Pride Month 2024 brings LGBTQIA+ rights and healthcare into focus

The Buzz This Week

June 1 marked the start of 2024 Pride Month, with people all over the world celebrating and supporting the LGBTQIA+ community. Pride Month is a time to bring awareness to the policy and resource issues the community faces and to support the work to achieve equal justice and equal opportunity.

According to the Human Rights Campaign, 130 bills targeting trans rights have been filed and 325 anti-LGBTQIA+ bills have been proposed in 2024. More than 650 anti-LGBTQIA+ bills were introduced in 2023. Transgender youth are particularly under fire. Twenty-five states currently have laws banning gender-affirming care for minors.

In April, a federal appeals court ruled that North Carolina and West Virginia’s refusal to cover certain healthcare for transgender people with government-sponsored insurance is discriminatory. The Biden administration also announced that it had finalized an update to Section 1557 of the Affordable Care Act (ACA), restoring and expanding protections that had been rescinded during the Trump administration.

The update to the nondiscrimination statute, which prohibits discrimination in health programs or activities based on race, color, national origin, sex, age, or disability, reaffirms that discrimination based on sex includes sexual orientation and gender identity. The change also explicitly protects against discrimination based on sex characteristics and sex stereotyping, which is especially important for intersex and transgender individuals.

Many advocacy groups were delighted and encouraged by the Biden administration’s actions. Rep. Mark Pocan, Chair of the Congressional Equity Caucus, said, “This rule’s explicit nondiscrimination protections for our community will improve health outcomes and ensure countless LGBTQI+ people are not denied care just because of who they are.”

Why It Matters

LGBTQIA+ individuals experience discrimination in healthcare settings for things as simple as denial of routine care to more complicated issues like refusals of gender-affirming treatments, including hormone therapies and surgeries. A recent report from KFF, previously Kaiser Family Foundation, examines the discrimination and discrepancies that adults who identify as LGBT experience compared to adults who do not identify as LGBT.

According to the survey of nearly 6,300 adults, adults who identified as LGBT are twice as likely to report negative experiences while receiving healthcare in the last 3 years. Among this group, the following was reported:

Twenty-four percent said those experiences caused their health to get worse.
Thirty-nine percent said those experiences made them less likely to seek healthcare.
Thirty-six percent said the experiences made them switch healthcare providers.

In the same survey, 12% of adults who identified as LGBT said they are not comfortable asking doctors and other healthcare providers questions about their health or treatment during visits. And 60% said they prepare for insults from healthcare providers or staff, or feel that they need to be careful about their appearance to be treated fairly when seeking care, compared to 39% of non-LGBT adults. Alex Shelden, Executive Director of GLMA, commented that the survey results underscore the “critical link between discrimination and health outcomes” and that as long as LGBTQIA+ individuals fear discrimination in healthcare settings “we’re not going to be able to actually get the full range of healthcare that we need.”

The LGBTQIA+ community experiences significant disparities in areas like mental health, access to care, homelessness, and physical health. A study from the Journal of the American Medical Association revealed that lesbian and bisexual women die 20% and 37% younger, respectively, than their heterosexual peers. LGBTQIA+ individuals are 2.5 times more likely to experience depression, anxiety or substance misuse compared to their non-LGBTQIA+ peers. Many of these disparities can be linked to the social stigma that LGBTQIA+ individuals face. The combination of health disparities and discrimination has a compounding effect, exacerbating feelings of anxiousness, loneliness, or depression in these individuals and creating an even greater need for accessible, culturally sensitive, and affordable care.

The recent update to ACA language serves as a step in the right direction, but providers need to be diligent with their efforts to deliver compassionate and comprehensive care to this population.

Institutions and industry leaders across the country have made strides in recent years to move the needle for more inclusive and equitable healthcare. For example, Harvard University opened its LGBTQ Health Center of Excellence earlier this month. The Callen-Lorde Community Health Center launched a first-of-its-kind Nurse Practitioner fellowship for culturally competent training for LGBTQIA+ healthcare in 2019. And the American Medical Association launched a national fellowship program in 2022 that trains physicians and promotes best practices on LGBTQIA+ health while working to decrease disparities.

Research has shown that culturally informed training is paramount to caring for members of the LGBTQIA+ community. During a time when the rights of this group are challenged across the country, access to qualified and compassionate healthcare professionals is more critical than ever.