Inclusivity in Healthcare: Supporting LGBTQIAP+ Individuals with Chronic Conditions
- laurenmcl6
- Oct 3, 2023
- 5 min read
Awareness regarding the health disparities faced by sexual and gender minority adults has been on the rise in recent years; however, more information is needed on how chronic conditions impact and intersect with the LGBTQIAP+ community. Within the LGBTQIAP+ community, the challenges and experiences of those living with chronic conditions can be particularly unique. In this blog post, I will explore the intersection of chronic illness and the LGBTQIAP+ community, shedding light on the often unseen struggles, resilience, and support networks that exist within this diverse community.
Disparities in health have been documented in the LGBTQIAP+ community mainly for adults. There is evidence that LGBTQIAP+ adults are more likely to experience chronic conditions such as cancer, arthritis, hepatitis, and lung disease. In addition, these adults are more likely to report poorer general physical and mental health, higher rates of disability, and a greater degree of functional impairment (National Health Interview Survey, 2013). Could this be due to more risky behavior such as excessive drinking, overeating, risky sexual behavior, and substance abuse? Maybe. But it could also have something to do with barriers to accessing care, including financial and societal, that lead to chronic stress and adverse experiences.
Chronic stressors can affect physical health over time. In studies of sexual and gender minority older adults, discrimination and victimization have been shown to be a significant predictor of poor health outcomes (Fredriksen-Goldsen, et. al., 2013 & 2014). Some of these disparities begin in childhood and continue on into adulthood leaving a lasting impression on someone’s physical and mental health. As a whole, this population tends to be invisible when it comes to their health needs and they do not always receive the medical attention they deserve. For example, pap smears may be denied or not even mentioned if a person, or professional, automatically assumes that one is not needed even though anyone with a cervix should obtain one regardless of sexuality or gender identity. Many LGBTQIAP+ individuals, in addition to facing the challenges of the health conditions, also grapple with the added layers of social stigma, discrimination, and mental health struggles and this unique intersection of identities can lead to a sense of isolation and a reluctance to seek help.
Health disparities within the LGBTQIAP+ community are well documented. Factors such as lack of access to affirming healthcare, discrimination by medical professionals, and barriers to health insurance can exacerbate the challenges of managing a chronic illness. Transgender and gender non-binary individuals, for example, may face additional difficulties when seeking gender-affirming care while managing their chronic conditions. Another example is that a vast majority of woman-identifying individuals are often dismissed as hypochondriacs when they first tell doctors about their symptoms, which results in taking an average of 3.5 years and 5 doctors to finally receive a diagnosis and treatment. In addition, trauma or intense stress (such as the kind that comes from being discriminated against or victimized) may increase your odds of developing an autoimmune disease, with the increased risk being greater for woman-identifying individuals vs. male-identifying individuals.
In addition to chronic physical conditions, living with a chronic illness can take a significant toll on one’s mental health. For LGBTQIAP+ individuals, who already experience higher rates of depression, anxiety, suicidal thoughts, substance abuse, trauma, etc. due to societal discrimination, the added stress of managing a chronic condition can further contribute to those challenges (NAMI, 2023). Research has established that greater levels of social support and community connectedness are associated with good health and optimal aging in LGBTQIAP+ older adults; however, many LGBTQIAP+ adults report lacking companionship and feeling lonely and isolated (Fredriksen-Goldsen, 2013). Building a strong support network and seeking culturally competent mental health care becomes crucial. Local LGBTQIAP+ organizations, online forums, and peer support groups can provide a sense of belonging and understanding. These communities offer not only emotional support but also valuable information and resources for managing chronic illnesses.
Despite the numerous challenges they face, many LGBTQIAP+ individuals living with chronic illnesses demonstrate remarkable resilience and advocacy. They often become champions for their own healthcare, advocating for the rights and needs of their community. Through support groups, online communities, and grassroots activism, they work tirelessly to create a more inclusive and affirming healthcare system. In addition to taking care of and advocating for others, it is important to also take care of and advocate for yourself. Finding a supportive and affirming healthcare team (although not often easy) is essential for helping you to explore healthy avenues for managing your symptoms. It is also important to incorporate stress management techniques into your life and take steps to combat loneliness. This can look like:
Meditation, yoga, regular exercise
Venting your feelings to someone you trust
Finding purposeful opportunities to get out and socialize, such as going to community events or volunteering
Being mindful of what you put in your body
In addition, check out resources such as SAGE’s LGBT Healthy Aging Toolkit or the Chronic Disease Self-Management Program (CDSMP), which can help you build skills to manage chronic conditions.
Fearing discrimination or a lack of acceptance from the medical community, many LGBTQIAP+ people are more likely to skip routine health screenings or to see a doctor when they have a health issue. All of this adds up to health inequalities for the LGBTQIAP+ community. Therefore, it is vital for professionals to be inclusive and recognize intersectionality in their approach to treatment. Intersectionality is a fundamental concept when discussing the experiences of LGBTQIAP+ individuals with chronic illnesses. An individual’s experience is shaped not only by their sexual orientation or gender identity, but also by factors such as race, ethnicity, socioeconomic status, and disability. Recognizing and addressing these multiple layers of identity is essential to providing effective support and care. To better support LGBTQIAP+ individuals with chronic illnesses, healthcare providers must strive for inclusivity and cultural competence. This includes practices that respect the individuals’ identifying names and pronouns, understanding the unique healthcare needs of transgender and gender non-binary individuals, and creating safe spaces for people to discuss their health concerns openly.
The intersection of chronic illness and the LGBTQIAP+ community is a complex and often overlooked topic. LGBTQIAP+ individuals living with chronic conditions face a unique set of challenges, from health disparities to mental health struggles and discrimination. However, they also exhibit incredible resilience and advocacy, working to create a more inclusive and affirming healthcare system. As we move forward, it is essential to acknowledge and address the needs of LGBTQIAP+ individuals with chronic illnesses, both within the healthcare system and society at large. By fostering inclusivity, promoting culturally competent care, and supporting one another, we can create a more compassionate and equitable world for all members of the LGBTQIAP+ community, regardless of their health status.
For more information, check out these resources below.
Fredriksen-Goldsen KI, Emlet CA, Kim HJ et al. The physical and mental health of lesbian, gay male, and bisexual (LGB) older adults: the role of key health indicators and risk and protective factors. Gerontologist. 2013;53(4):664–675.
Fredriksen-Goldsen KI, Cook-Daniels L, Kim H-J et al. Physical and mental health of transgender older adults: an at-risk and underserved population. Gerontologist. 2014;54(3):488–500.
https://www.ncoa.org/professionals/health/center-for-healthy-aging/national-cdsme-resource-center
https://www.nami.org/Your-Journey/Identity-and-Cultural-Dimensions/LGBTQ#:~:text=LGB%20adults%20are%20more%20than,experience%20a%20mental%20health%20condition.
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