When you think of people at a health disadvantage, you might think of low-income or rural populations, the elderly, or infants. But actually, in October 2016, sexual and gender minorities were officially recognized as a health disparity population by the National Institute on Minority Health and Health Disparities (NIMHD)—meaning they're more apt to be affected by disease, injury, and violence and are lacking opportunities to achieve optimal health, according to the Centers for Disease Control and Prevention (CDC). (This came just a few months after a huge study showing that LGBT people are at risk for a multitude of mental and physical health issues.)
By being formally recognized as a health disparity population, the LGBT community's health issues will become the focal point for much more research by the National Institutes of Health (NIH)—and it's about time. The research we do have shows that sexual minorities need better health care, stat. People who identify as a sexual or gender minority face elevated health risks for HIV/AIDS, obesity, mood and anxiety disorders, depression, substance abuse, and potentially more that we don't know about, according to a recent study in JAMA Internal Medicine and a 2011 report by NIH. (See also: 3 Health Problems Bisexual Women Should Know About)
But why is the LGBT community in this situation in the first place? The biggest reason is simple: prejudice.
LGBT people living in communities with high levels of anti-gay prejudice have higher mortality rates than in low-prejudice communities, according to a 2014 study published in Social Science and Medicine—translating to a shorter life expectancy by about 12 years. Yes, 12. Whole. Years. This gap is caused mainly by higher rates of homicide and suicide, but also by higher rates of death from cardiovascular disease. Why? The psychosocial stress from living in a high-prejudice area might lead to more unhealthy behaviors (like a poor diet, smoking, and heavy alcohol consumption) that are linked with heart disease risk, according to the researchers.
But even outside high-prejudice areas, well-informed LGBT care is hard to come by. NIH says that LGBT people are each part of a distinct population with unique health concerns. Yet in a survey of more than 2,500 health and social care practitioners, almost 60 percent say they don't consider sexual orientation to be relevant to one's health needs, according to a 2015 survey by YouGov for Stonewall, an LGBT organization in the U.K. And even if these health care pros do consider sexual orientation important, most of them aren't getting the training they need; one in 10 say they aren't confident in their ability to understand and meet the specific needs of LGB patients, and even more say they don't feel capable of understanding the health needs of patients who are trans.
All of this means that quality baseline care is harder to come by for LGBT people. And when getting a simple checkup becomes a face-to-face action with discrimination, it's easy to see why they might skip out on the doctor altogether—that could be why lesbian and bisexual women may be less likely to use preventative care than straight women, according to the NIH. If you've ever gotten "the look" from you gyno when you've been brutally honest about your sexual history, you understand that health professionals aren't always as objective as we'd like them to be. (This is especially worrisome, because more women are having sex with women than ever before.)
And this discrimination isn't just hypothetical—it's real. The YouGov study found that 24 percent of patient-facing health staff have heard colleagues make negative remarks about lesbian, gay, and bisexual people, and 20 percent have heard negative comments made about trans people. They even found that one in 10 staff members have witnessed a peer express belief that someone can be "cured" of being lesbian, gay, or bisexual. An idea which, TBH, belongs back in the days of crying "hysteria" at women who dared to—God forbid—have a sex drive.
The good news is that we're making progress towards full acceptance of the LGBT community (yay for equal marriage rights!), and NIH's attention to research in the health arena will certainly help. The bad news is that, well, this is even an issue in the first place.