Within the healthcare sphere, lesbian, gay, bisexual, transgender, and queer (LGBTQ) people face specific challenges and hardships that make access to healthcare less equitable. According to the US Gay and Lesbian Medical Association (GLMA), some of the most common issues related to LGBTQ health are HIV/AIDS, breast and cervical cancer, hepatitis, mental health, substance use disorders, alcohol use, tobacco use, depression, access to care for transgender persons, issues surrounding marriage and family recognition, conversion therapy, refusal clause legislation, and laws that are intended to "immunize health care professionals from liability for discriminating against persons of whom they disapprove." These negative social stereotypes and pressure presented by the media are correlated with an increase of negative body image and declining self-worth, which can coincide with developing eating disorders and impact obesity rates. LGBTQ people may face barriers to accessing healthcare on the basis of their sexual orientation and/or gender identity or expression. Many avoid or receive inferior care due to perceived or real homophobia, transphobia, or discrimination by healthcare providers and institutions. In other words, negative personal experiences, or fear of experiencing discrimination may deter these individuals from accessing care.
General health issues affecting LGBTQ individuals According to the Committee on Lesbian, Gay, Bisexual and Transgender Health Issues and Research Gaps and Opportunities, there are several difficulties in conducting health research on LGBTQ populations. These challenges include the complexity of defining sexual orientation and gender nonconformity, and the hesitancy among individuals to answer questions concerning these topics. Other posed challenges include logistical and financial challenges of recruiting a sufficient sample size for meaningful analysis, considering the difficulty of an already smaller proportion of LGBTQ individuals among the general population. Lesbian, gay, bisexual, and transgender people are often grouped together in research and discussions. This can become problematic because they are each distinct groups that are non-inclusive of all non-heterosexual or gender non-conforming. In some studies, lesbian, gay, bisexual, and queer individuals are all combined under the label "non-heterosexual", while in HIV research, participants may be grouped together in categories that include various identities. Most research focuses on lesbian women and gay men, with significantly less attention given to bisexual, transgender, intersex, asexual, and other queer individuals, resulting in higher levels of discrimination. These disparities in research and perspectives of LGBTQ identities as a monolith erases the individuality of each identity. A review of studies in North America found that LGBTQ individuals generally reported poorer self-rated health, more physical health symptoms, and higher rates of certain health conditions, including diabetes, asthma and high blood pressure, compared to heterosexuals. These disparities were most pronounced among adolescents and young adults, with smaller differences among older age groups. Factors such as health behaviors and experiences of discrimination, victimization, and violence among sexual minorities were found to contribute to these disparities in physical health. Mental health appears worse among LGBTQ people than among the general population, with depression, anxiety, self-harm, and suicide ideation being higher than the general population. This arises partly from the societal discrimination, bias, and marginalization they face. About 30 percent of all completed suicides have been related to sexual identity crisis. Students who also fall into the gay, bisexual, lesbian or trans gendered identity groups report being five times as more likely to miss school because they feel unsafe after being bullied due to their sexual orientation. These mental health disparities are also evident in LGBTQ+ youth, with self-harm being reported by 65% of LGBQ youth and 46% of TGNC youth. Research indicates noticeable barriers separating LGBTQ patients and health professionals, likely due to homophobia, assumptions of heterosexuality, and a lack of knowledge about LGBTQ people and their needs. Institutional barriers were also identified as a detriment to LGBTQ healthcare, including issues such as inappropriate referrals, lack of patient confidentiality, discontinuity of care, absence of LGBTQ specific healthcare, and lack of relevant psycho-sexual training. Research points to issues encountered from an early age, such as sexual and gender minorities being targeted for bullying, assault, and discrimination, as contributing significantly to depression, suicide and other mental health issues in adulthood. Social research suggests that LGBTQ individuals experience discriminatory practices in accessing healthcare. One way that LGBTQ individuals have attempted to deal with discriminatory health care is by seeking "queer-friendly" health care providers.
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