By Vandana M Kissoon
Access to proper healthcare services and facilities may arguably be one of the most important aspects of human rights that everyone regardless of their experiences and identities should have. The morbidity and mortality of human beings depend on our ability to access quality healthcare. “Without our health we—literally—do not live, let alone live with dignity” (Gerisch). Even though the right to healthcare is considered universal, this is not the reality for marginalized groups in society, particularly, the LGBTQIA+ community. Gender and Sexual minority groups face significant barriers in accessing healthcare as a result of social stigma, discrimination, and lack of training for healthcare professionals.
Stethoscope and LGBT rainbow ribbon pride symbol. Blue background
Rooted in our heteronormative culture, the discrimination, stigmatization and violence LGBTQIA+ people face in society because of their sexual and gender identities undoubtedly results in poorer mental health outcomes when compared to their heterosexual counterparts. However, the fear of discrimination and potential discrimination which engenders the mental health disparities initially, is the same fear which deters LGBTQIA+ people from seeking not only mental medical care, but physical medical care as well. Healthcare providers’ personal biases and opinions, whether explicit or implicit, on sexual and gender orientation can obstruct them from providing impartial supportive and sensitive care for LGBTQIA+ patients. This causes them to shy away from seeking preventative and urgent care causing worsening health outcomes and may even prove to be fatal.
Data collected in a 2017 Center for American Progress (CAP) survey, attests to the alarming rates of healthcare discrimination face by LGBTQIA+ people from medical practitioners when seeking care at hospitals and pharmacies in the United States. Eight percent of respondents identifying as lesbian, gay, bisexual, and queer (LGBTQ) who visited a doctor or healthcare professional, a year prior to this survey, were denied medical care due to their actual or presumed sexual orientation. Six percent disclosed that they experienced the refusal of services from health care providers because of their actual or perceived sexual orientation, and nine percent reported being treated abrasively by practitioners. It was also highlighted that twenty- three percent of healthcare providers knowingly misgendered transgender persons or dead- named them.
Healthcare practitioners training, with regards to the healthcare needs of LGBTQIA+ people is a crucial step in overcoming the barriers they face in accessing healthcare and addressing healthcare inequities. A study done in Barbados in 2016 unveiled that more than half of the general practitioners who participated in this study lacked experience dealing with LGBT patients. The lack in knowledge on LGBT specific healthcare coupled with health- related stereotypes were further compounded by the findings that they lack LGBT specific training and health recommendations during medical school.
This was reflected in their interactions and treatment with patients who willingly disclosed that they were a member of the LGBT community, focusing mostly on sexual transmitted infections (STI), safe sex and glossing over mental health issues. The first step towards increasing the quality of health care that practitioners provide to queer patients is to increase knowledge and training in medical school. This includes knowledge on unique health risks faced by LGBTQIA+ people such as substance abuse, bias awareness to combat personal discrimination of healthcare practitioners and highlighting the role that health care providers’ biases can play in contributing to the health care disparities faced by the LGBTQIA+ community.
The Covid-19 pandemic has only magnified the healthcare inequities faced by LGBTQIA+ people. A public health crisis which mandates that persons stay at home and isolate with family members can take a mental toll on queer people who are shunned by family members and lack a supportive network at home. LGBTQIA+ people are statistically more likely to suffer from anxiety and depression, and social isolation may amplify these mental health issues. Being less probable to be insured due to employment discrimination and record high unemployment rates as a result of the Covid-19 pandemic, LGBTQIA+ people may face additional financial hardships in relation to being able to afford health care.
Even when analyzing the drafting of emergent public health policies in response to this global crisis, it is evident that the needs and concerns of queer persons are underrepresented or not considered altogether. For example, even though the Affordable Healthcare Act in the United States has been amended to increase access to insurance, LGBTQIA+ people still face systemic barriers in accessing insurance which were not addressed or even attempted to be addressed in the amended act. Increasing data collection and analysis on the health care and financial needs of the LGBTQIA+ demographic can lead to improved and inclusive health care policies which may lessen the hurdles queer persons face in accessing healthcare.
LGBTQIA+ people have been denied and had their human rights violated for much too long. While systemic causes of health inequities may take considerable time and countless policy changes to effect substantial change, community level actors such as health care practitioners, educational institutions and civil society organizations hold the power to initiate change by transforming the narrative and advocating for the promotion of health equity for all.
For access to training and resources for health care professionals, check out:
Access to health services by lesbian, gay, bisexual, and transgender persons: systematic literature review. (2016). PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4714514/#CR5
Discrimination Prevents LGBTQ People From Accessing Health Care. (2021, March 5). Center for American Progress. https://www.americanprogress.org/issues/lgbtq-rights/news/2018/01/18/445130/discrimination-prevents-lgbtq-people-accessing-health-care/
Health Care As a Human Right. (2021). Retrieved 26 July 2021, from https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/health-care-as-a-human-right/
International Journal of Sexual Health. (2016). Rambarran and Grenfell. Published. https://researchonline.lshtm.ac.uk/id/eprint/2965034/1/Rambarran%20&%20Grenfell%20(2016)%20-%20International%20Journal%20of%20Sexual%20Health,%20AAM.pdf
Mental health challenges of lesbian, gay, bisexual and transgender people: An integrated literature review. (2021). PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7876969/
Morris, M. (2019, August 30). Training to reduce LGBTQ-related bias among medical, nursing, and dental students and providers: a systematic review. BMC Medical Education. https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-019-1727-3#:%7E:text=Thus%2C%20training%20health%20care%20professions,ultimately%2C%20for%20eliminating%20health%20disparities.
Training healthcare professionals in LGBTI cultural competencies: Exploratory findings from the Health4LGBTI pilot project. (2020, May 1). ScienceDirect. https://www.sciencedirect.com/science/article/pii/S0738399119305518
Vandana M Kissoon is the holder of an LLB (Hons) and is currently pursuing her LPC. She is an animal lover and coffee enthusiast. Vandana is a writer at Feminitt Caribbean and is passionate about dismantling oppressive systems.