LGBTQIA+ Representation in Health Justice
Compared to the general population, LGBTQIA+ people are more likely to have a disability. According to 2020 data, 36% of LGBTQ+ adults self-reported having a disability. Rates were higher for transgender people, with 52% of transgender adults reporting a disability. Intersex people report higher health disparities than both the general population and their endosex LGBTQ+ peers. Health disparities and barriers to equitable care can be exacerbated for individuals with other layers of marginalization.
Discrimination remains too common for LGBTQIA+ people based on disability status (or perceived disability). In a 2017 GLSEN survey, 25% of LGBTQ+ students surveyed reported disability-related discrimination. Intersex and transgender people have a higher risk than LGB people for discrimination in healthcare, especially those with lower socioeconomic status. Stigmatization of intersex traits leads to high rates of distress. In the more recent 2022 US Transgender Survey, 48% of transgender people reported a negative experience with a healthcare provider in the past year because of transphobia.
Discrimination based on sex, gender, or sexual orientation in healthcare can and does lead to people delaying or avoiding healthcare altogether. Barriers to accessible and equitable care impact long term health and wellness in our communities. It is unacceptable that LGBTQIA+ people experience discrimination at such high rates.
One contributing factor to this is a lack of education on how to treat LGBTQIA+ patients. Medical students typically receive less than 5 hours of education on LGBTQ+ issues. Some intersex people are forced to undergo nonconsentual and medically unnecessary surgeries as children. LGBTQIA+ patients may avoid seeking healthcare and miss necessary screenings and treatments because of possible or past discrimination or traumatic experiences and not feel comfortable discussing their experiences with their identities and gender, sex, or sexual orientation. This can especially impact patients with rare diagnoses because there are often additional cost barriers and a limited number of specialists available without the same options to transfer care to another specialist or healthcare facility.
While some LGBTQIA+ people choose to be open about their identities and experiences in health justice advocacy spaces, visibility without protections can make LGBTQIA+ people vulnerable to discrimination. In order for more individuals to have the choice to safely share their stories, we also need to push for educational and legislative changes so that LGBTQIA+ people have the choice of visibility without its potential risks. If you don’t see any openly LGBTQIA+ people in a space, question why. Learn to build inclusive spaces proactively instead of waiting for us to ask for inclusive language, policies, and treatment.
Highlighting LGBTQIA+ voices in disability and rare disease spaces can increase education about community experiences and challenges, identify gaps in resources and services, and foster allyship between communities as we work to create a more inclusive and accessible world.
There are a few things we can all do to ensure disability advocacy includes LGBTQIA+ people:
- Listen to LGBTQIA+ voices, ask questions, and invite us to share our experiences on our terms.
- Use your voice to make spaces more inclusive and push back against anti-LGBTQIA+ policies.
- Understand that you may make mistakes & have gaps in knowledge. Take time to continually learn about LGBTQIA+ community issues.
Disability justice must include and take the lead from marginalized individuals, and that means understanding disabled LGBTQIA+ people’s experiences.
References:
“Barriers to Health Care — National LGBT Cancer Network.” National LGBT Cancer Network -, 14 Feb. 2017, cancer-network.org/cancer-information/cancer-and-the-lgbt-community/barriers-to-health-care/.
James, S.E., Herman, J.L., Durso, L.E., & Heng-Lehtinen, R. (2024). Early Insights: A Report of the 2022 U.S.
Medina, Caroline, and Lindsey Mahowald. “Key Issues Facing People with Intersex Traits.” Center for American Progress, 4 Oct. 2023, www.americanprogress.org/article/key-issues-facing-people-intersex-traits/.
Transgender Survey. National Center for Transgender Equality, Washington, DC.
Rodríguez-Roldán, Victoria M. (2020) “The Intersection Between Disability and LGBT Discrimination and Marginalization,” American University Journal of Gender, Social Policy & the Law: Vol. 28 : Iss. 3 , Article 2. Available at: https://digitalcommons.wcl.american.edu/jgspl/vol28/iss3/2
“Understanding Disability in the LGBTQ+ Community.” Human Rights Campaign, www.hrc.org/resources/understanding-disabled-lgbtq-people. Accessed 2 June 2024.
Zeeman, Laetitia, and Kay Aranda. “A Systematic Review of the Health and Healthcare Inequalities for People with Intersex Variance.” International journal of environmental research and public health vol. 17,18 6533. 8 Sep. 2020, doi:10.3390/ijerph17186533
