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Understanding LGBT+ Patient Experience, Healthcare Needs

August 3, 2021
Patient Engagement Hit
By Jill McKeon

KFF survey results reveal that the LGBT+ population faces higher rates of chronic disease, mistreatment by providers, and care access barriers than non-LGBT+ people..

The LGBT+ population experiences more adverse health outcomes, mistreatment by providers, and negative patient experiences than their non-LGBT+ peers, according to a survey conducted by Kaiser Family Foundation (KFF).

More than half of LGBT+ people in the United States are between the ages of 18 and 35. Despite the young population, almost half of LGBT+ survey respondents reported having an ongoing health condition that requires regular monitoring and medical care, compared to 40 percent of non-LGBT+ respondents.

Over 11 million LGBT+ people live in the US, according to KFF. But care disparities and discrimination continue put LGBT+ communities at a high risk for chronic disease, mental health issues, and poor health outcomes.

“Social inequality is often associated with poorer health status, and sexual orientation has been associated with multiple health threats,” the Centers for Disease Control & Prevention (CDC) website explained.

“Members of the LGBT community are at increased risk for a number of health threats when compared to their heterosexual peers. Differences in sexual behavior account for some of these disparities, but others are associated with social and structural inequities, such as the stigma and discrimination that LGBT populations experience.”

KFF found that over 30 percent of the LGBT+ community reported having incomes below 200 percent of the federal poverty level, compared to 25 percent of non-LGBT+ populations. Income-based health disparities and other socioeconomic factors are known to fuel adverse health outcomes and access barriers.

In addition, those with Medicaid coverage, limited educational attainment, and lower incomes reported poor health at higher rates than their non-LGBT+ peers, pointing to social determinants of health as a driver for negative outcomes.

“While LGBT+ people are as likely to have a usual source of care and regular provider, and use similar sites of care as their non-LGBT+ counterparts, they were more likely to report a range of negative provider experiences, including being blamed for health problems or having their concerns dismissed,” KFF discovered.

“At the same time, LGBT+ people were more likely to discuss certain health and social issues with their providers than non-LGBT+ people.”

While care access appears to be relatively equitable, LGBT+ people tend to have worse experiences with their providers than non-LGBT+ people. LGBT+ people were more likely to report that they had a provider who did not believe they were telling the truth, suggested that they were to blame for a health problem, assumed something without asking, or dismissed their health concerns altogether.

Over a third of LGBT+ people reported having at least one of the previously mentioned negative interactions with their provider. These experiences were more common among LGBT+ women.

Despite a significant share of negative provider interactions, LGBT+ people also reported being asked about topics like mental health, alcohol or drug use, smoking, and domestic violence more often than non-LGBT+ populations.

In addition, 26 percent of LGBT+ respondents reported that their providers asked about housing security, compared to 17 percent for non-LGBT+ people.

Despite some advancements and increased attention toward LGBT+ care, the LGBT+ population continues to face financial and social issues when it comes to healthcare. KFF’s survey found that 30 percent of LGBT+ people had trouble paying their medical bills in the past 12 months, compared to 19 percent of non-LGBT+ people.

Over 65 percent of LGBT+ people who reported struggling with medical bills said they’d nearly exhausted their savings, and over half had trouble paying for basic necessities like food and housing.

Most respondents also cited the COVID-19 pandemic as a major driver of financial struggles in the past year.

While LGBT+ people experienced similar healthcare experiences to their non-LGBT+ counterparts in many instances, overall health outcomes were still worse. LGBT+ people were less likely to feel listened to by their providers and more likely to incur medical debt, on top of already disproportionate levels of poverty.

In addition, KFF acknowledged a lack of data on non-binary and gender-fluid people, which did not allow for fully inclusive analysis.

“While data collection on LGBT+ people is improving, particularly at the federal level, it is still not standard, and as such, knowledge gaps remain, including with respect to health status, health needs, and health care access. Lack of research in this area limits the ability of those in both policy and health care sectors to address health needs and disparities within the population,” KFF concluded.

“Given LGBT+ people’s common experiences with stigma, discrimination, and violence in a range of environments (e.g., home, work, school, health care, etc.) and the evolving legal protections based on sexual orientation and gender identity, collecting this data is especially important in furthering goals of equity and access.”

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