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America's Health Care System is Failing LGBT Citizens: Learning from Reagan's Mistakes

Posted: 12/21/09 09:40 AM ET

America's health system is failing its LGBT citizens. President Obama should establish a federal Office of LGBT Health to tackle the unique dangers that threaten this community.

President Ronald Reagan jeopardized the lives of millions of lesbian, gay, bisexual, and transgender Americans by failing to commit federal attention to the HIV/AIDS crisis in the 1980s. President Barack Obama should learn from Reagan's mistakes and attack the health problems LGBT people face today.

Our health system is failing miserably to address LGBT health disparities and needs across the United States. The limited data that does exist has proven valuable in identifying the most troublesome health disparities. A recent study of this data by the Center for American Progress found some staggering trends in the rates at which LGBT populations experience mental and physical health problems.

Lesbian, gay, and bisexual adults are twice as likely to experience psychological distress as their straight counterparts. They are more than twice as likely to need medication to treat emotional health issues, many of which are induced by those stresses.

Their transgender counterparts are in more acute danger from mental illnesses. They are 25 times more likely to have suicidal ideations than heterosexuals and 10 times more likely than lesbian, gay, or bisexual adults -- who already suffer from elevated risk levels -- to endure this suffering. And only one-third of African-American lesbians have received a mammogram in the past two years--the lowest screening rate of all demographic groups.

The dangers that affect LGBT youth are equally concerning. Lesbian, gay, and bisexual youth are three-and-a-half times more likely to attempt suicide, and many health experts would argue that the rate for transgender youth is probably much higher -- as it is for their adult counterparts.

Even if these youths are able to overcome their internal challenges, external threats can pose equally harmful dangers: LGBT youth are nearly four times as likely to be threatened or injured with a weapon in school and three times more likely to be in physical fights that require medical treatment.

Another challenge is that doctors, nurses, and other health care providers often don't know how best to treat LGBT people. Most medical schools and educational health programs don't include training on LGBT health needs, even though this type of preparation can dramatically improve the quality of care they can provide.

But medical schools and other training programs don't share all of the blame. The lack of information on LGBT health needs makes it extremely difficult to design effective education and training programs.

CAP found that the negative health outcomes that uniquely and disproportionately affect LGBT people are due to the cumulative and intersecting impact of three different factors, all of which played a major role in the HIV/AIDS epidemic that ravaged the LGBT community during the 1980s and 1990s.

First, LGBT Americans experience substantially reduced access to employer-provided health insurance. Second, for those who have coverage, many face a health care system that still lacks a cultural competence to treat their unique needs. And finally, all LGBT Americans, covered or not, still face the incessant, harmful social stigma that exists against LGBT people in our society.

There is also a lack of knowledge about the LGBT community's health needs, and influential policymakers and advocates aren't properly armed with information to implement effective policies and allocate the necessary resources to solve them. The main reason for this is that no national government surveys include questions related to sexual orientation or gender identity.

At the state level, only a handful of states regularly ask questions about sexual orientation. And to date only Massachusetts includes a question on gender identity in any government health survey.

To start reducing LGBT health disparities the U.S. Department of Health and Human Services should establish a dedicated Office of LGBT Health. This office would take the lead in coordinating a consistent and scientifically driven response across HHS to LGBT health disparities and needs.

Data collection should be a priority for this office. It must ensure that any federally funded health study that collects demographic information on categories such as age, sex, race, ethnicity, primary language, or socioeconomic status must also include questions about sexual orientation and gender identity. The Office of LGBT Health should also support efforts to design educational and training curricula that directly address LGBT health needs.

Finally, current efforts in Congress to expand coverage to more Americans would help reduce some of the disparities LGBT people face. The House-passed bill also included provisions related to LGBT health -- for example, expanding the definition of "disparities populations" to include LGBT people and inclusive nondiscrimination protections in health care treatment. House and Senate leadership should work to maintain these provisions in the final bill.

As the rest of society moves toward a more comprehensive and supportive understanding of the LGBT population, the nation's health care system needs to do the same. Decisive action and bold leadership now will help protect -- and save -- millions of lives.


Jeff Krehely is the Director of the LGBT Research and Communications Project at the Center for American Progress. This project builds on American Progress's early commitment to lesbian, gay, bisexual and transgender equality with a strategic policy and communications agenda including marriage equality, military service, youth homelessness, retirement security, and more. Jason Rahlan is a Press Aide at the Center for American Progress.

