“If our goal is to be tolerant of people who are different than we are, then we really are aiming quite low. Traffic jams are to be tolerated. People are to be celebrated.”
Pride Month 2021: Exploring LGBTQ+ Health Disparities
Pride Month is celebrated in June, a nod to the June 1969 Stonewall uprising in New York City that paved the way for the gay rights movement. Festivities are widespread here in Washington DC: Pride Weekend kicked off on June 11th and many flocked to the parade, happy hours, and newly reopened nightclubs, and others took to virtual Pride events that continue throughout the month.
While Pride Month is a rightful time for joyous celebration, it is also a time to raise awareness of the effects that stigmatization and discrimination have on the LGBTQ+ community — notably lacunas in access to healthcare and health disparities. In this post we’ll explore the health disparities in the LGBTQ+ community, with a particular focus on lesbian and bisexual healthcare.
Understanding the history of and current oppression and marginalization of the LGBTQ+ community is key to beginning to grasp the current landscape of healthcare disparities. Demographic factors, legal barriers to care, pitfalls in the medical system, paucity of research, and societal stigma are all interrelated.
Members of the LGBTQ+ community come from diverse backgrounds; the community includes those from all races, ethnicities, socioeconomic backgrounds, from all places, and from all walks of life. Each subpopulation of the LGBTQ+ umbrella has their own concerns based on these demographic factors. Accessibility to healthcare needs to be examined in these contexts; certain demographics, such as racial and ethnic minorities and those with low incomes, face more discrimination and barriers to care than others.
Legal barriers to care are some of the social determinants that lead to disparities. Same-sex marriage laws, for instance, have created challenges for obtaining housing and health insurance.
Historically, the medical setting for LGBTQ+ patients has been unwelcoming, alienating, and traumatic. Healthcare providers have often not been culturally competent or aware of the specific needs and concerns of LGBTQ+ patients. This has created fear, a distrust in the medical system, and perpetuated institutional stigma and discrimination. Due to discrimination, little research has been conducted on the health needs of the community as a whole.
Overall, the chronic stress and historical trauma from being a marginalized group is the foundation on which disparities from other social determinants build.
Lesbians and bisexual women face particular behavioral and physical health disparities. Behavioral health disparities are emphasized, in particular, by lack of social support and the stress of stigmatization. Compared to their heterosexual peers, lesbians and bisexual women are more likely to suffer from susbstance abuse, addiction, mood disorders, anxiety, and eating disorders.
There are also certain health issues that are more prevalent among lesbian and bisexual women compared to heterosexual women. Lesbian and bisexual women are less likely to access preventive healthcare screenings, such as mammograms and pap smears. As a result, rates of breast cancer, ovarian cancer, HPV, and cervical cancer are higher among lesbian and bisexual women. Lack of comprehensive sex education contributes to misconceptions about STD risks and undiagnosed infections. Lesbian and bisexual women over age 50 are also more likely to develop cardiovascular disease.
Additionally, lesbian and bisexual women are less likely to have access to healthcare in the first place. Legal barriers for insurance coverage in combination with insitutional discrimination in healthcare may prompt lesbian and bisexual women to delay seeking treatment until their health needs are dire.
In order to eliminate disparities and advance health equity for lesbian and bisexual women, as well as the LGBTQ+ community as a whole, we need to first recognize and identify the disparities and work to create more supportive and educated physical spheres. Mental and physical health status is inextricably intertwined with the social environment: LGBTQ+ communities need supportive, safe spaces — schools, housing, green spaces, recreational facilities, workplaces, healthcare facilities, among others.
Physicians and other health professionals play a critical role in eliminating disparities. It is imperative that healthcare professionals are trained in cultural competence, understand disparities, and are knowledgeable of LGBTQ+ health concerns. Healthcare settings should be positive environments where patients feel comfortable disclosing their sexual orientation and can trust that they will receive individualized care.
Everyone should have access to quality, holistic, empowering healthcare. At Bloom, we understand each patient has their own unique needs. We strive to create a supportive, welcoming environment where each patient can feel heard and respected.
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