These are brutal results that we need to see — no matter what kind of health care reform we end up with in this country, it’s still a huge hill to climb to be treated equally and fairly.

“The results of this survey should shock the conscience of this nation and make clear that the system is broken when it comes to health care for many lesbian, gay, bisexual, and transgender people and those living with HIV,” said Beverly Tillery, Director of Community Education and Advocacy and one of the authors of the report. “No one should be turned away or face discrimination when they are sick or seeking medical care.”

In spring 2009, Lambda Legal and over 100 partner organizations distributed a survey to LGBT people and people living with HIV across the country. When Health Care Isn’t Caring: Lambda Legal’s Survey on Discrimination Against LGBT People and People Living with HIV, is based on responses from approximately 5,000 people and provides a powerful snapshot of the experiences of a diverse cross section of members of the LGBT and HIV communities all over the country.

The survey included questions about the following types of discrimination in care: being refused needed care; health care professionals refusing to touch patients or using excessive precautions; health care professionals using harsh or abusive language; being blamed for one’s health status; or health care professionals being physically rough or abusive. According to the results, almost 56 percent of lesbian, gay or bisexual (LGB) respondents had at least one of these experiences; 70 percent of transgender and gender-nonconforming respondents had one or more of these experiences; and nearly 63 percent of respondents living with HIV experienced one or more of these types of discrimination in health care. We found that not only did sexual orientation or serostatus affect the respondents’ access to quality health care, but transgender or gender-nonconforming respondents faced discrimination two to three times more frequently than lesbian, gay, or bisexual respondents. In nearly every category, a higher proportion of respondents who are people of color and/or low-income reported experiencing discriminatory and substandard care. Close to 33 percent of low-income transgender and gender-nonconforming respondents reported being refused care because of their gender identity and almost a quarter of low-income respondents living with HIV reported being denied care.

In addition to instances of discrimination, respondents also reported a high degree of anticipation and belief that they would face discriminatory care.  Overall, 9 percent of LGB respondents are concerned about being refused medical services when they need them and 20 percent of respondents living with HIV and over half of transgender and gender-nonconforming respondents share this same concern.  Nearly half of LGB respondents and respondents living with HIV and almost 90 percent of transgender respondents believe there are not enough medical personnel who are properly trained to care for them.  These barriers to care may result in poorer health outcomes because of delays in diagnosis, treatment or preventive measures.

Within the report, Lambda Legal provides key recommendations for health care institutions, government, individuals, and organizations to combat these issues. We recommend comprehensive cultural competency, inclusive policies, research and training for medical personnel, stronger laws, as well as advocacy and community education.  

For the full report and the list of partners in Lambda Legal’s national Health Care Fairness Campaign, please visit www.lambdalegal.org/health-care-report

Some demographics:

Sexual Orientation: Slightly over half the respondents, or 2,727 people, identified as gay, with just fewer than 30 percent, or 1,453 people identifying as lesbian. The categories of queer (nearly 16 percent or 774 people) and same-gender loving (just over 5 percent or 261 people) include both women and men, as does the bisexual category (just over 11 percent percent or 542 people). A very small number of responses came from heterosexuals (just over 1 percent or 66 people), who are either living with HIV or transgender.

Gender Identity: Almost 56 percent of all respondents identified as male and almost 38 percent of all respondents identified as female. These numbers include transgender and nontransgender respondents. Almost 53 percent (2,593 people) identified as non-transgender male and nearly 33 percent (1,614) as non-transgender female; 8 percent (397) as transgender (either transfeminine or transmasculine); just over 4 percent (220) as gender-nonconforming; and almost 2 percent (83) as two-spirit.

Race and Ethnicity: Eighty-six percent of all respondents or 4,241 people identified as White and slightly over 18 percent or 892 people identified as people of color – meaning that they selected a racial/ethnic category other than or in addition to White. These numbers add up to more than 100 percent because some of the multiracial people selected white and another race or ethnicity.