Individual Health Care Reform

Now, this may come as a shock, but LGBT folks don't get as good of service from the medical community as others.

Obviously this isn't really a surprise, but the specific data on this phenomenon may be.

Lambda Legal has released a free report on this, "When Health Care Isn't Caring."

This survey is the first one to examine the issue on a national scale. It documents refusal of care and barriers to health care among LGBT and HIV communities. The hope is to use these data to raise awareness of this issue and to influence decisions being made about how health care is delivered in the future.

Some of the key findings include:

• More than half of all respondents reported that they have experienced at least one of the following types of discrimination in care:
  = being refused needed care
  = health care professionals refusing to touch them or using excessive precautions
  = health care professionals using harsh or abusive language
  = being blamed for their health status
  = health care professionals being physically rough or abusive

• Almost 56 percent of lesbian, gay, and bisexual 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 HIV+ respondents experienced one or more of these types of discrimination in health care.
• Almost 8 percent of LGB respondents reported that they had been denied needed health care outright. Just under 27% of all transgender and gender-nonconforming respondents reported being denied care. Finally, 19 percent of respondents living with HIV also reported being denied care.
• Just over 10 percent of LGB respondents reported that health care professionals used harsh language toward them; 11 percent reported that health professionals refused to touch them or used excessive precautions; and more than 12 percent of LGB respondents reported being blamed for their health status.
• Almost 36 percent of HIV+ respondents reported that health care professionals refused to touch them or used excessive precautions and nearly 26 percent were blamed for their own health status.
• Nearly 21 percent of transgender and gender-nonconforming respondents reported being subjected to harsh or abusive language from a health care professional, and almost 8 percent reported experiencing physically rough or abusive treatment from a health care professional. Over 20 percent of transgender and gender-nonconforming respondents reported being blamed for their own health conditions.

Not all discrimination is equal, though.

In almost every category measured in this survey, transgender and gender-nonconforming respondents reported experiencing the highest rates of discrimination and barriers to care. Transgender and gender-nonconforming respondents reported facing barriers and discrimination as much as two to three times more frequently than lesbian, gay, and 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.

Respondents reported a high degree of anticipation and belief that they would face discriminatory care and such concerns were a barrier to seeking care. Overall, 9 percent of LGB respondents are concerned about being refused medical services when they need them, and 20 percent of HIV+ respondents and over half of transgender and gender-nonconforming respondents share this same concern.

Even worse, the survey respondents had higher proportions of people with advanced degrees, higher household incomes, and better health insurance coverage than the LGBT community in general. Since these factors tend to improve access to care, this means the report likely understates the barriers to health care experienced by all LGBT people and those living with HIV.

Things that people can do to improve the conditions documented by this survey include:

• Educate themselves and health care providers about the rights and needs of LGBT and HIV+ patients.
• Advocate for improved laws and policies.
• Use existing mechanisms that are appropriate, such as medical powers of attorney and other legal documents, to create as much protection as possible for themselves and their loved ones.
• Fight back when discrimination occurs, including reporting discriminatory practices, sharing stories, and contacting advocacy organizations and/or attorneys.
  

The report is a tough read, but it has a lot of good information. You have to identify the problem before you can fix it, and this report does an excellent job of chronicling many of the issues in health care.