It’s no secret that people in the LGBTQIA+ community face certain barriers when it comes to accessing high-quality health care. In a survey of more than 30,000 people who identify as LGBTQIA+, researchers reported significant health disparities ranging from increased suicide risk to lack of insurance.
“There’s plenty of research to support the idea that people who are LGBTQ+ have to lobby for themselves to get appropriate care,” says Rachel Lee, M.D., a family medicine physician at Henry Ford Health. “Some providers aren’t even aware of preventive treatments, counseling and support services for the LGBTQIA+ community. Their patients are the first to educate them.”
Overcoming LGBTQIA+ Health Disparities
And not every provider includes questions about sexual orientation or gender identity as part of their intake. Yet, this same community is disproportionately affected by health problems, including depression, substance abuse and HIV.If you’re a member of the LGBTQIA+ community, use these four strategies to ensure you’re receiving the highest quality care – and staying on top of health concerns.
- Bring a friend. It’s not uncommon for LGBTQIA+ people to feel unsafe in their surroundings. Studies show that people who identify as LGBTQIA+ are significantly more vulnerable to verbal and physical abuse – even in the waiting room at a doctor’s office. There’s safety in numbers. Plus, having a loved one or trusted friend near can help you remember to address all of your concerns.
- Know when to disclose. Physicians should always ask for sexual orientation and gender identity status, says Dr. Lee. But you should never feel obligated to disclose your preferences or circumstances. “If you’re in the emergency room for a cut or broken bone, no one has to know your sexual preferences or gender identity,” says Dr. Lee. If, however, you’re establishing primary care with a new doctor, you should address LBGTQIA+ status during your first visit. If your doctor doesn’t ask about your sexual orientation or which pronouns you prefer, you should consider seeking care elsewhere.
- See an experienced provider if you’re considering transitioning. Gender-affirming care should be accessible, yet many people seeking gender-affirming hormone therapy don't know where to get help. “Managing gender-affirming hormone therapy does not require you to see a specialist, but it's important to work with a provider who is comfortable in this arena,” says Dr. Lee. If you think you are in the wrong place, don’t be afraid to ask for a referral.
- Ask questions. A few to consider: What made you interested in working with the LGTBQIA+ community? What percentage of your practice is LGTBQIA+? Are you comfortable managing gender-affirming hormone therapy? Then, ask targeted questions about the environment where they practice, such as: What is your health system doing to create equity? How are they creating an inclusive environment? What types of training do they offer? These are all valid questions that can be asked before or during your first appointment.
The best way to find the right provider is to ask your peers for a referral. “Word of mouth is a good way to identify LGBTQIA-friendly physicians,” says Dr. Lee. “Forums, chat rooms, Facebook groups often share helpful providers.”
Local organizations, community centers (like Affirmations and Ruth Ellis Center) and nonprofits that focus on equity issues may also be able to point you to providers who are interested in LGBTQIA+ care.
“At Henry Ford, we are committed to providing comprehensive services to all patients, regardless of their sexual orientation or gender identity,” says Dr. Lee, citing the health system’s Healthcare Equity Index Award. “If patients find themselves in a facility that doesn’t prioritize LGBTQIA+ concerns, it’s critical that they seek care elsewhere.”
Reviewed by Dr. Rachel Lee, a family medicine doctor who sees patients of all ages at Henry Ford Medical Center – Harbortown in Detroit.