Gays and lesbians face discrimination in many venues, but the doctor’s office can be one of the places with the most consequences. Health care, LGBT advocates say, is too often designed with only heterosexuals in mind. As a result, LGBT patients face unique barriers to access and providers who are sometimes insensitive or ignorant of their needs.
“LGBT people have many of the same health needs as everyone else,” says Rebecca Fox, director of the National Coalition for GLBT Health. “But there are certain things they are more at risk for.”
LGBT people can be vulnerable to certain types of cancer, substance abuse and depression, but because there aren’t many large-scale studies about LGBT health, many doctors aren’t trained to look for these issues.
“Sometimes it’s up for the patient to educate the doctor, and that’s not always the most conducive environment for health care,” Fox says. In some cases, a doctor may not even know that a patient is gay. Fear of discrimination can cause LGBT patients to withhold information about their orientation or behavior from their doctors or avoid seeking health care altogether.
But while homophobia exists in the medical community, the most widespread problem is many doctors aren’t educated about creating a welcoming environment for their LGBT patients.
Health care professionals shouldn’t assume that every patient walking into their offices is heterosexual, says Fox. Even filling out forms in the waiting room that don’t offer “partnered” as a choice among “married,” “single” or “divorced” can make an already nerve-wracking experience even more uncomfortable.
“There are tons of cues that most LGBT people are all too familiar at reading,” Fox says.
Lack of insurance can be another health care barrier for gay patients. Because many businesses don’t offer domestic partner benefits, members of the LGBT community often have fewer health insurance options than married heterosexuals.
“LGBT people are significantly more likely not to be covered than the general population,” Fox says.
Groups such as the Gay and Lesbian Medical Association and Fox’s National Coalition for GLBT Health are working to address barriers to access and to educate providers about serving their LGBT patients. But the education should really start before doctors begin practicing, Fox says.
“Sexual orientation isn’t covered in a lot of medical schools,” she says.
But that might be changing.
Andrea Knittel is the chair of the Lesbian, Gay, Bisexual and Transgender Health Action Committee, which is part of the American Medical Student Association. Her mission is to create more awareness about the needs of LGBT patients.
“We are trying to educate future physicians and current physicians to eliminate the discrimination as much as possible against GLBT patients,” she says.
That includes teaching students things such as not assuming every gay male patient needs to be tested for HIV.
“What’s important to me is that providers get a real solid handle on what the risk factors are and how to ask about them appropriately,” she says.
Now there are ways for LBGT patients and LBGT-friendly doctors to find each other. Some health departments, such as Seattle-area King County’s, provide lists of local gay-sensitive providers and clinics. And the GLBT Center of Colorado launched an online service in June called Link, which is designed to connect patients with GLBT-friendly health care providers.
The GLBT Center has been providing patient referrals for years, says Link program manager Jared Ostermiller. But the Web site allows patients to search among 150 providers with various specialties.
The center also holds trainings to teach providers how to better care for their LGBT patients.
“It’s so important for doctors and health care providers to treat all parts of a patient, and that includes sexual orientation,” says Fox.