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Little Health, and Even Less Care

Our health is one of the most important things in life. But when it comes to gay, lesbian, bisexual and transgender Americans, our nation’s health care system can involve little “health” and even less “care.”

Few medical service providers are educated in the health issues for which gay and transgender people are most at risk. Meanwhile, medical professionals may harbor prejudices that prevent optimum care from being delivered.

In fact, every aspect of our country’s health care system prevents gay and transgender patients, and their families, from receiving the best of care—often in situations where they most need it.

We need to give a damn.

Institutional assumptions

As with other minorities, gay and transgender patients are at risk for certain health issues, including certain types of cancer, depression and anxiety, substance abuse, HIV/AIDS and more.

But most medical schools offer little, if any, formal training in gay and transgender health issues, and many health care institutions operate on the assumption that their patients are straight. As a result, medical providers often don’t bother taking down their patients’ sexual histories—histories that would help in screening and preventive care for specific risk factors. One study found that only 35% of providers often or always took patients’ sexual histories.

Meanwhile, fears of being stigmatized or discriminated against prevent many gay and transgender patients from disclosing their sexual orientation or gender identity to their doctors. As many as 44% of gay men, and 45% of lesbian and bisexual women, are not out to their providers—hardly surprising, given that more than 1 in 2 gay and transgender respondents have reported experiencing discrimination, from being blamed for their health condition to being denied treatment, from a health care provider.

Imagine if you got sick, and your doctor told you it was your own damn fault.

Imagine receiving substandard care because your doctor didn’t bother learning your medical history—and feeling grateful that at least you weren’t turned away.

Access to care

Then again, what if you couldn’t even afford to go see a doctor? Many employers don’t extend health insurance coverage to domestic partners of their employees—up to 30% of lesbians lack health insurance, compared to only 15% of the general population. Even when insurance is extended to same-sex partners, inequities in federal tax law require that they pay taxes on the insurance. It’s an onerous financial obligation from which married couples are exempt.

Just as critical, even if a gay or transgender patient legally appoints their partner to make treatment decisions on their behalf, health care providers that don’t recognize same-sex couples may explicitly ignore these advance health care directives. Thus couples in medically critical situations can be prevented from making decisions about their partner’s care. And, depending on hospital policy, they may even be denied the opportunity to visit their loved ones.

Imagine if you rushed your sick husband or wife to the hospital, only to be told you couldn’t be with them after they were checked in.

Imagine not being allowed to make decisions about your spouse’s care—decisions that you and your spouse had already discussed at length, that no one else was familiar with.

Imagine not being able to comfort and support your spouse in their time of greatest need. Or worse, imagine not even being allowed to be with them in their final moments of life.

Care for all

We need to give a damn, and change our health care system to consider the needs of all Americans.

We need to give a damn, and give our doctors the medical knowledge they need to treat all patients thoroughly and sensitively.

Because no one should be denied the opportunity to get the best care possible.

It’s time for things to change.

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Visit our nonprofit partner’s website; they’re experts on health care. They can provide you a ton of additional resources and ways to get involved:

Information on this page was provided by:

  • Gay and Lesbian Medical Association
    • “Lesbian Health Fund.”
    • “Ten Things Gay Men Should Discuss with Their Health Care Providers”
    • “Ten Things Lesbians Should Discuss with Their Health Care Providers”
    • “Ten Things Transgender Persons Should Discuss with Their Health Care Providers.”
    • “Guidelines for Care of Lesbian, Gay, Bisexual and Transgender Patients.”
    • “Lesbian, Gay, Bisexual and Transgender Health: Findings and Concerns (Conference Edition, work in progress),”
    • “Presentation to the Institute of Medicine’s Committee on Lesbian, Gay, Bisexual and Transgender Health Issues and Research Gaps and Opportunities”
    • “Healthcare Equality Index: Creating a National Standard for Equal Treatment of Gay, Lesbian, Bisexual and Transgender Patients and their Families”
  • Human Rights Campaign
    • “Healthcare Equality Index”
    • “Health: Introduction”
    • “Health Reform for LGBT Americans”
  • Lambda Legal
    • “When Health Care Isn’t Caring: Lambda Legal’s Survey on Discrimination Against LGBT People and People Living with HIV”

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