The issue doesn’t get much attention, and the available data are limited, but what we know should be a wake-up call for the health professionals and health care institutions about the care provided to LGBT+ people.

The big number: over a third of LGBT+ people – those who are lesbian, gay, bisexual, transgender, or something else other than straight – say they have had a negative experience with a provider over the last two years (see chart below). Those bad experiences range from their provider not believing they were telling them the truth, to suggesting they were to blame for their health problems, to making assumptions about them without asking, to outright dismissing their concerns.

That compares with 22 percent for non LGBT+ people.

At the same time, they have been hit harder by COVID in certain ways, including being more likely to have had to quit their job because of the pandemic.  More than half of LGBT+ people who report having problems paying medical bills in the past 12 months say it was at least in part because of the pandemic.

LGBT+ people need a health system that is responsive because they are more likely to be low income and have a chronic condition or disability.

Most LGBT+ people (72%) have a doctor or health care provider they see when they need care, mostly a family practitioner or an internist, just as non LBGT+ folks do (78%). That means it is likely not where they seek care that is different, it is their providers who appear to be letting them down.

One good thing: LGBT+ people are more likely to discuss mental health and non-medical issues such as housing or transportation with doctors, likely reflecting their higher needs in these areas.

There is an obvious need for more research and data to sort out what is behind these warning signals about LGBT+ health care. But they are also a challenge to the health system to address problems in the provider-patient relationship LGBT+ patients see that can be corrected without waiting for more research.

3. LGBTQ patients’ bad provider experiences

Over a third of LGBTQ Americans say they’ve had a negative experience with a health care provider over the past two years, according to KFF survey research.

Why it matters: These findings, especially when coupled with the pandemic, should be a wake-up call about another big disparity in how the health care system treats different patients, KFF’s Drew Altman writes in today’s column.

What they’re saying: LGBTQ patients’ negative experiences included providers not believing them, suggesting they were to blame for their health problems, making assumptions without asking, and outright dismissing their concerns.

  • Just 22% of non-LGBTQ patients reported similar experiences.
  • The pandemic has also taken a disproportionate toll.
  • LGBTQ workers were more likely to have had to quit their job because of the pandemic, and most of those who reported having problems paying medical bills in the past 12 months said it was at least in part because of the pandemic.

Between the lines: LGBTQ people are more likely to discuss mental health and non-medical issues such as housing or transportation with their doctors.

The bottom line: There is an obvious need for more research and data to sort out what is behind these warning signals.

  • But it’s clear that LGBTQ patients — who are disproportionately likely to have low incomes and chronic conditions — need a more responsive health care system.

Go deeper.

Drew Altman , Published: Aug 02, 2021