Fact Sheet: LGBT Health Disparities

Access to Coverage
Discrimination and inequitable treatment, deterring LGBT people from attempting to access coverage (now prohibited by the Affordable Care Act). Lack of employer-provided health benefits due to anti-gay family policies (this is changing with marriage equality). Denial of coverage for pre-existing conditions -- like HIV -- leaving more than one-quarter of people with HIV uninsured, most of which are gay men and transgender women (because of the Affordable Care Act, you can no longer be denied health coverage due to a pre-existing condition). Inability to access Medicaid due to strict eligibility requirements (eligibility for Medicaid has expanded to cover more low-income people).

Physical Health & Abuse

Significantly higher risk for lesbians to develop breast cancer than heterosexual women, due in large part to fewer full term pregnancies, fewer mammograms, and higher prevalence of being overweight. Bisexual women have the highest level of never having received a Pap test of any group of women. Gay and bisexual men are estimated to be 17 times more likely to develop anal cancer than are heterosexual men. Gay and bisexual men, especially those from communities of color, account for almost half of Americans living with HIV/AIDS, and 66 percent of new infections in 2010. Transgender women of color have the highest prevalence of HIV infection; male-to-female transgender youth are at extremely high risk for HIV infection. Up to 60% of transgender people are victims of physical assault or abuse; up to 66% are victims of sexual assault.

Mental Health & Substance Abuse

Due to the burden of stress that comes from being a minority group member who has been subject to discrimination, compounded by poor health status, LGBT individuals experience more mental health problems than does the general population. These include major depression, anxiety and PTSD. Bisexual adults have the lowest level of emotional well-being among people of any sexual orientation. LGBT individuals use tobacco at twice the rate of heterosexuals; for bisexual men and women, smoking rates are between 30 and 40%, and use among the transgender population ranges from 45 to 74%.

Some studies show the transgender population using methamphetamines at rates up to 46%, and injection drugs up to rates as high as 40%; barriers to substance abuse treatment services include discrimination, provider hostility and insensitivity, strict male/female segregation within programs, and lack of acceptance in gender-appropriate recovery groups.

Economic
35% of LGBT adults have incomes of less than $24,000 a year, compared to 24% for the general population. Same-gender couples raising children are more likely to be poor than straight couples with children; there are about 2 million children in the U.S. being raised by same-gender parents. Transgender people face double the unemployment rate of the general population, and 90% report harassment or discrimination on the job. Lesbian and gay seniors, especially women, are poorer on average than heterosexual seniors, in part because marriage inequality prevents/prevented same-sex couples from receiving spousal Social Security benefits. LGBT youth make up 40% of homeless youthlargely because of family rejection.

References:
Substance Abuse and Mental Health Services Administration. (2012). Top health issues for LGBT populations information & resource kit. Retrieved from: http://store.samhsa.gov/shin/content/SMA12-4684/SMA12-4684.pdf Francisco Maulbeck, B. (2013, May 23). No, LGBT people are not richer than straights. Huffington Post. Retrieved from: http://www.huffingtonpost.com/ben-francisco-maulbeck/nolgbt-people-are-not-ri_b_3322306.html Cahill, S. & Makadon, H. (2013, September 6). The Affordable Care Act: Real Benefits for LGBT People. Huffington Post. Retrieved from: http://www.huffingtonpost.com/sean-cahill/theaffordable-care-act-real-benefits-for-lgbt-people_b_3867921.html The Fenway Institute, Center for Population Research in LGBT Health. http://lgbtpopulationcenter.org/