LGBTQ+ Healthcare Discrimination
Identity is integral to self-esteem and wellbeing. It also plays an important part in empowering individuals to exercise their rights and responsibilities in a modern society. When an individual faces restriction or discrimination on how they choose to self-identify, it simultaneously restricts their ability to freely access all parts of society, including healthcare.
Around 1 in every 14 Americans identify as lesbian, gay, bisexual, transgender or something other than cisgender (that is, those whose sex assigned at birth aligns with their gender identity) or heterosexual. Those in LGBTQ+ communities are often also members of other marginalized groups including Black, Indigenous, and People of Color (BIPOC), and those with disabilities. LGBTQ+ people often experience persistent discrimination in many parts of life – within work places, social environments, and even when trying to access healthcare.
In fact, more than one third of LGBTQ+ Americans experienced discrimination of some kind in 2020, according to a survey by the Center for American Progress. Discriminatory experiences ranged from seeing a physician who was visibly uncomfortable treating them, to being denied care, or having a healthcare professional (HCP) be verbally or physically abusive.
The net result of this is that LGBTQ+ people have poorer health outcomes than their non-LGBTQ+ peers, with higher risk of cardiovascular disease, diabetes, poor mental health, cancer, some sexual diseases like HIV, and alcohol and substance abuse.
What Causes LGBTQ+ Health Disparities?
A combination of factors contribute to the inequity faced by LGBTQ+ individuals. Many of these stem from a lack of sufficient knowledge in HCPs and health institutions on the unique healthcare challenges faced by those of sexual minorities. Other factors include:
- Lack of specific LGBTQ+ training for healthcare workers.
- Sparse clinical research on LGBTQ+ related health issues.
- Limited role models within healthcare systems for LGBTQ+ individuals.
- Fear due to stigma, discrimination, and institutional bias within healthcare.
- Poor past experiences with less-than-supportive HCPs.
- Inadequate open discussions about LGBTQ+ health, especially in the context of transgender people.
How Digital Therapeutics Can Make A Difference
Digital health and digital therapeutics (DTx), as clinical treatments, are obliged to acquire cultural competence regarding LGBTQ+ health. However, these treatments are uniquely primed to tackle health inequity. Inherently accessible by design, with over 85% of Americans owning a smartphone from which these health applications can be used, DTx can offer a safe, inclusive and discreet platform for LGBTQ+ people to improve their health.
61% of LGBTQ+ respondents from a recent survey were more satisfied with telemedicine experiences compared to in-person interactions, versus 52% of non-LGBTQ+ identifying adults. This demonstrates how valuable remote, digital healthcare already is for these communities.
Digital tools are essential, especially for LGBTQ teens who might not have other ways of reaching out to others who might understand them.
Julie Cerel, Ph.D, clinical psychologist and past president of the American Association of Suicidology
Increasingly, more DTx companies are upgrading their design to ensure use of inclusive language, culturally-appropriate, information and offering increased support to those in LGBTQ+ communities. Other digital health platforms are emerging that are LGBTQ+-centric from the outset, often designed by HCPs from marginalized sexuality groups themselves.
Some great examples of inclusive digital health companies include:
Plume is a digital health platform that offers video telehealth appointments in-app, prescriptions for hormone treatment, ongoing monitoring and support groups for their LGBTQ+ patients, injection tutorials, medical letters of support for surgery or name-changes, all coordinated by a trans-led care team.
Folx Health offers hormone treatments for LGBTQ+ people, but also primary healthcare appointments, including for problems relating to gastrointestinal issues, dermatology, common respiratory viruses, allergies, mental health and STI prevention and treatment. Folx also support patients on lifestyle issues such as smoking cessation, nutrition, safe sex, fertility and general health through coaching sessions.
Unfortunately, the monthly fee is not yet covered by insurance, but prescriptions can be reimbursed. The clinical team is made up of queer and trans HCPs, from medical doctors, registered nurses and experienced nurse practitioners, providing patients with empathetic healthcare.