 
 
 
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09:05 PM on 01/12/2010
I have just found this post, so I do not know how many people will read my reply: For those of you who do not believe there is a problem, then you need to do your research. My company is in the process of contacting health care providers that will ACCEPT GLBT patients. There are a lot of health care providers that will not accept them nor will they treat them. THAT IS A FACT!. I have a list of providers that ACCEPT and a larger list that will not ACCEPT. The term is homophobia. Don't you think that a person has the right to go and see a doctor, a dentist or any type of Dr, just like the straight person???? They do have that right! Yes, they do get sick just like a straight person and it is a shame they are refused service. I know personally of a person that went to the dentist, she was sitting in the chair ready for the dentist to come in, when they found out she was transgender they asked her to leave!!! READ AGAIN!!! TO LEAVE...REFUSED SERVICE!!! Who made these professionals GOD??
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Theresa N
01:37 PM on 12/22/2009
Yes, christians are to blame for a lot of TLGB problems. I have experienced frequent disrespect, even ridicule, from christian health care workers. There is no other group with so much hatred for queer people than fundamentalists, including so called evangelicals. I think we need to make it clear in this country that religion cannot be a shield for hateful people. As far as receiving "special" treatment, what is needed is special education for all in society, especially health care and law enforcement personnel.
12:53 PM on 12/22/2009
America's health care system is failing ALL citizens
TryToBeFlexible
MENSA, Gay, Atheist, Believer in justice, age 58
09:21 AM on 12/22/2009
Diseases and epidemics come along all the time, and the governments of the world respond forcefully. Suddenly, a disease epidemic comes along that seems to be mainly striking gay people, and Ronnie Raygun decides to NOT respond to it at all. Hmmmmm.
To me, that would seem to imply that Ronnie wanted the gay people to die in the hundreds of thousands. And to me, that inaction in the face of mass suffering and death is kind of evil. Now, the early inaction has led to millions and millions being infected and millions dead. All due to Ronnie taking advantage of a chance to do nothing so he could kill hundreds of thousands of people he didn't even know, but hated anyway.
Yeah, Ronnie is a real hero.
09:03 PM on 12/21/2009
Last time I checked members of the American LGBT community are as human as the rest of Americans susceptible to the SAME health issues as ALL other Americans.

There are NO health issues which are specific to JUST the LGBT community so why the need for "special" attention with respect to health issues?

I would say the same thing to any other community who whines for "special" heatthcare attention from the federal government JUST BECAUSE they are members of their communities.

REAL healthcare reform will be beneficial to ALL Americans, including members of the LGBT community.
09:02 AM on 12/22/2009
People of different groups are not the same. For instance, some racial groups have a high risk for specific diseases like Tay Sachs and it's important for prospective parents to be screened for genetic compatibility so they can choose whether or not to risk having a child who will die young.

The article mentioned a number of reasons why LGBT people need improved health care. Social stigma is one example. I suggest reading the article again.
09:31 AM on 12/22/2009
Tay Sachs is a genetic caused disease.

AIDS is a lifestyle disease that can easily be prevented with lifestyle choices. They are not the same.
04:26 PM on 12/21/2009
Gentlemen,

Asking this administration to do ANYTHING to benifit the LGBTQ community is simple p***ing in the wind.

Save your breath, and send your money to LGBTQ charities that work on these issues.
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rextrek
50yr old, Moderate-liberal in S.NJ/Phila
03:12 PM on 12/21/2009
Give LGBT American citizens FULL Equality - and over 1/2 of those "said" problems you mention would go away.......the thing about being LGBT in America....is acceptance....self/and through others....and mostly THIS COMES WITH AGE......at 49...I aint taking crap from anyone (except at wrk), otherwise I'll tellm to thier face...I have NO problem being ME in 2009. ..and I will continue to Fight for Equal rights for ALL.....tho its disgusting you should even have too - in 2009 the SUPPOSED LAND OF LIBERTY & JUSTICE FOR ALL.....yea,right.
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KDog76A
Radical Centrist
05:24 PM on 12/21/2009
what do you need to be fully equal? repeal don't ask don't tell, be given the right to marry, equal pay for equal work... what else? Im interested in finding out what the real discriminatory issues are besides the ones I mentioned.

