The lack of affordable and reliable health care for “standard citizens” is a long enough uphill climb, but it gets even more complex when we consider the unique needs and risks of our minority communities — including LGBTQ women — who already face violence, threats of violence, discrimination and a lack of basic resources even before conservative politicians enter the rhetorical fray.
Recognizing and providing for the unique needs of women in the LGBTQ community is as urgent a moral issue as any we face — and in many ways exemplifies the larger human struggle for health dignity.
Disparities in Risk and Care for Lesbian, Bisexual and Transgender Women
Living one’s best life in a world dominated by profit-driven health care and insurance companies is difficult enough already. But things get even more problematic when we take a closer look at the risk factors unique to members of the LGBTQ community. Affordable access to timely and competent health care is a human rights issue, which makes LGBTQ women second-class citizens by most standard definitions.
Here are some of the risks and unaddressed needs among minority women:
- Lesbian women are far less likely to seek out preventive services related to cancer..
- Transgender women are at a far greater risk of developing mental health issues, including suicidal thoughts and behaviors, as well as STDs, HIV and domestic and social violence.
- Members of the LGBTQ community are twice as likely as heterosexual individuals to abuse tobacco, leading to 30,000 preventable deaths per year from smoking-related complications.
- Bisexual women face an even greater risk of bodily violence, assault, stalking and rape than heterosexual women and even lesbian women.
Why is this?
First, it’s a byproduct of run-of-the-mill discrimination and harassment. One might’ve hoped our collective furor over people’s sexual orientations would have abated by 2018, but conservative thought and politicking is still milking this wedge issue for all it’s worth. And now it appears conservative extremists will hold the Supreme Court for another generation, which means LGBTQ rights have never been in a more precarious position than they are right now.
In other words, when the LGBTQ community isn’t facing institutionalized discrimination in the form of a lack of basic resources and infrastructure, they face discrimination of the more personal kind, which often leads minority women into despair, depression and self-neglect. Even when there are resources available, the often-poor mental health of these women — and the unrelenting message from the mainstream that they’re not worthy of dignity — can lead them to postpone or not bother seeking attention for their medical needs.
Which brings us to the second reason for the huge discrepancy: the apparent lack of resources and funding for health care in general, particularly for minority communities.
Addressing the Lack of Resources and Support
Over the past few years, the Department of Health and Human Services has turned its attention to the coverage gap between the LGBTQ community and “mainstream” America. In 2011, they published a series of recommendations on addressing the unique and institutionally neglected health needs of lesbian, gay, bisexual and transgender women.
They update these recommendations every year, but here are the basics:
- Better enforcement of visitation rights in hospitals for non-heteronormative couples.
- Improved clarification in Medicare and Medicaid rules pertaining to spousal coverage and protection for same-sex partners and married couples.
- The establishment of a nationwide resources database for older members of the LGBTQ community so they can better understand their needs and the care options available to them.
- The Health Resources and Services Administration began exploring and publishing information about lesbian and bisexual women’s health needs for the first time as part of its Women’s Health USA reports.
What we see here is a coalition of compassionate, left-leaning governmental and private endeavors that have come together to raise the public’s consciousness about, and provide practical solutions for, the very real coverage gap between LGBTQ women and the rest of society. The beleaguered Affordable Care Act also set its sights on closing this gap by introducing far more comprehensive protections for minorities when it comes to discrimination and denied coverage on the basis of gender identity and sexual orientation.
The long-promised repeal of the ACA by Republican extremists would constitute a willful dismantling of these small steps toward health care equanimity and universal dignity for all people. It’s worth noting the attack on Planned Parenthood and other community-based health providers — which lately has taken the form of denying federal funding for such providers — would also strike a blow to the tentative progress being made here. The LGBTQ community frequently relies on community health centers because they face discrimination elsewhere or, indeed, a lack of any other options in their area.
From cancer screenings and HIV and STD testing and treatment, as well as transition-related aftercare, community medicine is the first and last resort for many members of our minorities. Since 2001, Catholic Church-owned hospitals in the U.S. have increased by 22 percent. It is extremely common for such establishments to turn women away because of their sexual orientation, marital status and other factors.
In some of the more extreme cases, it can take multiple years for unmarried and minority women to successfully find a doctor willing to perform basic outpatient procedures, including tubal ligations. That’s what institutional-level discrimination, informed by conservative and Christian politics, looks like.
A Plea for Health Care Dignity
Nobody is asking for special treatment for minorities. The campaigns underway today — and the marches and the lobbying by compassionate human rights groups — are in the name of equality, which in this case looks like unequivocal, affordable, no-strings-attached health care dignity for all. The LGBTQ community finds itself up against an apparently immovable and very well-funded juggernaut powered by equal parts religious rancor and political theater.
As for our so-called lack of money and resources? Consider that America, a very rich and powerful nation, is virtually the last “developed” country standing that does not have a comprehensive and universal health care system for its citizens. Once the U.S. remedies that and joins the U.N. and the rest of modern society, the practical and financial barriers standing between LGBTQ women and health care dignity will fall away. After that happens, all this prejudice will look even more vestigial than it does already.