Health Disparities in the LGBTQ+ Community

Imagine this scenario: You are at the doctor’s office for an appointment you waited months for. You were concerned about a recent sexual encounter and have been feeling anxious. You’re not sure what to do, but you want to make smart health choices. Throughout the visit, your doctor uses a name you don’t go by, misgenders your recent sexual partner or even asks questions that aren’t relevant to your concerns. There is no health screening or follow-up care recommended. You walk away without any of your questions answered and a feeling that you wasted your time. 

Poor or negligent provider care is a main reason for postponed or avoided care in the lesbian, gay, bisexual, and transgender (LGBTQ+) community. [i] In fact,  over one in five LGBTQ+ adults have avoided or skipped medical care entirely due to past experiences. As a result, LGBTQ+ people have a higher risk of having untreated health-related issues or gaps in their health care. Relatedly, those who identify as both disabled and LGBTQ+ are also more likely to have negative healthcare experiences. These problems can range from refusal of care, not having enough resources, or needing to educate their provider on disability or culturally appropriate care.

Ashley Bhola, MD, MPH, a primary care physician at Crystal Run Healthcare, notes that these gaps in care contribute to a wider healthcare problem.

“LGBTQ+ patients are twice as likely to have a bad experience at the doctor’s office. That’s a major reason why people in the LGBTQ+ community are more likely to delay medical care than their straight or cisgender peers,” said Dr. Bhola. “This puts them more at risk of missing preventative screenings and yearly health services, not having medical conditions properly managed or not taking their medication as prescribed.”

There are many reasons why a person who identifies with the LGBTQ+ community needs access to consistent medical care. LGBTQ+ people have a higher chance of having mental health issues, developing diabetes, and having a lower health-related quality of life. Additionally, people in the LGBTQ+ community, on average, are three times more likely to have risky or unprotected sex or use illegal drugs than their straight, cisgender peers[ii]. These unhealthy habits can increase a person’s risk of contracting a sexually transmitted disease (STD), like syphilis or HIV.[iii] HIV can be spread through unprotected sex, particularly unprotected anal sex, or sharing drug injection equipment. 

“Condom use, regular screening, and, if possible, early treatment or management of STDs, addiction, or chronic conditions can reduce risk of long-term health problems,” said Dr. Bhola. “It’s important to share any symptoms or concerns you have, including those related to your sexual history or drug use, with your doctor – it helps them address your health concerns or schedule necessary screenings to make sure you are healthy.”

As mental health awareness increases, it is also important to have accessible mental health resources. In addition to environmental or social factors that affect mental health, LGBTQ+ folks are also more likely to experience minority stress and discrimination, both of which affect mental health. A young person who identifies as LGBTQ+ is twice as likely to report feeling sad and hopeless and four times as likely to attempt suicide compared to their classmates. [iv]

Every healthcare team member, including front desk staff and clinicians, can play role in developing an environment that respects and meets the needs of LGBTQ+ patients. Dr. Bhola believes that advocating for yourself and increased provider knowledge on LGBTQ+ patient care can go a long way in providing proper healthcare for all patients.

“There are very practical things your doctor’s office can and should do to be respectful of your identity,” said Dr. Bhola. “Asking and using preferred pronouns, mirroring your language about your partner or spouse, explaining the need for any needed medical screenings, and making sure to add all of this data into your patient chart are all straightforward ways for a more welcoming medical experience.”

Primary care doctors (also called primary care physicians or primary care providers) provide both the first point of contact for patients with health concerns as well as continuing care for varied medical conditions, not limited by cause, organ system or diagnosis. The Primary care providers at Crystal Run Healthcare take care of their patient's physical, mental, and emotional health and are trained to care for patients through each life stage. Plus, our sophisticated electronic health records system digitally links your primary care provider with any specialist in our practice. They can see and share your information instantly, enabling them to work together to bring you more responsive, immediate care with the option to add any personal information, like pronouns, sexuality and preferred name, to use for further appointments with all of your providers.

Ashley Bhola, MD, MPH is a primary care physician Board Certified in Family Medicine. She earned her Medical Degree at SUNY Downstate College of Medicine in Brooklyn, NY. She completed her Residency in Family Practice at Tower Health Reading Hospital in West Reading, PA. Dr. Bhola also has her Master of Public Health degree, which she earned at SUNY Downstate School of Public Health in Brooklyn, NY. Her clinical interests include chronic conditions, preventative care, women’s health, pediatrics and reducing health disparities in the LGBTQ+ population. Dr. Bhola is seeing patients in West Nyack, NY.