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 Understanding LGBTQ+ disparities 

Even though LGBTQ+ Americans have made social and legal gains in recent years, health disparities have persisted and continue to undermine LGBTQ+ well-being. Perhaps most prominent among health disparities is the ever-present shadow of HIV/AIDS across all LGBTQ+ communities, and especially in the lives of LGBTQ+ persons of color and young men. In addition to the risks posed by HIV/AIDS and other STIs, LGBTQ+ people are more likely to attempt or commit suicide; transgender women have the highest rates of suicidal ideation/attempts in the country at around 40%. (, 2013James, et al., 2016) From the APA, additional health disparities include:

  • risk of injury via harassment, victimization, and violence
  • chronic stress and trauma due to persistent homophobia and transphobia
  • social determinants such as homelessness, poor family life, geographic location
  • substance abuse, smocking, alcohol abuse
  • higher rates of obesity among lesbian-identifying women
  • health and wellness exams that do not correlate with gender identity
  • chronic loneliness and fears of isolation

As stated by the NIH, "eliminating [these and other] LGBT health disparities and enhancing efforts to improve LGBT health are necessary to ensure that LGBT individuals can lead long, healthy lives." (, 2018) This is particularly necessary, not only to make LGBTQ+ health more equitable, but also because reducing sex/gender stigmatization allows persons who identify as heterosexual and/or cisgender to explore their own sexuality and gender identity without fear of discrimination.

In order to increase equity, the NIH suggests:

  • collecting SOGI (sexual orientation & gender identity) data in health-related surveys and health records to identify disparities
  • being open and supportive as to a person's sexual orientation and gender identity in healthcare spaces and interactions
  • training medical and allied health students to provide knowledgeable care
  • implementing policies that protect LGBTQ+ identities in schools
  • providing services that help reduce suicide attempts and homelessness among LGBTQ+ youth
  • continuing to develop meaningful interventions and prevention programs for HIV/AIDS and other STIs

 Organizational resources for LGBTQ+ populations 

 Disparities in transgender / gender-expansive populations 

As with LGBTQ+ populations as a whole, transgender people continue to experience extreme health and healthcare disparities, even as access and medical services have improved. Transgender people are more likely than any other social group to experience psychological distress leading to suicidal ideation, with 40% having attempted suicide at least once in their lifetime (James, et al., 2016). This is an astoundingly high figure that grows even higher when compounded along intersectional lines; for instance, 54% of transgender people with disabilities report attempting suicide at least once, and 42% report being mistreated by health care providers (James, et al., 2016). Unsurprisingly, transgender people report chronic anxiety and stress, mostly resulting from cultural discrimination and transphobia, but also from experiencing high rates of economic instability and poverty (James, et al., 2016). Transgender people also deal with HIV/AIDS at a higher rate than other LGBTQ+ people; 19% of black transgender women live with HIV, higher than any other social group in the United States (James, et al., 2016).

In many ways, disparities among transgender populations can be combated by dealing with the sociocultural pressures that cause emotional and mental trauma across the lifespan. Additionally, providers should become knowledgeable as to transgender-specific healthcare needs such as: hormone replacement therapy, puberty-blocking hormones, surgeries, and counselling services. Providers should also strive for increased cultural competence, for instance, by finding ways to create electronic healthcare records that allow people to select multiple gender options. 

 Resources for transgender / gender-expansive populations 

 Disparities in lesbian, gay, bisexual, and queer populations 

We described various health and healthcare disparities for LGBTQ+ people as a whole in the first tab. However, many facets of LGBTQ+ health are intersectional, especially regarding sexuality and gender identity. However, just because sexual orientation and gender identity overlap, they do function as a single phenomenon; rather, the two operate interdependently, and for that reason, LGBTQ+ people are likely to experience a wide range of health disparities that are different for cisgender gay men and transgender gay men (this is only of many possible examples). 

Providers should be cognizant to the intersections of LGBTQ+ identity. In order to this, it's important to establish healthcare spaces and services which are recognize the many facets of gender/sexual orientation. Electronic health records should be redesigned to include multiple genders as well as sexual orientations (Grass & Makadon, 2016). Providers, policy makers, and community organizers should also increase awareness towards LGBTQ+ people who do not identify as gay or lesbian. For instance, 39% of bisexual men and 33% of bisexual women report not disclosing their sexual orientation to a provider, as opposed to 13% of gay-identifying men and 10% of gay-identifying women (, 2016). For the most part, this discrepancy is due to negative experiences involving lack of understanding as to bisexual identity and deligitimizing stereotypes that erase bisexual people's experience (, 2016). The result is a significant portion of LGBTQ+ people who experience chronic stress and anxiety, depression, higher rates of alcohol and tobacco abuse, and unsafe sexual practices. This is especially concerning considering the likelihood that LGBTQ+ people as a whole will experience these and other disparities.These inflated figures are just as likely to occur for people who identify as sexually queer (pansexual, asexual, demisexual, etc.).

 Resources for lesbian, gay, bisexual, and queer populations 

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