It's a major accomplishment to lock down a medical provider you click with. The process of finding a Unicorn M.D. (or D.O.) can be time-consuming, expensive and sometimes awkward, even under the best circumstances. But what if you also had to factor in whether your doctor will judge you — or even deny you care — because of your sexual orientation or gender identity?
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That's the reality for many LGBTQ+ people when they need a check-up or a specialist. And the prospect of encountering homophobia and transphobia at the doctor's office is very real.
According to the Human Rights Campaign's 2022 Healthcare Equity Index, 56% of lesbian, gay or bisexual patients and 70% of transgender and gender non-conforming patients reported experiencing some form of discrimination while getting care. What's more, a 2015 study found that straight health care providers generally showed a stronger preference toward heterosexual patients over those who identified as gay or lesbian.
Though the findings don't necessarily mean gay and lesbian patients receive worse care, the fear of being judged, or even denied care altogether, is enough to keep many from going in, or returning for follow-up care. Individuals who avoid care, or have interruptions in care, are more likely to suffer from a myriad of health problems at rates significantly higher than the general population.
Lesbian and bisexual women, for example, are far less likely to undergo routine screenings for cervical and breast cancer than heterosexual women, and less likely to have access to regular medical care in general. Transgender and nonbinary people are more likely to contract STIs, suffer from depression, anxiety or substance abuse and be victims of violence.
One bright spot is that more LGBTQ+ people do have access to health care because of the Affordable Care Act. And California law says mandatory cultural competency requirements for doctors must include training to address the needs of LGBTQ+ patients, including care for transgender, gender non-conforming and intersex people.
While you're on your search for a provider, here are some things to keep in mind:
In 2005, Holly Painter was an undergrad studying English at USC. She went through a bad breakup, and sought counseling through the university.
"I had the expectation, because it was a university, and it was in Southern California, that it would go ok," said Holly, who's now an English professor at the University of Vermont. She describes herself as a genderqueer lesbian who dressed in 2005 like "a 12-year-old boy."
After a few sessions, Holly said her counselor began making comments about her appearance — particularly, suggesting that she wear more feminine clothing. "It was a really inappropriate suggestion, and he kept returning to it," she said.
Holly ended up staying on with that same counselor for the rest of the semester — because, as she put it, "you're at the mercy of whoever is available at any given time." Because of that experience, she said it took her eight years to return to therapy.
Holly said it's been difficult to get regular check-ups over the years, in part because she's moved several times. "You have to start over with a new doctor every time," she said, "and it's not easy to have to constantly come out or explain how my gender identity works to a new person."
And for Holly, homophobia at the doctor's office doesn't just affect her: She and her wife have to contend with how it might affect their 3 year-old son.
"Everything we have to do with him — medical care, preschool, all of that — we always have to think about how people are going to treat him," Holly said. "Basically, we're worried about whether they're thinking more about his parents than they are about his health."
Travis Avery lives in Temecula, and is taking testosterone as part of a transition from female to male.
The 27-year-old regularly drives out to Oceanside for his health care — even for routine blood work.
"Out where I am, my experience for any kind of medical care has not been positive," he said.
Instead, he's chosen to make those long drives out to the San Diego area, and even out to Los Angeles, to see a doctor he can trust.
Travis is dealing with other health issues in addition to his hormone regimen, so "for a person in my situation," he said, "[my doctor] kind of needs to know what they're doing."
