Addressing the Issue of Healthcare and the LGBT Community

In the past decade lesbian, gay, bisexual, and transgender, or LGBT, people have made rapid progress in winning and securing equal rights. Fifteen states and Washington, D.C. now give same-sex couples at least some of the same rights afforded to heterosexual married couples. Even more states offer nondiscrimination protections based on sexual orientation, gender identity, or both. Polling data show that the general public has increasingly positive views of LGBT people and are becoming more supportive of their civil and political rights. In short, heterosexual Americans are finally recognizing LGBT people as a legitimate social minority that should have equal access to our society’s basic rights, opportunities, and responsibilities.

Despite this progress, however, members of the LGBT population continue to experience worse health outcomes than their heterosexual counterparts. Due to factors like low rates of health insurance coverage, high rates of stress due to systematic harassment and discrimination, and a lack of cultural competency in the health care system, LGBT people are at a higher risk for cancer, mental illnesses, and other diseases, and are more likely to smoke, drink alcohol, use drugs, and engage in other risky behaviors.

People who are both LGBT and members of a racial or ethnic minority will often face the highest level of health disparities. For example, as the National Coalition for LGBT Health notes, a black gay man faces disparities common to the African-American community as well as those suffered by the LGBT community, and a transgender Spanish-speaking woman, regardless of her sexual orientation, must navigate multiple instances of discrimination based on language, ethnicity, and gender. A companion CAP brief, “How to Close the LGBT Health Disparities Gap: Disparities by Race and Ethnicity,” explores these in more detail.

Health surveys cannot continue to treat populations in isolation: Members of the LGBT community who are members of other populations that are recognized as suffering from health disparities must be allowed to identify themselves fully on surveys, including their sexual orientation and gender identity.

We can only estimate the full extent of LGBT disparities due to a consistent lack of data collection on sexual orientation and gender identity. No federal health survey includes a question on sexual orientation or gender identity, and only a few states ask respondents their sexual orientation or gender identity, severely limiting researchers’ ability to fully understand the LGBT population’s needs and hindering the development of public policies and programs that seek to improve the LGBT population’s health and well-being.

To overcome this lack of data and make it easier for researchers and advocates to get a full and accurate accounting of LGBT health outcomes and needs—and ultimately to close the gap between the health and well-being of LGBT people and the heterosexual population—the U.S. Department of Health and Human Services should establish a dedicated Office of LGBT Health. This office would take the lead in coordinating a consistent and scientifically driven response across HHS to LGBT health issues. A top priority of this office should be to ensure that any federally funded health study that collects demographic information—be it age, sex, race, ethnicity, primary language, or socioeconomic status—must also include questions about sexual orientation and gender identity.

This memo will outline the health disparities LGBT populations face, look at why these disparities occur, and examine why we need better data on these populations and what we can do to solve this problem. [READ MORE]