The Difficulty of Accessing Health Services for the Queer Community
Tiffany Wicks, Ed.D.
Nearly four percent of the population identifies as Lesbian, Gay, Bisexual or Transgender (LGBT) (Romanelli & Hudson, 2017). This community experiences a higher volume of mental health issues including but not limited to depression, anxiety, post-traumatic stress, and suicidality. The mental health issues that arise are often from the hatred, discrimination and violence that increases the stress of the LGBT community. There is a need for intervention of these mental health services. However, barriers exist to accessing these services. In a study conducted by researchers from New York University, obstacles to mental health care were explored for the purpose of a call to action in impacting the gaps of services.
In this study, participants were recruited through several LGBT organizations using purposive and snowball sampling. Twenty-nine participants over the age of 18, LGBT identified participants qualified for the study. Among those in the study, many identified as bisexual, Black and poor. The researchers conducted narrative interviews about the experiences of queer individuals and their health care along with their perceptions of health care access. The study sought to understand cultural, racial, and behavioral factors that contributed to the healthcare barriers that existed for each participant. There were three interview questions:
1) “Thinking about yourself and community members, what do
you think are the most pressing health concerns in LGBT
2) What are the challenges for keeping healthy?
3) What do you think are the root causes of these health
Analysis of the data involved social constructionist framework application to the themes presented in the interviews. Through the analysis procedures, a person-centered and thematic-centered approach emerged. This means that both the narratives of the participants as well as the commonality among participants was highlighted in the results.
Several themes were indicated in the results. First, participants voiced a lack of identifiable services for LGBT individuals from organizations that may provide health care. This lack also included a scarcity of health education from organizations that provide education to LGBT communities. Second, lack of inclusive services emerged as a theme. This issue included the types of services that providers may be biased against providing and the implicit bias and judgment that can occur in healthcare provision. HIV was a service some of the participants indicated a health care provision they had difficulty finding, or they experienced bias from the provider once they accessed the service. Finally, the affordability of services was an issue highlighted from the study. Participants found difficulty not only accessing health care, but the health care provided was not financially feasible. For transgender participants, they noted that many care provisions are not covered by insurances or at the discretion of insurances as to whether or not they are necessary. The results from the study led to a discussion by the authors about the implications of individual and systemic health care barriers.
The authors discussed the issues that arose from the study as a call to action for change. The barriers presented can lead to poorer health care for LGBT individuals and a lack of treatment for Sexually Transmitted Infections (STIs) such as HIV due to lack of access. Furthermore, the unaffordability of services can impact the mental health of transgender individuals wanting to transition through surgical procedures. The systemic barriers to health care trickle down to individual barriers such as socioeconomic status and geography. Being economically disadvantaged and in a marginalized community such as the LGBT population presents obstacles that need to be mitigated from a systems-based level.
The implications for change are that providers and organizations need more clear strategies of advertising services and access to services that would benefit the LGBT population. Additionally, policy change is critical. While some legislation exists such as the Affordable Care Act and policy protections in the state of California pertaining to insurance coverage and affordability of care, there are many more policies that need to occur to continue to open access to services that benefit and protect the LGBT community.