Barriers to Health Care for LGBTQ+ Individuals

Written by: Abby Chamberlin, Mobile Response Care Coordination Team Member

In the United States, some federal, state, and local laws have been enacted that offer protections against discrimination on the basis of gender identity as well as sexual orientation. However, despite these laws, LGBTQ+ people are often discriminated against in a variety of settings in their daily lives, including some health care settings. Studies have shown that members of the LGBTQ+ community experience higher rates of behavioral health conditions, including mental health and substance use disorders. One theory on why this happens is called the Minority Stress Model, which states that stressors unique to the LGBTQ+ minority group that are associated with a homophobic culture can lead to a lifetime experience of harassment, discrimination, and victimization. Some of these stressors that can exist in the healthcare field include microagressions (a statement, action, or incident regarded as an indirect, subtle, or unintentional discrimination against members of a marginalized group). Examples of these healthcare specific microagressions include misgendering a client, not including all options on paperwork for gender and sexual orientation identities, and assuming that mental health conditions and/or substance use disorders stem from sexual or gender identities. This minority stress model is also intersectional, meaning that a person with multiple minority identities will experience more stress. This is why transgender people of color have the highest suicide rate; they experience stress as a result of both racial discrimination and as a result of gender and sexuality discrimination. Thus, in order for any behavioral health therapy and counseling to be effective, it must take all of a person’s identities into account because this is how the person sees the world and, just as importantly, it is how the person is seen by the world.

Another issue that LGBTQ+ people may face in the healthcare field is that many elderly members of the community do not always have their healthcare needs met. More specifically, many LGBTQ+ people do not have children to support them as they grow older, and some are closer to a found family of friends than to their blood relatives. One of the positives that came with the legalization of gay marriage is that now LGBTQ+ partners can legally make decisions about their significant others as equally as heterosexual couples can. However, there is also the problem of LGBTQ+ people not outing themselves to their doctors out of fear of discrimination. Not being open about one’s sexuality with a doctor can prevent open and honest discussions about sexual health, HIV, or other risks.

Once a client has a bad experience with health services, like being misgendered, they are less likely to seek out help again. This means that not only is their mental health affected by how they were treated, but because of that mistreatment they are unlikely to participate in treatment in the future. When a client is treated at a behavioral healthcare center, they should not worry about being misgendered, being blamed for their mental health issues or substance abuse issues, or worry about teaching the healthcare provider about their identity. Even something as simple as not using gendered language or not making assumptions about a person’s gender and sexuality can be ways to be more inclusive. To learn more about supporting the LGBTQ+ community click here.

At NorthKey Community Care, we offer a person-centered approach to behavioral health care needs for all individuals, including members of the LGBTQ+ community.  Our behavioral health care professional staff focus on treating the whole person using a trauma-informed care approach to ensure that each person’s specific needs are met in a way that assists in setting and accomplishing the person’s health and well-being goals.

To learn more about the behavioral health challenges the LGBTQ+ Community faces click here.

Additional Resources and Support:


The Trevor Project

Human Rights Campaign

The Fairness Campaign


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