Jun 01, 2023



Gaps and Opportunities in LGBTQ+ Healthcare

For many LGBTQ+ patients, finding high-quality, affirming care is a challenge. Improve access to healthcare by guiding patients toward affirming doctors they can trust.

Healthcare is meant to be inclusive. But as many LGBTQ+ patients know, that’s not always the case. In 2016, the National Institute on Minority Health and Health Disparities identified the LGBTQ+ community as a health disparity population. And over the past few years, the American College of Physicians, the Association of American Medical Colleges, and The Joint Commission have been working to bring awareness to the healthcare inequities experienced by many LGBTQ+ patients.

For years, discrimination, gaslighting, and negative healthcare experiences have caused significant challenges for LGBTQ+ patients to find the care they need. According to a 2022 global study by Sanofi, 70% of people from LGBTQ+ communities say they have had experiences that damaged their trust in the healthcare system. Additionally, a recent report shows that sexual and gender minority individuals, namely lesbian, gay, and bisexual adults, are more prone to developing mental health conditions and have higher cases of underlying conditions that can lead to severe illnesses such as cancer, kidney disease, and hypertension. Despite the efforts made in recent years, why is there still a lack of awareness and action?

A major aspect of the issue lies in the fact that LGBTQ+ patients are often grouped into a collective identity rather than addressed as individuals, which keeps harmful assumptions and biases alive. In healthcare, this means a tendency to generalize experiences and symptoms, which can lead to misdiagnosis, delayed treatment, and a lack of trust. It’s important to remember that the LGBTQ+ community encompasses all races, ethnicities, religions, and social classes, necessitating personalized care that takes all of these factors into consideration. 

In this special report, we’ll dive into the roadblocks and experiences LGBTQ+ patients continue to face in healthcare and how hospital and pharma marketers can support LGBTQ+ members in their journey to find affirming care.

Barriers to LGBTQ+ Care

According to the Kaiser Family Foundation, nearly half of all LGBTQ+ people have a chronic condition that requires consistent treatment and monitoring, compared to 40% of cisgender, heterosexual patients. It is evident that there is a strong need for thoughtful and effective care, yet several obstacles are preventing many LGBTQ+ patients from seeing a doctor:

Inaccessible or Limited Healthcare

People from LGBTQ+ communities are less likely to have health insurance because of societal rejection, according to the National LGBT Health Education Center. Whether they’ve been cast out from their families or discriminated against in the workforce, LGBTQ+ individuals are more likely to be homeless or unemployed than cisgender, heterosexual people. Even then, many health insurance plans do not cover services that LGBTQ+ patients may need, such as gender-affirming surgeries.

Lack of Affirming Care

LGBTQ+ patients often do not receive comprehensive sexual health counseling, screenings, or care because some doctors and specialists assume such services aren’t needed. For instance, a healthcare professional may believe that a queer woman may not need birth control or that a trans man doesn’t need gynecological exams. Cisgenderism and heteronormative assumptions—that is, binary worldviews that center on cisgender, heterosexual experiences—have been historically used in the medical field, and they can lead to misinformed care.

Negative Medical Experiences

Although steps are being taken to remove biases surrounding LGBTQ+ communities, those stigmas still, unfortunately, exist within the medical space. And even if unintentional, adverse experiences such as unwelcoming staff members and dismissive doctors can drive patients away from the care they need.

Several studies conducted by OutCare Health show that healthcare professional populations, including primary care doctors, dementia care specialists, residents, and students across a variety of fields, lack proper LGBTQ+ patient education, training, exposure, and preparedness. For example, a recent OutCare Health pilot study conducted from August to September 2022 surveyed urology students about the level of LGBTQ+ healthcare training and education they received. Most respondents reported receiving only two annual curricular hours of LGBTQ+ education and admitted to being inexperienced and unprepared for caring for LGBTQ+ individuals. These shortcomings can greatly discourage patients from feeling confident that their health needs will be appropriately addressed. It’s important to note that many LGBTQ+ patients have reported looking for clues when arriving at a healthcare facility, such as the way they’re greeted by the staff, whether non-discrimination policies are posted in public areas, or if there are single occupancy or gender-neutral restrooms.

