LGBTQ students discuss bias in health care access

The bias in health care toward LGBTQ people adds to overall poorer health for the community.

Approximately three in 10 LGBTQ Americans faced difficulties last year accessing necessary health care due to cost issues, more than half of them including transgender Americans, according to an October report by the American Center for Progress.  

Some LGBTQ Temple University students have shared this difficulty finding medical care.

Discrimination in the health care system contributes to LGBTQ people having worse health outcomes compared to their cisgender and heterosexual counterparts, according to a report from the American Center for Progress, a nonprofit policy institute in Washington, D.C.

Fifteen percent out of the 1,528 LGBTQ adult respondents reported they postponed or avoided seeking care due to anti-LGBTQ discrimination, according the report.

Sinh Taylor, a junior secondary education major who identifies as nonbinary, has avoided seeking treatment because of discrimination. 

Taylor has been misgendered and deadnamed, when someone refers to a transgender person’s birth name instead of their preferred name, by doctors and was told their identity is the reason for their depression, they said. These experiences have made them reluctant to seek care, they added.

“Unless I’m literally dying I don’t go to the doctors,” Taylor said.

Rebecca Zalkin, a sophomore mathematics major who is transgender, had a similar experience with medical professionals invalidating her identity. When she was hospitalized for a panic attack last year, a nurse was rude to Zalkin and asked invasive questions about her gender, she said. 

The nurse attending to Zalkin asked if she was on her period, something she does not experience as a transgender woman. 

“I told him I was transgender, and he started to look at me as if I had three heads,” she wrote. “After a grueling time waiting there, trying to figure out my health insurance, and crying my eyes out to a new doctor, I was allowed to leave. I vowed never to go back to that hospital.”  

In order to begin medically transitioning, Zalkin needed a note from her therapist, she said. When she was first coming to terms with her gender and wanted to medically transition, Zalkin was turned away by therapists because of her gender identity and learning disability, she said. 

Zalkin said that because most medical professionals either act like treating her is proof of how accepting they are or try to avoid her, she will not see any new doctors unless her current one can vouch for them. 

“I’m just exhausted at this point,” Zalkin wrote. 

Taylor and Zalkin’s experiences are part of a larger trend. The American Center for Progress found 32 percent of the 1,528 respondents had a doctor or provider who intentionally misgendered them or used the wrong name. 

“Discriminatory health care practices, bias and stigma contribute to disparities and inequities in health care among LGBTQ+ individuals,” wrote Omar Martinez, a social work professor, in an email to The Temple News. “Health and social service professionals are bound by professional and ethical standards; these should be enforced and further expanded to better serve and protect LGBTQ+ patients.” 

One in three transgender patients had to educate their doctors about their identity in order to receive the necessary care, according to the American Center for Progress report. 

“Providers’ bias and lack of training on inclusive care contribute to these inequities. For example, transgender people face barriers to accessing health care, resulting in population-level disparities in health outcomes,” Martinez wrote.  

LGBTQ individuals are also more likely to have fewer insurance options, delayed access to proper care and be refused services by medical professionals, according to Cigna, a global health insurance company.

“Stigma and discrimination continue to disproportionally impact LGBTQ+ individuals,” Martinez further wrote. 

To bridge the health care gap, health care professionals must understand the role discrimination plays in LGBTQ people’s health, according to the National Alliance on Mental Illness

“When providers use heteronormative terminology and don’t recognize they are doing so, that is immediately a barrier for patients,” said Jennifer Aldrich, a medicine professor. 

Aldrich said she has tried to include space for nonbinary pronouns in the electronic record system at Temple Health and make note of preferred names for transgender patients on their forms. 

Martinez worked on projects led by Kimberly McKay, a social work professor, to make the curriculum more inclusive, like creating two graduate-level courses on responding to the specific needs of LGBTQ people. 

It is vital that health care workers understand the role being a minority plays in LGBTQ health and that there is nothing inherently wrong with LGBTQ people, Aldrich said. 

“Queer individuals must stop being viewed as a lesser person, they should be treated the same in the medical field and respected as any other person,” Taylor said. 

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