I don't get the discriminatory angle on healthcare, particularly when more money has gone towards AIDS and HIV research than any other single disease or cause of death. The suicide rates and depression levels mentioned in the articles may truly be higher in the LGBT community, but that has little if anything to do with discrimination by healthcare workers or an imbalance of medical coverage against LGBT. These are not unique cases to the LGBT.

Im all for equal rights for all, but the article smacks more of a lobby for special benefits by a special interest group as opposed to a legitimate argument that the healthcare industry is discriminatory. I have taken LGBT sensitivity classes though HR departments at my various jobs, if you want your community to be truly equal, I think LGBT should take straight sensitivity training as well, offensiveness does work both ways.
09:05 AM on 12/22/2009
Research has found that closeted gays have worse health outcomes. Social stigma often pressures gays to remain closeted.

Research has also found significant bias on the part of some medical professionals when it comes to gay people, especially gay men. Research has also found bias against women and against racial minorities.

The differences that are the source of prejudice in larger society are not mystically cast aside in medical practice.

As or AIDS funding, some of that has gone to the fund religious right which aligns itself with people like the preachers and politicians in Uganda who hold condom-burning parties and scapegoat gays for the rise in HIV rate caused by abstinence-only and anti-homosexual programs.
02:27 PM on 12/21/2009
Not to worry ....

Barack is our community's "fierce advocate," or didn't you know that?

Have you seen what he's done about DOMA? or DADT??

And you think his White House is going to give a damn about LGBT health?

Rick Warren (Obama's inaugural pastor) and the Evangelicals were supporting the people behind the Uganda bill to execute gay people until they got outed in the media.

Why are you wasting your breath on this man?
He only wants our money and votes, and after that, as Rahm Emanuel said, "Don't worry about the left."
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KDog76A
Radical Centrist
03:58 PM on 12/21/2009
yeah for 2009 AIDs research came in at $2.9 billion. Breast cancer came in at $716 million. Darn the bigots!

http://www.fairfoundation.org/factslinks.htm
09:08 AM on 12/22/2009
AIDS is not a gay disease. And, the abstinence-only funding that has gone to the religious right has helped to result in things like a higher HIV rate, condom burning parties held by religious leaders, "ex-gay" quackery, and proposed scapegoating legislation designed to scapegoat gays for the negative consequences of abstinence propaganda.
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04:59 PM on 12/22/2009
Your numbers are not really true. Any disease that someone with HIV can get, various cancers, pneumonias etc., is counted as giving money to AIDS research, so the numbers are highly inflated.
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FearlessFreep
A radical leftist with a JS Woodsworth avatar.
02:09 PM on 12/21/2009
The only thing the Republicans learned from Reagan's mistakes was to repeat them with even worse results.
02:39 PM on 12/21/2009
Are you kidding me? Are you talking about this health care bill that the DEMS are trying to pass? Since not one Republican voted for it, how on earth do you blame them?
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FearlessFreep
A radical leftist with a JS Woodsworth avatar.
10:50 PM on 12/21/2009
I wasn't talking about this bill, I was making a general point about the Republicans.
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BarryS
01:16 PM on 12/21/2009
of course any sane person would support this. However, a large slice of so-called-compassionate christians don't feel ANYONE deserves medical care. What do we do about that?
02:51 PM on 12/21/2009
Have you considered moving to one of the countries whose existing health care system agrees with you?
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KDog76A
Radical Centrist
03:53 PM on 12/21/2009
I love it when people christian-bash, while claiming they are more compassionate and understanding because of their own unique minority status. It just shows the limited understanding people have.
TryToBeFlexible
MENSA, Gay, Atheist, Believer in justice, age 58
09:17 AM on 12/22/2009
I think the issue is that christians claim to be the only true religion, and the only truly moral people, then do astonishingly hateful things. It is the hatefulness and hypocrisy of the religion that makes people angry. And yes, lots of non-christians are way nicer generally than alot of christians. I hope that helps your limited understanding of this issue that seems to confuse you.
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billy goat
Sniffing Out Bad Cheese Everywhere!
12:58 PM on 12/21/2009
Well of course you're right in all that you say. Unfortunately, a large segment of our society is not confortable our the existance of LGBT. Others are actively trying to further marginalize gay people and obstruct even the most obvious attempts at equity. Unfortunately, I think these folks are much too self involved to care that LGBT face unique health challenges.
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KDog76A
Radical Centrist
03:51 PM on 12/21/2009
I would be interested in knowing if you have personally felt discriminated against by your doctor, or what particular health issues you personally have that are unique to the LGBT community.