Anti-LGBTQ+ Legislation

Under the Affordable Care Act, patients are federally protected from healthcare-related discrimination based on gender identity or sexual orientation—yet 1 in 8 LGBTQ+ Americans live in states where doctors can refuse service. It’s also becoming more possible for medical teams to opt out of treating LGBTQ+ patients, especially as the country faces a record number of anti-LGBTQ+ bills this year. According to the American Civil Liberties Union, nearly 500 of these bills have been introduced in 2023—more than twice the total amount introduced last year. As a result, LGBTQ+ patients are having a hard time finding accepting care. Data from the Center for American Progress (CAP) shows that 18% of LGBTQ+ people would find it extremely difficult or impossible to find high-quality service at a different medical facility after being dismissed elsewhere. For transgender people, that percentage jumps to 31%. With compassionate, culturally affirming care so challenging to come by, LGBTQ+ patients might feel tempted to avoid care altogether, which can lead to dangerous health consequences.

Discrimination Endangers LGBTQ+ Lives

Having a doctor who doesn’t support you in your healthcare journey can be emotionally devastating and frustrating—but it can also be life-threatening. Prejudice often delays medically necessary care, which can accelerate conditions that worsen without treatment. According to a 2018 CAP study, many sexual and gender minority individuals reported experiencing:

  • Abusive language from a healthcare professional (9% of LGBQ patients and 21% of transgender patients)
  • Inappropriate physical contact during an examination (7% of LGBQ patients and 29% of transgender patients)
  • Restricted access to essential medication and treatment (6% of LGBQ patients and 12% of transgender patients)
  • Refusal of care (8% of LGBQ patients and 29% of transgender patients)
  • Intentional misidentification (7% of LGBQ patients and 23% of transgender patients)

When patients don’t receive the treatment they need or avoid care for fear of being stigmatized, ridiculed, or violated, they’re left to fend for themselves on an isolated healthcare journey. With few people to guide them and address their care concerns, LGBTQ+ patients live with conditions that impact their everyday routine and overall quality of life. Updated data from CAP reveals that 41% of LGBTQ+ people have trouble working, enjoying recreational activities, and prioritizing self-care because of poor health, compared to 32% of those who identify as cisgender and heterosexual. However, transgender and nonbinary individuals were found to be almost three times more likely to have poor physical health compared to cisgender adults.

These studies point to one thing: there are plenty of opportunities for health systems and pharma marketers to improve and address these gaps in care.

Ongoing Healthcare Gaps Leave LGBTQ+ Patients in the Dark

Traditional medical training is largely based on studies conducted on cisgender, heterosexual white men, meaning that diagnostic guidelines and treatment advice do not always apply to patients with diverse backgrounds and health histories. While some doctors and specialists are doing their part in expanding their knowledge of proper LGBTQ+ care, they may not always be as prepared as they think.

Doctors Need More Guidance with LGBTQ+ Care

In Healthgrades’ cultural competency special report, 85% of doctors considered themselves ready to care for patients of diverse gender identities or sexual orientations. But when tested with LGBTQ+-related health questions, doctors scored an average of 51% in competency, according to a study by OutCare Health. Learning about current disparities in LGBTQ+ care and how to address them effectively helps build an educational foundation for better diagnoses, communication, and patient outcomes. However, many medical institutions lack the opportunities for students and residents to apply this knowledge through training and patient exposure, leaving progress for more equitable care at a dead end.

Field Experience Matters

Proper LGBTQ+ education requires a lot of time, dedication, and motivation—specifically, 35 hours or more of field experience and in-class learning. With average LGBTQ+ healthcare curriculum hours topping at two hours, doctors barely scratch the surface of what it takes to feel confident and ready to care for LGBTQ+ patients in the way that LGBTQ+ people expect and deserve.

Closing these education and care gaps will take time and concerted efforts, but health systems and pharma marketers can help drive change by keeping these conversations active. For instance, OutCare Health partners with health groups, plans, and systems to deliver LGBTQ+ education and training to improve knowledge, skills, and strategies regarding LGBTQ+ care and equity as well as patient, employee, and member outcomes.

