Common Barriers to LGBT Individuals Receiving Adequate Health Care

LGBT individuals have been marginalized by some segments of the health professions. Historically, their sexual orientations and gender diversity were labeled deviant or pathological by many in the medical and psychiatric community. As a result, many gays and lesbians do not disclose their sexual orientation to their health care providers (Cochran & Mays, 1988). consequently, many LGBT individuals, particularly transgender individuals, are reluctant to use mainstream health care services and are medically underserved. However, LGBT health advocates and professionals have lobbied for changes in mainstream professional organizations that have resulted in policy statements addressing the needs of LGBT clients and the formation of official LGBT affiliates, such as the American Psychological Association’s Task Force on the Status of Lesbian and Gay Psychologists and the American Psychiatric Association’s Committee on Gay, Lesbian, and Bisexual Issues. Although these changes have been important steps in establishing ethical guidelines for appropriate care, many health and mental health treatment providers remain uncomfortable with sexual diversity and continue to discriminate against LGBT clients.

A 1994 survey of the membership of the American Association of Physicians for Human Rights (now called the Gay and Lesbian Medical Association) (1994) found that, of 711 members, 52 percent had observed the denial of care or the provision of suboptimal care to lesbian and gay clients. Eighty-eight percent heard colleagues make disparaging remarks about their lesbian and gay clients. However, 64 percent of the members stated that it is important for clients to reveal their sexual orientation but also noted they risk receiving substandard care when doing so. Transgender individuals are even more marginalized and are often denied care, and LGBT individuals of color may experience racial bias in addition to homophobia. Thus, sensing these prejudices, many LGBT persons have not used the health care system adequately.

Their hesitation to seek health care may result in later diagnoses of illnesses, which results in poorer treatment outcomes. Many physicians are ignorant of the special health concerns of LGBT individuals, such as the possibility of anal warts in gay men or the surgical and hormonal treatment options for transgender individuals.