Bridging Gaps in LGBTQIA+ Health Disparities

LGBTQIA+ letters in hands

The United States provides some of the most advanced healthcare the world has to offer, and while many people would agree access to quality healthcare is a priority in their lives—if not a right—distorted health equity in the U.S. is still a major concern. For those who have access to care, and have experienced care they trust and appreciate, equity can easily be taken for granted.

The unfortunate truth is that health disparities are still common in the industry, and although significant progress has been made to improve access and quality of care for all, there is much work to be done. In 2016, the National Institute on Minority Health and Health Disparities identified the LGBTQIA+ community as a health disparity population, and with the issue on the Healthy People 2030 list of goals, it seems like little progress has been made. Continuing education is one of the most important ways to bridge the gap, and content like Anti-Discriminatory Practice as Cultural Competence with LGBTQIA+ Patient Populations is helping to reduce these challenges for vulnerable populations in a variety of settings.

Regardless, there is still plenty of work to be done to deliver equitable healthcare for all, and ensuring LGBTQIA+ populations are well-served is a major focus for health systems and professionals today.

Understanding Health Disparities

Many vulnerable populations experience health disparities, and although the contributing factors may be different, the outcomes are often very similar. These disparities involve any healthcare process that produces sub-optimal care because of barriers such as limited access to healthcare, socioeconomic variables, and other unique factors such as geography and culture.

Health disparities can also evolve from implicit or explicit biases resulting from stigmatization and discrimination, as well as lapses in understanding related to community-specific risks.

Stigmatization and the LGBTQIA+ health disparities they produce can also cause these patients to have negative experiences, creating a sense of distrust in the healthcare system as a whole and pushing them to avoid care whenever possible. The unfortunate result is that easily treatable conditions go unmanaged, some of which may become serious, life-altering emergencies or chronic conditions.

Common LGBTQIA+ Health Disparities

In addition to general health disparities experienced by all vulnerable populations, LGBTQIA+ communities have specific areas of concern that healthcare providers and their employees need to be aware of. These represent institutional and interpersonal challenges that may be encountered in a variety of settings and disciplines, including:

Mental Health

At baseline, members of the LGBTQIA+ community are at greater risk for mental health challenges like depression, anxiety, suicidality, eating disorders, and substance use disorders. These challenges often arise from the perpetual pursuit of acceptance and equality in the face of frequent discrimination and barriers to comfortable self-expression.

Health disparities that manifest through things like a denial of treatment—or just a pure lack of understanding—can also contribute to a negative impact on someone’s mental health and wellness. Additionally, the lack of trust engendered by negative experiences may deter people from seeking the help they desperately need. When it comes to topics like depression and suicidality, not seeking help when needed for fear of further discrimination can have a devastating impact.

Substance Abuse

Substance abuse is a national health concern, and when combined with existing societal pressures and health disparities it is an even greater challenge in the LGBTQIA+ community than in heterosexual and cisgender groups. Research has found that people who identify as lesbian or gay are more than twice as likely as people who identify as heterosexual to abuse alcohol or tobacco.

Unfortunately, healthcare professionals may make inappropriate and inaccurate assumptions about the impact lifestyle has on these issues, which can lead to ignoring or minimizing other serious pressures that are relevant and causal. As with any substance abuse patient—and particularly with vulnerable communities—staff should rely on patient-centered care that addresses evidence-based factors in their lives.


It’s increasingly clear that transgender people are subject to rates of violence that are up to four times higher than their cisgender counterparts. Additional factors such as race can have a compounding effect on the problem; research has found that black transgender women experience significantly higher rates of physical and sexual assault and murder than any other trans group.

Additionally, transgender women also suffer from much higher poverty rates. As poverty increases, so does the risk of prostitution, imprisonment, and violence. LGBTQIA+ people with histories of experiencing discrimination and violence are at increased risk of suicidality and substance use. All of these factors contribute to a complex and integrated set of disparities that make awareness and action even more critical when serving these patients—particularly in trauma-related settings.

Turning the Tide for LGBTQIA+ Health Disparities

One of the first thoughts entering the mind of many LGBTQIA+ persons when thinking about new people, places, or resources is “Will I be accepted there?” As a healthcare system, the first step in reducing disparities is to maximize and publicize institutional acceptance.

Fortunately, when it comes to channeling resources and treating illnesses, there are few institutional hurdles left to clear. However, historical trauma and biases still linger; facilitating a sense of acceptance and rebuilding trust with the LGBTQIA+ community is crucial for changing the relationship they have with the healthcare system at large.

Every health professional can support better outcomes for LGBTQIA+ patients through:

  • Establishing trust and rapport with all patients.
  • Normalizing and validating: Ask questions as you would to any patient.
  • Asking open-ended questions: Don’t assume anything about relationships, partners, or sexual behavior.
  • Developing awareness of issues particular to, or different for, the LGBTQIA+ population, like having children, parenting, aging, and legal rights.

Bridging Gaps in LGBTQIA+ Health Disparities Begins with Education

Breaking down institutional and interpersonal obstacles are key areas all providers and professionals need to focus on from the ground up. Members of the LGBTQIA+ community who are being denied complete and compassionate care are still slipping through the cracks, and it’s everyone’s responsibility to keep themselves updated and engaged with the latest information and trends.

Closing the gaps in LGBTQIA+ health disparities needs to begin with increased awareness and education. Premiere is leading the way to more inclusive healthcare, and courses like Anti-Discriminatory Practice as Cultural Competence with LGBTQIA+ Patient Populations created by Brian Masciadrelli Ph.D., LICSW, LMSW can expand your health disparity definition and provide the insights and strategies it takes to be an ally for underserved and at-risk communities.

All of Premiere’s content is created by leading industry experts and is designed to make it easy to meet your professional obligations and stay at the forefront of your profession.

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