of Infectious Diseases, gay and bisexual men are about 20 times as likely as heterosexual men to develop anal cancer and a 2000 study analysis of data from more than 93,000 women between ages 59-70 published in the Archives of Family Medicine suggests that lesbian and bisexual women have higher rates of breast and cervical cancer compared to heterosexual women.
LGBTQ+ Cancer Resources
Whitman-Walker Health, a leading nonprofit community health center in Washington, D.C., is committed to meeting the health care needs of LGBTQ+ individuals.
As a Health Care Partner, Whitman-Walker utilizes CSC’s social and emotional support programs. Whitman-Walker assures that people can be themselves at their organization and their health care professionals are dedicated to treating people with dignity, respect, humility, and empathy.
There are other resources help LGBTQ+ patients find pro- LGBTQ+ medical providers to ensure a safe space, including:
- National LGBT Cancer Network
- The National LGBT Cancer Project
- The Gay and Lesbian Medical Association (GLMA)
- National Institutes of Health: Sexual & Gender Minority Research Office
- What is the Federal Government Doing to Help People Impacted by Coronavirus?
- PRIDE Month: Health Disparities and Care for LGBT Cancer Patients
- What Cancer Patients, Survivors and Caregivers Need to Know about the Coronavirus
- Addressing and Overcoming Health Inequities
- Advocate Spotlight: Rachel Gerstenfeld