The landscape of LGBTQ+ healthcare has often been portrayed as a battle between states restricting access to gender-affirming care and those championing the protection of this crucial healthcare need. While it is true that access to transgender care continues to expand in the majority of the United States, this narrative overlooks the far-reaching health disparities experienced by the LGBTQ+ community. There exists a shortage of healthcare providers who are adequately trained in LGBTQ+ affirming care, leading to detrimental impacts on the overall health outcomes of queer individuals. To bridge this gap, it is imperative to cultivate a greater number of culturally competent healthcare providers in the United States.
According to the latest Gallup Poll, approximately 7.2% of the population identifies as LGBTQ+. Alarmingly, LGBTQ+ individuals experience worse health outcomes compared to their heterosexual counterparts. This includes higher rates of certain types of cancer, heart disease, and mental health issues. Despite the urgent need for LGBTQ+ healthcare, there is a significant lack of cardiology fellowships and other specialized programs that focus on LGBTQ+ health. For instance, whereas heart disease affects approximately 5-6% of U.S. adults, few fellowships offer training in LGBTQ+ cardiac care, exacerbating the health disparities faced by this community.
In addition to the shortage of specialized fellowships, LGBTQ+ individuals frequently encounter negative experiences and mistreatment within the healthcare system. Approximately one in three LGBTQ+ adults reported encountering some form of mistreatment when interacting with a mental health professional in the past year. This figure rises to four in 10 for LGBTQ+ people of color and more than half for transgender or nonbinary individuals. These negative encounters deter LGBTQ+ individuals from seeking necessary healthcare and contribute to the overall disparities in their health outcomes.
Contrary to misconceptions, a lack of evidence, science, or guidelines is not the issue hindering LGBTQ+ healthcare. Every major healthcare association and specialty group has published comprehensive guidelines for providing care to LGBTQ+ individuals at every life stage. These guidelines cover critical aspects such as cervical cancer screening in lesbian and bisexual women, the benefits of pre-exposure prophylaxis (PrEP) for gay and bisexual men, and the provision of hormone therapy for gender affirmation in transgender and nonbinary people. Furthermore, numerous case studies demonstrate the positive outcomes of LGBTQ+ affirmative care.
As progress stagnates within larger healthcare systems and state governments, the private sector is stepping up to ensure access to LGBTQ+ healthcare. Gaingels, an LGBTQIA+/Allies private investment syndicate, has reaffirmed its commitment to funding LGBTQ+ entrepreneurs. Notably, several LGBTQ+ healthcare startups have emerged as frontrunners in connecting queer individuals with culturally competent providers. Startups like Violet have introduced a “badging” system that highlights a provider’s cultural competency, making it more likely for LGBTQ+ patients to seek care from them. Another startup, Plume, led by transgender individuals, utilizes virtual care to provide hormone therapy to thousands of individuals. By credentialed healthcare professionals who adhere to evidence-based guidelines, Plume ensures the provision of culturally competent and sensitive care from the safety of patients’ homes.
While some states have made progress in affirming the right to healthcare for transgender and LGBTQ+ individuals, it is crucial to continue raising the bar. Large-scale systemic changes are necessary to ensure equitable access to care, free from discrimination. Nonetheless, the innovative endeavors of these startups are making a tangible difference, filling in the gaps of healthcare provision in creative ways. The LGBTQ+ community deserves both rights and innovation, and it is through these collaborative efforts that we can begin to address the disparities and improve the overall healthcare experiences of LGBTQ+ individuals.
LGBTQ+ healthcare is far more complex than the headlines often suggest. Despite progress in transgender care access, health disparities still plague the LGBTQ+ community. The shortage of culturally competent healthcare providers continues to hinder comprehensive and equitable care provision. By fostering a greater number of providers trained in LGBTQ+ affirmative care, we can bridge these gaps and provide holistic healthcare to LGBTQ+ individuals throughout their lifetimes. As the private sector takes up the mantle of progress, it is necessary for larger healthcare systems and state governments to follow suit in order to meet the needs of the LGBTQ+ community. By embracing both innovation and a commitment to inclusivity, we can truly transform the landscape of LGBTQ+ healthcare for the better.