LGBTQIA Health Needs and Disparities

Lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA) individuals are members of every community. They are diverse, come from all walks of life, and include people of all races and ethnicities, all ages, all socioeconomic statuses, and from all parts of the country. The healthcare needs of LGBTQIA people are sometimes unique and often overlooked, contributing to health disparities experienced by vulnerable populations.


Experts report that LGBTQIA people often avoid seeking out medical care or refrain from “coming out” to their healthcare provider. This compromises an entire community of lesbian, gay, bisexual, transgender, and intersex individuals who are at increased risk for several health threats when compared to heterosexual or cisgender peer groups: Gay men are at higher risk of HIV and other sexually transmitted infections; lesbians are less likely to get cancer screenings; transgender individuals are among the least likely to have health insurance along with risks from hormone replacement and atypical cancers; intersex people (those born with reproductive or sexual anatomy that doesn’t fit the binary definitions of female or male) often have trouble finding doctors familiar enough with their bodies to provide appropriate care


The Affordable Care Act (ACA) had helped over 10 million Americans gain insurance during the Obama administration, including many LGBTQIA people. The ACA prohibited health insurance marketplaces from discriminating on the basis of sexual orientation and gender identity. The 2015 Supreme Court ruling of Obergefell v. Hodges recognizing marriage between gay and lesbian couples throughout the United States led to more married couples to access their spouse’s health insurance.

The Trump administration has since dismantled many protections for equal access to care for LGBTQIA people. Shortly after Trump took office, regulations to ban discrimination in Medicare and Medicaid were stopped and the White House declined to enforce the ACA’s anti-discrimination mandate. Throughout his term, senior advisers for LGBTQIA health have been reassigned to less effective positions and questions regarding sexual orientation were removed from federal surveys. He has been accused of orchestrating “an effort to erase LGBTQ people” in the wake of dismissing members of his administration who cited Trump’s disinterest in helping the HIV/AIDS community. The Trump administration has repeatedly rolled back protections of LGBTQIA people to make it easier for them to be discriminated against at the workplace, at school, in healthcare, housing, and public life.


Mental health is a major concern for LGBTQIA individuals often dealing with physical or emotional abuse, body dysmorphia, depression, or feeling unsafe at school or work, and there are still areas of the United States where finding sympathetic and appropriate help can be prohibitively difficult. Recent research has found that LGBTQIA people are 29% more likely to experience memory problems as compared to peers with similar characteristics such as age, gender, race and ethnicity, marital status, and income. Other studies have found that 71% of LGBTQIA people reported feeling sad or hopeless for at least two weeks within the past year, 39% have contemplated suicide, and 20% have attempted suicide. Even as youths, LGBTQIA people are at higher risk of violence, substance abuse, homelessness, and other suicide-related behaviors If you are experiencing a mental health crisis, reach out to a hotline such as Samaritans, The Trevor Project, or Trans Lifeline.

The LGBTQIA community continues to rank among the most underserved populations in terms of healthcare. Homophobia/transphobia and stigma can negatively impact one’s ability to receive suitable care. Over 27% of transgender people in the U.S. report being denied healthcare. If you are looking for a LGBTQIA-friendly medical center, the Human Rights Campaign (HRC) has an interactive map with locations of over 1600 healthcare facilities in the United States. The HRC also has information on finding insurance for transgender-related healthcare, which can be a challenge for many transgender people even after the ACA.


While LGBTQIA individuals have not been found to be more susceptible to contracting COVID-19 from the ongoing coronavirus pandemic, some health habits have raised concern among health professionals. LGBTQIA people use tobacco at a rate 50% higher than the general population and COVID-19 is a respiratory disease that has proven particularly harmful to smokers. Higher rates of HIV and cancer in the LGBTQIA community mean a larger percentage have a compromised immune system, which increases vulnerability to coronavirus infection. As with the general population, LGBTQIA people are encouraged to practice social distancing measures and wash their hands frequently to prevent spreading the virus.


To further help those in need, NeedyMeds has a growing list of programs in our Diagnosis-Based Assistance database for transgender/gender non-conforming people that offer various forms of assistance such as financial aid or legal services. We also list academic scholarships available for LGBT youths looking to continue their education. NeedyMeds’ unique crowdfunding platform HEALfundr is also available for individuals trying to raise funds for their transition and other members of the LGBT community to receive appropriate healthcare. For more information, call our toll-free helpline at 1-800-503-6897 (open 9am to 5pm ET, Monday through Friday).

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Welcome to the NeedyMeds Voice! We look forward to presenting you with timely, provocative pieces on healthcare reform, patient advocacy, medication and healthcare access, and other health-related news. Our goals are to educate, enlighten, and elucidate; together, we will try to make sense of the myriad and ongoing healthcare-related changes in the U.S. today.