There are so many factors that affect a person’s overall health. Race, gender, age, genetics — all of these things play a part, making some of us more likely to experience health challenges than others. For people in the LGBTQ community, unique health challenges often start at a young age. Many times these needs are misunderstood or hidden, and that can result in adverse health outcomes.
“In addition to higher rates of diseases like cancer, LGBTQ people are more susceptible to mental health issues like anxiety, depression and suicide,” says Del Ray Zimmerman, director of the Office for Diversity Affairs and LGBTQ Health at Vanderbilt University Medical Center.“When you study the issue, you find there’s nothinginherently wrong with this group, but our mental and physical health suffers because of the biases we face over our lives.”
Chronic stress and the LGBTQ community
Zimmerman is talking about minority stress theory, which suggests sexual minorities face hostility and stress that’s connected to their very identity. Over time, this chronic stress has negative effects.
“When you’re constantly facedwith prejudice, there’s low-level fear running in the background, and that affects your health,” says Zimmerman. “For example, chronic stress can cause your body to release cortisol, which can increase your likelihood of high blood pressure. In order to overcome these challenges, we all have to know what we’re facing.
Here are 10 unique health care needs LGBTQ individuals may have.
1. Depression and anxiety
LGBTQ patients are more likely to experience depression or anxiety, possibly due to violence, discrimination or isolation. About 30-60% will deal with anxiety and depression at some point in their lives.
“If you grow up in an environment where you’re told that being gay is wrong, it skews your self-perception,” says Zimmerman. “Even if you get away from that mindset, it’s difficult to pull out an authentic self after hearing those messages.”
2. Bullying and suicide
Members of the LGBTQ community — especially youth — are at increased risk for bullying and suicide. Most LGBTQ students in Tennessee report hearing anti-LGBTQ remarks at school, and in the U.S., LGB youth contemplate suicide at almost 3 times the rate of heterosexual youth.
“In the past year, 10% of our community as a whole has attempted suicide, and we see very high rates for youth,” says Zimmerman. “Luckily we have an organization, GLSEN, doing research around the youth experience, and working to create safe schools and improve academic outcomes,” says Zimmerman.
3. Alcohol, tobacco and substance abuse
LGBTQ patients are more likely to drink or smoke, which can put them at increased risk for liver and heart disease, lung cancer and other chronic conditions. Gay men and bisexual men and women are also more likely to abuse drugs.
Experts believe these higher rates may occur because of the added stressors the LGBTQ population faces, including social stigma, discrimination and a greater risk of violence.
4. Diabetes and metabolic issues
Bisexual and transgender people are more susceptible to diabetes and metabolic issues related to stress.
“In the LGBTQ community, 52% of us are bisexual, yet many people experience bi erasure, which is society’s tendency to ignore, remove or explain away bisexuality in our culture,” says Zimmerman. “That causes bi people to feel like they don’t fit into queer orstraight communities, and that can create chronic stress and related health issues.”
5. Body image and obesity
Men who have sex with men are more susceptible to eating disorders, while women who have sex with women are more likely to struggle with obesity. Both are thought to be reactions to psychosocial stressors connected with homophobia.
Trans people are more likely to experience gender dysphoria, which is a condition sometimes described as being uncomfortable in your own body, especially during puberty. They are also more likely to enact self-harm as a result.
Hate crimes directed at LGBTQ individuals have increased in recent years, and sexual violence is a disproportionately large problem in the community. Roughly 44-61% of bisexual and transgender women will experience sexual violence at some point in their lives.
“Violence occurs among our trans friends at alarming rates, and especially among trans women of color,” says Zimmerman. “It’s also crucial that people understand and be on the lookout for intimate partner violence, which is physical or sexual violence, stalking or psychological harm committed by a current or former partner. It’s something that affects millions of people, and especially LGBTQ folks who may not have had success finding affirming care in the past.”
Men who have sex with men are at increased risk for HIV.
“We have the tools to end HIV, but 1 in 7 people who has the disease doesn’t knowthey have it because of the stigma around education and testing,” says Zimmerman.
Gay and bisexual men have a higher risk of cancer, especially if they are HIV+. Lesbian women are at increased risk for breast, cervical and ovarian cancer.
9. Hormone therapy
Hormone therapy can have adverse effects for people, including transgender individuals.
“While we don’t know as much as we’d like about the long-term risk factors of hormone therapy, we do know it is lifesaving,” says Zimmerman. “If patients can’t access hormone therapy to affirm their gender, they’re more likely to commit suicide.”
In general, one of the biggest reasons the health care needs of LGBTQ individuals aren’t met is that they have difficulty accessing affirming care where they live and work. LGBTQ people are more likely to:
- Be underinsured
- Delay care because of attitudinal barriers or negative past experiences
- Have difficulty accessing care in rural communities
- Lack of information about where to find care
For a library of LGBTQ resources, click here.
For two years in a row, BlueCross BlueShield of Tennessee has earned a 100% score from the Human Rights Campaign Foundation’s Corporate Equality Index. The national benchmarking survey and report measures corporate policies and practices relating to LGBTQ workplace equality. Click here to learn how BlueCross creates an inclusive workplace for its LGBTQ employees.
We value the role of clinicians and partner with providers like Vanderbilt to help our members get the care they need for better health.