Lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals are at higher risk of suffering from mental disorders and have less access to health care than straight and cisgender individuals, according to a 2015 Harvard study.
Already having to face prejudice due to their sexuality and gender identity, LGBTQ individuals also have to deal with the social stigma surrounding mental disorders, health experts say.
“They are balancing multiple oppressions,” said Robin McHaelen, founder of True Colors, a nonprofit organization that advocates for LGBT youth. “It makes their recovery much more challenging.”
These oppressions expose LGBTQ individuals to higher risks of depression and anxiety disorder, which contribute to suicidal thoughts and behavior.
In 2015, Harvard Professor Sari Reisner conducted a study on the mental health of transgender youth and found transgender teenagers are up to three times more likely to suffer from mental disorders and suicidal ideation than cisgender teenagers. Cisgender refers to people whose identity corresponds with the gender assigned to them at birth. The study also reported that LGBTQ youth are six times more likely to experience depression and anxiety than the general population.
Many LGBTQ individuals hide their sexuality and gender identity from their health care providers due to fear of rejection and ignorance, according to the Gay Men’s Health Crisis. The organization reported that 75 percent of lesbians delayed seeking health care and 34 percent of transgender people postponed care due to fear of discrimination. In addition, 21 percent of LGBTQ individuals reported that doctors have refused them health care.
McHaelen encourages LGBTQ people to recognize that they cannot get the appropriate care that caters to their needs if they do not disclose this information since their doctors would not be aware of their sexual preference.
Today, many health care providers still lack adequate knowledge and training on LGBTQ mental health issues, she said.
“Many medical schools have only an hour or two of training available to students,” McHaelen said.
As a result, these providers tend to focus on a patient’s sexuality and gender identity rather than their mental health, she said.
Another barrier to health care is insurance coverage. LGBTQ people, especially transgender individuals and those of color, are dramatically uninsured and underinsured, mostly due to unemployment. According to the Center for American Progress, LGBTQ people of color are twice as likely to be uninsured as straight people of color. These individuals do not have health insurance because they are unemployed, yet their unemployment might be due to workplace discrimination.
LGBTQ people are also at higher risk of poor sexual health than their straight and cisgender counterparts. One of the most notable LGBTQ health disparities is in the rates of sexually transmitted infections and HIV/AIDS. In 2015, the Centers for Disease Control and Prevention reported gay and bisexual men represented 73 percent of new HIV infections among the male population.
State laws have a responsibility for the health disparities in the LGBTQ community as well, experts say. A study in March 2016 by the American Foundation for Suicide Prevention reported that LGBTQ people who live in states that do not have anti-discrimination laws are five times more likely to have a mental disorder than those who are protected by anti-discrimination laws.
Starting in 2010, the Affordable Care Act prevents insurance companies from denying coverage to people with pre-existing conditions and makes prescriptions more affordable. These provisions play a significant role in making health care more accessible to the LGBTQ community, especially transgender individuals and those living with HIV/AIDS, experts say.
“Coverage of medically necessary health care is available for those who want it,” McHaelen said. “However, lots of folks don’t know that it exists. Since discrimination exists and people are scared to go to their providers, many folks do not get the health care they need.”
More awareness is needed, she said.
“The goal is to help folks let go of shame,” she said.
“Understand that the issue more rightly belongs with the people who are prejudiced not the people who are the target of the oppression.”
Vyanne Dinh is a student at South Windsor High School.