LGBTQ Health Care Discrimination

Health care is an ongoing issue in the United States. The Affordable Care Act (ACA) made health insurance readily available to many Americans who could not afford health care. However, health care providers and insurance companies still discriminate against gay, lesbian, and transgender individuals.

The ACA and court rulings under the Obama administration addressed some inequities in the health care system. LGBTQ people received some protection against overt discrimination in health care. The first Trump administration rolled back many of these protections. The Biden administration added additional coverage for transgender youth, including gender-affirming care.

Now, those health services are at risk once again.

LGBTQ+ Health Issues

The LGBTQ community suffers the same health problems as the cisgender/straight community. But, they suffer some disorders at much higher rates. These health disparities are often due to:

• A lack of health care resources
• Insurance coverage
• Negative experiences when visiting medical professionals

Compared to straight patients, LGBTQ+ patients suffer a higher incidence of:

• Heart disease, coronary artery disease, and related illnesses like high blood pressure
• Obesity, eating disorders, and body image disorders. Research suggests lesbian and bisexual individuals may be prone to overeating. Gay men, on the other hand, are more likely to experience body dysmorphia and anorexia.
• Breast, cervical, and anal cancers. These cancers are treatable with early detection. But individuals who are uncomfortable with their healthcare providers are often unwilling to visit regularly.
• Mental health issues are common among transgender and gender-nonconforming youth. Depression, anxiety, and body dysmorphia are unfortunately common.

Around 30% of LGBTQ adults do not have a regular health care provider, compared to around 10% of heterosexuals.

Types of Health Care Discrimination

The forms of discrimination facing LGBTQ+ patients are like those facing people of color and other minorities:

• Lack of legal protection in accessing Medicaid and other low-cost health insurance: The past 20 years have seen coverage protections swing back and forth in mandating coverage for LGBTQ+ patients.
• Lack of experienced healthcare professionals: Public opinion about providing gender-affirming care and transition services has made medical professionals wary of providing medical care without legal protection. This leads to a lack of care in underserved areas where it is most needed.
• Financial issues: Lack of insurance means paying out of pocket for essential treatment and medication.

The medical system focuses on providing care for straight males and females with health insurance. It is not equipped for individuals with nonconforming gender identities.

Poor Provider Attitudes

One of the most common causes of chronic health care issues among the LGBTQ population is negative provider attitudes. Prompt treatment is essential for positive health outcomes. But negative attitudes lead many LGBTQ+ patients to delay or avoid care.

Like patients who experience discrimination because of their race or ethnicity, patients who encounter discrimination due to sexual orientation or gender identity don’t go to the doctor when they’re sick or injured.

According to a 2018 survey, a significant percentage of LGBTQ+ patients reported:

• Denial of service because they were gay, lesbian, or transgender
• Abusive language or conduct by doctors or staff
• Sexual misconduct, abuse, or rape by physicians or staff

Finding a new doctor is not always an option for individuals living outside of metropolitan areas. Rural hospitals have shut down at an alarming rate over the past decade. Public stigma against transgender people has led to doctors and medical clinics requesting and receiving religious exemptions to federal nondiscrimination protections.

Effects of LGBTQ+ Discrimination

It is always in the public interest to ensure that everyone has access to the best health care possible. When one segment of a population experiences discrimination in health care settings, the effects ripple through the entire community.

According to a KFF survey, in general, LGBTQ+ individuals are:

• Younger
• More likely to be unemployed, disabled, or on Medicaid
• Less likely to see a doctor for wellness visits
• Have the same issues affording healthcare as non-LGBTQ+ patients

A public health policy that ignores minority groups, including LGBT people, leaves a significant percentage of people without essential treatment until their condition requires emergency care. This type of policy is ultimately more costly than providing needed care up front.

Responding to Health Care Discrimination

If you experience discrimination in a healthcare setting, consider speaking with a discrimination attorney. Section 1557 of the Affordable Care Act prohibits discrimination based on:

• Race
• Color
• Religion
• Sex
• National origin

In 2024, a federal district court stopped enforcement of this section based on “gender identity.” And on January 20, 2025, an Executive Order directed all federal agencies to immediately rescind and revoke all policies related to transgender equality. Transgender advocates are understandably upset about the ramifications of this order. It is not clear what the final impact of this policy change will be.

Anyone needing assistance with health care issues should discuss their options with a health care attorney.