June is Pride Month.
For many people, Pride is a celebration of identity, community, visibility, and progress. As a patient advocate, I also see it as an opportunity to talk about something that affects many LGBTQIA+ individuals every day: healthcare.
If you’ve ever delayed an appointment because you were worried about how a provider would react, struggled to find a healthcare professional who understood your needs, felt uncomfortable disclosing important information about yourself, or left an appointment feeling dismissed, you are not alone.
While healthcare can be difficult to navigate for anyone, research shows that LGBTQIA+ individuals continue to face additional barriers when accessing care. These barriers contribute to measurable differences in healthcare access, chronic disease outcomes, disability rates, and mental health outcomes compared to heterosexual and cisgender populations (National Academies of Sciences, Engineering, and Medicine, 2020).
Importantly, these disparities are not caused by a person’s sexual orientation or gender identity.
They are largely the result of how healthcare systems, insurance processes, and societal factors impact access to care.
Why Healthcare Can Feel Harder to Navigate
Many LGBTQIA+ patients spend time evaluating something that many other patients rarely have to consider:
“Will this provider treat me with respect?”
Research has found that LGBTQIA+ individuals are more likely to report negative healthcare experiences, delays in care, unmet healthcare needs, and difficulty finding providers who understand their unique health concerns (Macapagal et al., 2016).
For some patients, those experiences may include:
- Having to repeatedly explain their identity to providers
- Feeling uncomfortable disclosing important health information
- Concerns about discrimination or bias
- Difficulty finding knowledgeable specialists
- Administrative barriers related to insurance or medical records
- Previous negative healthcare experiences that make seeking future care more difficult
Over time, these experiences can lead patients to postpone appointments, avoid preventive care, or delay seeking treatment when symptoms develop.
Unfortunately, delayed care often leads to larger problems later.
LGBTQIA+ Patients Experience Higher Rates of Certain Health Conditions
The National Institutes of Health formally recognizes sexual and gender minority populations as a health disparity population due to documented differences in health outcomes and healthcare access (National Institutes of Health, 2016).
Research has identified disparities in several areas, including:
- Chronic pain
- Arthritis
- Asthma
- Disability and functional limitations
- Depression and anxiety
- Substance use disorders
- Cardiovascular risk factors
- Sleep-related health concerns (Fredriksen-Goldsen et al., 2012; Cunningham et al., 2018)
This does not mean being LGBTQIA+ causes these conditions.
Instead, researchers point to factors such as chronic stress, discrimination, healthcare barriers, and social determinants of health as contributors to poorer health outcomes over time.
For patients already living with chronic illness, these additional challenges can make navigating healthcare even more complicated.
The Impact of Chronic Stress and Mental Health
One of the most well-established findings in LGBTQIA+ health research is the impact that chronic stress can have on both physical and mental health.
Researchers refer to this as Minority Stress Theory, which describes how ongoing exposure to stigma, discrimination, social exclusion, and other stressors can contribute to poorer health outcomes (Meyer, 2003).
The Centers for Disease Control and Prevention has also documented higher rates of depression, anxiety, psychological distress, and suicidal ideation among LGBTQIA+ populations (CDC, 2024).
Many LGBTQIA+ individuals are not just managing their health.
They are also navigating the cumulative effects of negative healthcare experiences, discrimination, family rejection, or years of wondering whether it is safe to be fully honest with their healthcare providers.
Those experiences can influence when people seek care, whether they trust their providers, and how comfortable they feel advocating for themselves within the healthcare system.
You Shouldn’t Have to Fight the Healthcare System to Receive Care
Many of the LGBTQIA+ patients I have spoken with over the years describe spending significant energy not only managing their health but also managing the healthcare system itself.
You may have experienced:
- Difficulty finding affirming providers
- Insurance barriers
- Prior authorization challenges
- Denials of medically necessary care
- Difficulty coordinating care between multiple specialists
- Problems obtaining referrals
- Medical records that are incomplete, inaccurate, or difficult to access
- Feeling unheard during appointments
Healthcare is already complicated.
When you add chronic illness, disability, rare disease, insurance issues, or multiple specialists into the mix, it can become overwhelming.
Patients should be able to focus on their health, not spend countless hours fighting administrative battles.
How a Patient Advocate Can Help
One of the things I have learned as both a patient and a Board Certified Patient Advocate is that healthcare navigation is a skill.
Most people are never taught how to organize complex medical records, evaluate provider options, prepare for specialist appointments, appeal insurance denials, coordinate care between multiple healthcare systems, or advocate effectively when something goes wrong.
Yet patients are expected to do these things every day.
For LGBTQIA+ individuals living with chronic illness, disability, rare disease, or complex medical conditions, those responsibilities can quickly become overwhelming.
A patient advocate can help by:
- Organizing medical records and health histories
- Preparing for appointments and developing questions in advance
- Researching providers and specialists
- Helping navigate insurance barriers, denials, and appeals
- Coordinating communication between healthcare providers
- Explaining healthcare and insurance processes
- Identifying resources and support options
- Helping patients feel more prepared and confident when navigating care
My role is not to make healthcare decisions for my clients.
My role is to help reduce confusion, identify options, navigate barriers, and empower patients to make informed decisions about their care.
Pride Month Is Also About Health Equity
Pride Month is often associated with celebration, visibility, and community.
It is also an opportunity to recognize that healthcare access remains unequal for many LGBTQIA+ individuals.
Every patient deserves to feel safe seeking care.
Every patient deserves to be treated with dignity and respect.
Every patient deserves access to competent, evidence-based healthcare.
The challenges many LGBTQIA+ patients face are well documented in the research and reflected in the experiences patients share every day.
And if you are feeling overwhelmed by chronic illness, insurance issues, medical complexity, or healthcare barriers, you do not have to navigate it alone.
References
Centers for Disease Control and Prevention. (2024). Health Disparities Among LGBTQ+ Populations.
Cunningham, T. J., Xu, F., & Town, M. (2018). Prevalence of Five Health-Related Behaviors for Chronic Disease Prevention Among Sexual and Gender Minority Adults, United States, 2016. MMWR Morbidity and Mortality Weekly Report, 67(32), 888-893.
Fredriksen-Goldsen, K. I., Kim, H. J., Barkan, S. E., Muraco, A., & Hoy-Ellis, C. P. (2012). Disability Among Lesbian, Gay, and Bisexual Adults: Disparities in Prevalence and Risk. American Journal of Public Health, 102(1), e16-e21.
Macapagal, K., Bhatia, R., & Greene, G. J. (2016). Differences in Healthcare Access, Use, and Experiences Within a Community Sample of Racially Diverse LGBTQ Emerging Adults. LGBT Health, 3(6), 434-442.
Meyer, I. H. (2003). Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence. Psychological Bulletin, 129(5), 674-697.
National Academies of Sciences, Engineering, and Medicine. (2020). Understanding the Well-Being of LGBTQI+ Populations.
National Institutes of Health. (2016). Sexual and Gender Minority Populations Formally Designated as a Health Disparity Population.
