Health care is a tricky thing, especially in the US. There’s insurance to deal with and finding the right doctors/therapists/other professionals that also take your insurance or are a right fit. And when you’re a part of the LGBTQ community, accessing health care can be even harder for a variety of issues and there are health issues that impact this community more than the overall population. (I do want to apologize – this post lacks a larger sense of intersectionality as I focus primarily on the LGBTQ community and the issues faced because of sexual orientation and gender identity.)
As far as mental health issues go, the National Alliance on Mental Illness has a section on LGBTQ mental health – breaking it all down into sections and particularly talking about why there’s a higher rate of suicide attempts and mental health issues in the LGBTQ community than the general population. And a big part of this conversation is suicide because LGBTQ people in the US have a higher suicide risk than the general population. A shocking 41% of trans people have attempted to commit suicide and suicide attempts are also elevated for LGBQ youth – with LGBQ youth more than 3 times more likely to attempt suicide than their straight peers.
Several months ago I wrote about the need for sober places in the queer communities, in part because of the significantly larger drug use in the community compared to the general population. The Center for American Progress has a study on why the LGBT+ community experiences higher rates of substance abuse and highlighted that a part is because of the targeted marketing from alcohol and tobacco companies but other factors include stress from prejudice and discriminatory and the lack of cultural competency in the health care system. One study also looked at the relationship between disclosing sexual orientation and substance use, finding that rejection is linked with coexisting and subsequent drug use.
Health Care and insurance
The health care system is not perfect and there are many ways in which it fails the LGBTQ+ patients. A big part of this is really how the medical industry and many health care professionals fail trans people – something that is highlighted with the Twitter hashtag #TransHealthFail. There’s a huge problem of gatekeeping within the industry but that gets even worse when you are trans and trying to get care and coverage.
Insurance is a big part of this conversation because it was for the longest time a completely common practice for insurance companies to have really explicit exclusions for trans related care. There are some states that have prohibited this practice but that list is really small and so there’s so much more work to do. And because the LGBTQ community is more likely to be in poverty than the general population (with LGBT women being most at risk for poverty), the high costs of health care can be prohibitive.
And finding doctors that are educated and competent about LGBTQ issues (especially for trans people) is also difficult – something that Katie Dupree writes about in her piece on ways that the health care system fails trans patients and something that Andy Marra also writes about. So many trans people have been in the position having to educate their health care professionals on trans identities and issues and often face misgendering, discrimination, and abuse. The National Transgender Discrimination Survey reported roughly 28% of trans people having been harassed in medical settings, 19% having been straight up denied care because of their trans identity, and 2% having been physically attacked in a medical setting.
Resources and Support
All of this is so angering and worrisome for many reasons, in particular because the health care industry should be about caring for people and doing no harm. But while there are so many issues around this, there are resources and sources of support for the queer community if you’re struggling with health issues and so many people that do want to help you.
- The Association for Lesbian, Gay, Bisexual & Transgender Issues in Counseling – this association provides resources, newsletters, therapist resource listing, continuing education, etc.
- The Association of LGBTQ Psychiatrists – this organization does a variety of things like publishing a quarterly newsletter and journal, provide referrals for LGBTQ patients, and more.
- GLBT National Help Center – this is a nonprofit organization that provides peer support, community connections, and resources for those with questions about sexual orientation and/or gender. Some resources include:
- MyTransHealth a website to help connect trans people with qualified and understanding doctors who will be able to help with whatever health need. The project was just recently funded last August and is working on becoming a fully functional website and resource!
- The Trevor Project – this organization provides crisis and suicide prevention services to LGBTQ youth. They have a lifeline, chat, support center, and other resources.