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Fighting Discrimination of LGBTQ+ Members in Healthcare – With Asia Sullivan, PA-C, MPH @coutureinclinic (Episode 7)

Nov 11, 2021

It’s no secret that LGBTQ discrimination is widespread between industries and geographical areas. Some discriminatory places are more obvious than others, but what can you do when it’s in a much more subtle, and necessary, setting? LGBTQ healthcare discrimination is one of the most overwhelmingly harmful ways LGBTQ individuals are experiencing medical discrimination.

LGBTQ healthcare discrimination creates another barrier for the already tricky task of finding proper medical care. Lesbian, gay, bisexual, transgender, and queer people should not have the extra task of finding providers that are not illicitly or explicitly anti-LGBTQ in addition to the already challenging task of seeking health care.

The What We Know Project, a Cornell initiative (published at Discrimination impacts health of LGBT people, analysis finds | Cornell Chronicle) completed a study in 2019 about LGBTQ healthcare discrimination, finding 95% of case studies had links between anti-LGBTQ and sex discrimination and harming health impacts on LGBTQ people. One of the most prominent and concerning findings included a higher risk of mental health issues like depression, anxiety, and substance abuse in gay, lesbian, bisexual, transgender, and queer individuals.

Insurance companies are also at fault, being less likely to offer their services to LGBTQ people. LGBTQ individuals are half as likely to have health insurance as non-LGBTQ members, according to Human Rights Watch.

Mental health is one of the largest impacted health issues for those experiencing LGBTQ healthcare discrimination, but overall health and wellness can be affected immensely. Same-sex couples seeking fertility specialists, HIV-related care, and transgender people seeking puberty blockers, hormone replacement therapy, or gender-affirming surgeries can cause LGBTQ members to need a higher level of healthcare than others, leaving them even more susceptible to discrimination-based trauma from the healthcare system (Anti-LGBT Discrimination in US Health Care | HRW). 

Discrimination Laws

Over the last few years, healthcare discrimination laws have been debated and reversed, and set back in place. At the time of this post, Section 1557 of the Patient Protection and Affordable Care Act prohibits discrimination based on sex, including gender identity and sexual orientation. The plain language of ‘discrimination on the basis of sex’ has been part of the section challenged primarily by the Trump Administration rule, with the Supreme Court and presidential administrations juggling back and forth every few years since the law’s inception in 2010. The Office for Civil Rights at the U.S. Department of Health and Human Services is responsible for enforcing this law, and you can read the fine print of Section 1557 or file an official discrimination complaint at their website – Section 1557 of the Patient Protection and Affordable Care Act | HHS.gov.

Steps for Handling Healthcare Discrimination

So, let’s get into how you can battle the discrimination occurring in healthcare settings to prevent your individual mental, physical, and emotional health harm.

1. Find an LGBTQ-friendly provider.

To avoid LGBTQ healthcare discrimination altogether, the most efficient route is to find providers that are LGBTQ-friendly. If you feel comfortable, ask friends who might know of a respecting provider. Or, try an online database like OutCare Health – LGBTQ Healthcare Resources & Provider, or the GLMA – GLMA Home Page. Both sites offer a search engine that can be specified down to the type of care you’re looking for and will give you names of ‘culturally competent’ primary physicians, mental health specialists, and even chiropractors.

2. Talk to a new provider before the appointment.

If you’re unable to find a provider that is known to be LGBTQ friendly, speaking to a new provider (or one of their nurses) on the phone can prevent a face-to-face discriminatory situation. When you call to make an appointment, ask. Are they LGBTQ-friendly? Most providers who are supportive will not have an issue answering this question. If they stutter, hesitate, or say anything inappropriate, you can steer clear and avoid the situation altogether.

3. Bring someone you trust to attend with you.

Not everyone may have the opportunity to be picky with their providers and vet them thoroughly before interacting, like in a rural area or a sudden emergency room visit. Asking a friend or family member you’re comfortable around to tag along can help relieve tension, and reduce hostility if you do have a prejudiced provider.

How to Make Global Change

The prior tips are helpful to protect yourself, but the solution to protecting the LGBTQ community from healthcare discrimination is ultimately not going to be solved by individual efforts. Ideally, the LGBTQ community should not be in charge of making sure they aren’t discriminated against. It should be a human problem, not an LGBTQ problem.

Here are a few of the ways you can help end the global issue, so those in the future community won’t have to find ways to defend themselves. These can be utilized by LGBTQ members and allies alike.

1. Be visible.

Showing up in the world and telling your stories can encourage others to do so, and this can humanize LGBTQ members to those that are not supportive or miseducated on the subject.

2. Champion education.

Primary care doctors receive only 5 hours of LGBTQ-specific training in their higher education. Pushing for institutions to require a higher level of training about sexual orientation and gender identity can increase the level of care delivered to LGBTQ individuals and reduce discrimination in health care.

3. Be politically educated and active.

All-encompassing anti-discrimination laws are in place, but that doesn’t mean they cannot be reversed or altered in the future. Staying updated on law changes and voicing your needs to lawmakers can make a difference.

4. Donate.

Sometimes putting your money where your mouth is can be the most impactful activism. Here is a list of organizations created in support of the LGBTQ community – Support LGBTQ+ Organizations All Year! | Modern Intimacy.

In this episode of Modern Intimacy, Dr. Kate Balestrieri speaks with Asia Sullivan, PA-C, MPH about providers can equip themselves to be safe and competent providers for members of the LGBTQ+ community, and how patients can screen providers to ensure their needs will be met and humanity respected.

Asia Sullivan is a certified physician assistant working in LGBTQ+ focused primary care in Los Angeles, CA. She is a native of Alabama and completed both her Master’s of Physician Assistant studies and Master’s of Public Health at the University of Alabama at Birmingham, where she graduated Summa Cum Laude and at the top of her class. Asia’s treatment philosophy is a “whole-person” approach that recognizes the interplay of one’s physical body, emotional wellbeing, environment, and psychosocial support systems. She is passionate about preventative medicine and considers herself to be a “judgement-free” provider with whom patients are free to be themselves. Asia’s hobbies include blogging, style and fashion, yoga, and spending time with her two dogs. To make an appointment with Asia please visit suite401.com.

Resources:

Health Professionals Advancing LGBTQ Equality 

OutCare

Folx

Nurx

 

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This is the cover for the Modern Intimacy with Dr. Kate Balestrieri podcast.
Dr. Kate Balestrieri, host of Modern Intimacy, a licensed psychologist and certified sex therapist, helps people live more fulfilled lives by shattering stigma and erasing shame. Dr. Kate invites you to join her as she investigates the relationship between sex, mental health, relationships and modern society.

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