Only 16% of LGBTQ+ patients choose to inform their doctor of their sexual orientation. Coming out is never easy. Those of us in the LGBTQ+ community find ourselves having to come out over and over and over again. Sometimes it’s easier. Sometimes it’s not. Whether it’s easy for you to come out to your doctor or not, there’s one thing that all physicians should agree on: it’s necessary. In order for your physicians to provide you with the best possible care, they need to know your sexual orientation and gender identity. The physician-patient relationship is just that: a relationship. The more your doctor knows and understands you, the better they can treat you.
Your Physician Needs to Understand LGBTQ+ History
Providing you with the best possible care requires your physician to understand LGBTQ+ history and the discrimination most (if not all) of us have faced. Before coming out became cool, LGBTQ+ individuals often only felt safe being themselves in bars and clubs. As a result, alcohol abuse is more prevalent in the LGBTQ+ community. Up to 25% of the general LGBTQ+ community has moderate alcohol dependency, compared to 5%-10% of the general population. LGBTQ+ individuals have also endured legal discrimination regarding:
- Access to health insurance
- Employment
- Marriage Adoption
- Housing
- Retirement benefits
Many LGBTQ+ individuals lack/have lacked access to social programs specific to their needs and protection from bullying in schools, at home, and in the workplace. Also, there’s a shortage of health care providers who are knowledgeable and culturally competent in LGBTQ+ health.
Coming Out to Physicians is Hard
Understanding LGBQT+ patients helps physicians take a holistic approach to LGBTQ+ health. However, part of understanding the members of the LGBTQ+ community also requires medical professionals to comprehend why LGBTQ+ individuals might not want to come out.
LGBTQ+ Youth
Many LGBTQ+ youth experience high levels of stress, anxiety, depression, and rejection. According to the HRC Youth Report:
- 95% of LGBTQ+ youth report having trouble sleeping at night
- 77% of LGBTQ+ youth report feeling depressing or down within the past week
- 70% report feelings of worthlessness and hopelessness in the past week
- Only 26% always feel safe in their classrooms
- LGBTQ+ youth are more likely to be homeless than their heterosexual peers
- LGBTQ+ youth are 2-3x more likely to attempt suicide
Transgender teenagers and LGBTQ+ youth of color face additional challenges. Only 11% of youth of color believe their racial or ethnic group is regarded positively in the US, and more than half of trans or gender expansive youth never use school restrooms that align with their gender identity. LGBTQ+ youth may avoid seeking health care due to fear of discrimination or may worry about disclosing their sexual orientation or gender identity. As a result, they may lie to their physicians about aspects of their health, which could lead to them not getting the treatment they need. Physicians that are understanding and empathetic can drastically improve the well-being of our LGBTQ+ youth.
Transgender Individuals
39% of transgender individuals report earning less than $30,000/yr per household, which can have negative effects on their health. They are also far more likely to face harassment.
- 78% of transgender individuals experience harassment in school (K-12)
- 53% of transgender individuals have been harassed in public spaces, such as hotels, restaurants, airports, or government agencies
- 50% of transgender individuals are harassed at work
- 26% of transgender individuals have lost a job because of their gender identity
- 26% of transgender individuals have been physically assaulted
To avoid harassment or retaliation, transgender people often hide their gender identities from their health providers. In fact, only 40% of transgender people report being out to their medical providers. When they have, 28% of transgender individuals report experiencing verbal harassment in a medical setting, while 19% report having been refused medical care by providers altogether. It’s no wonder why more on than one in four transgender people avoid getting care altogether.
LGBTQ+ People of Color and Disabled People
Identifying as LGBTQ+ is difficult enough sometimes. Being LGBTQ+ and a person of color can make choosing to come out that much more difficult. LGBTQ+ people of color are more than twice as likely to avoid the doctor’s office than their white LGBTQ+ peers. This is troublesome, because many LGBTQ+ people of color are at higher risk of contracting HIV or other STDs. The same study finds that both LGBTQ+ people of color and LGBTQ+ individuals with disabilities have experienced a pattern of healthcare discrimination. 20.4% of LGBTQ+ people with disabilities avoid public places versus 9.1% of LGBTQ people without disabilities. Both LGBTQ+ people of color and LGBTQ+ people with disabilities experience invisibility within both of their communities. They are also more likely to experience mental health conditions that can impact their daily lives.
Lesbians and Gay Men
56% of LGBTQ+ individuals have confronted discrimination while seeking medical treatment. However, finding LGBTQ+ friendly physicians is necessary so that they can address the problems unique to their community. For instance, gay men have a higher risk of transmitting HIV and other STDs. They are also more active in the “party-and-play” scene (PnP), which often involves poppers and party drugs. Meanwhile, lesbians are less likely to seek out preventive services for cervical cancer. Lesbians and bisexual females are also more likely to be overweight or obese.
Coming Out to Your Doctor: 5 Ways to Do It
There’s no right or wrong way to come out to your doctor. Here are a few suggestions to help make the process easier:
Write it out.
If you don’t feel comfortable vocalizing it, write out your sexual orientation and gender identities preferences on a medical questionnaire. Most (if not all) practices offer these when you’re first becoming a patient.
Bring a loved one.
Are you nervous about coming out alone? You don’t have to. Bringing a friend or loved one with you to your next appointment for support. It will make coming out much easier.
Write a list of questions.
Write up a list of questions about your health, safety, concerns, and support services to bring with you to your next appointment. Having these in your back pocket can help you prepare to come out to your doctor. Then, together you can determine the best approach to care.
Get referrals.
One of the easiest ways to come out to a doctor is to come out to a doctor who’s already out, or frequently works with LGBTQ+ patients. Check out the Gay and Lesbian Medical Association (GLMA) provider directory or Planned Parenthood to find a list of doctors that are unique to your needs.
Do your research.
Before getting a (new) primary care physician, call their office ahead of time and ask if they have experience with LGBTQ+ patients. You can ask this before giving out any of your information, which can make the process easier.
Coming Out Isn’t Easy
Coming out isn’t easy, but finding a physician who can help you shouldn’t be. If you’re a member of the LGBTQ+ community and are looking for an LGBTQ+ friendly physician in Boston, don’t hesitate to give us a call. We’re inspired to make a difference in your life, no matter what your sexual orientation, race, or gender identity may be.
