The Health System Appears To Be Selling LGBT+ People Short

A shorter version of this column has been published by Axios.

The issue doesn’t get much attention, and the available data are limited, but what we know should be a wake-up call for the health professionals and health care institutions about the care provided to LGBT+ people.

The big number: over a third of LGBT+ people – those who are lesbian, gay, bisexual, transgender, or something else other than straight – say they have had a negative experience with a provider over the last two years. Those bad experiences range from their provider not believing they were telling them the truth, to suggesting they were to blame for their health problems, to making assumptions about them without asking, to outright dismissing their concerns.

That compares with 22 percent for non LGBT+ people.

At the same time, they have been hit harder by COVID in certain ways, including being more likely to have had to quit their job because of the pandemic.  More than half of LGBT+ people who report having problems paying medical bills in the past 12 months say it was at least in part because of the pandemic.

LGBT+ people need a health system that is responsive because they are more likely to be low income and have a chronic condition or disability.

Most LGBT+ people (72%) have a doctor or health care provider they see when they need care, mostly a family practitioner or an internist, just as non LBGT+ folks do (78%). That means it is likely not where they seek care that is different, it is their providers who appear to be letting them down.

One good thing: LGBT+ people are more likely to discuss mental health and non-medical issues such as housing or transportation with doctors, likely reflecting their higher needs in these areas.

There is an obvious need for more research and data to sort out what is behind these warning signals about LGBT+ health care. But they are also a challenge to the health system to address problems in the provider-patient relationship LGBT+ patients see that can be corrected without waiting for more research.

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