Healthier Patients Start with Inclusive Care

According to a poll by 19th News and SurveyMonkey, 24% of LGBTQ+ Americans have been blamed by doctors for their health problems–compared to just 9% of cisgender, heterosexual adults. The same research saw this number jump to 40% for gender-nonconforming people. When patients feel uncomfortable divulging personal information to doctors, how can they receive the proper care they need?

In addition, a recent survey commissioned by CMI Media Group, the Human Rights Campaign, and Wells Fargo found that only 21% of cisgender gay and bisexual men strongly or somewhat agreed that pharmaceutical companies adequately reach out to understand their identity as gay, bisexual, and cisgender. LGBTQ+ individuals who disagreed cited reasons such as seeing only heterosexual couples in pharma ads, feeling that their unique healthcare needs aren’t recognized, and the high cost of medications.

Establishing more meaningful and compatible doctor-patient relationships and staying sensitive to medical concerns specific to the LGBTQ+ community can make a significant difference. So, how do hospital and pharma marketers fit into the equation? A good place to start is by helping patients find compatible and accessible LGBTQ+-affirming doctors with these best practices:

  • Integrate LGBTQ+ patient reviews in your health system that highlight affirming doctors who provide high-quality care
  • Ensure your brand’s website uses inclusive and LGBTQ+-conscious language so that prospective patients can feel welcome
  • Feature more same-sex couples in ads for a variety of conditions.
  • Provide transparency into accepted health insurance programs that cover LGBTQ+ patients’ needs
  • Sponsor LGBTQ+ community organizations and events and/or advertise in LGBTQ+ media
  • Offer appointment guides to help and encourage patients to ask questions during their appointment and if a doctor has experience with LGBTQ+ care
  • Integrate mental health service offerings into campaigns to support LGBTQ+ patients’ overall well-being

As a marketer, you have the platform and power to spread awareness of existing LGBTQ+ care gaps, foster deeper and more productive patient-doctor conversations, and, ultimately, improve care for the disproportionately affected LGBTQ+ community.

Healthgrades and OutCare Health: Pathways to LGBTQ+ Affirming Care

Healthgrades aims to help patients confidently find the care they need through better-informed decisions. As a partner of OutCare Health, whose mission is to improve LGBTQ+ patient outcomes through accessible healthcare, we’re dedicated to helping members of LGBTQ+ communities prioritize their health through better patient-doctor connections.

For Health Systems

Rebuild Patient Confidence and Trust with LGBTQ+-Affirming Care

Healthgrades is home to the largest pool of commercially-insured consumers searching for care online. Our physician profiles provide transparency into doctor backgrounds, including care philosophy, experience with specific conditions and procedures, and patient reviews, to help healthcare consumers vet their options and find the best doctor for their needs. 

Healthgrades, in collaboration with OutCare Health, has recently announced the launch of its new LGBTQ+ Affirming Care Designation on its website—identifying healthcare professionals committed to providing treatment and affirming health services to LGBTQ+ communities. 

Developed as part of Healthgrades’ continued partnership with OutCare Health—the nation’s most comprehensive resource for LGBTQ+ health equity—this designation will allow LGBTQ+ consumers to use healthgrades.com to easily find one of over 3,300 doctors and other providers identified on OutCare’s OutList as affirming in their care for LGBTQ+ patients. 

For Pharma Marketers

Enhance the Patient Journey for an Easier Road to Treatment

Our life sciences advertising solutions put your brand in front of the right patients at the right time—just before they’re ready to appoint. Connect with low-funnel LGBTQ+ consumers in our medically-reviewed editorial content or our PatientConnect Video Hub as they engage with highly targeted condition and treatment-related information. Our Guided Physician Search (GPS), a doctor directory tool, is embedded in every program so consumers can make an appointment when your brand is top of mind. The GPS can also be fully integrated into your brand.com to close the loop for consumers who are interested in your brand.

Help LGBTQ+ patients receive the care they deserve. Talk to us today to learn more about how Healthgrades can help you better engage with LGBTQ+ patients when they need your brand the most.