On January 5, Florida became the 36th state in the nation to legalize same-sex marriage, joining a movement that is sweeping across the United States. With federal judges striking down same-sex marriage bans left and right, it seems inevitable that we will soon live in a country that recognizes the freedom to marry. Yet, although more Americans than ever support marriage equality, the fight for the full inclusion of lesbian, gay, bisexual, and transgender individuals in our society is not over, as they continue to face significant barriers to quality medical services.
Full equality includes access to high-quality medical care, regardless of sexual orientation or gender identity.
The obstacles that have historically prevented LGBTQ patients from obtaining medical care continue to plague our modern health care system. Sure, the American Psychiatric Association no longer considers homosexuality a mental illness. But a concerning number of health care providers still refuse to serve LGBTQ individuals, and until the passage of the Affordable Care Act, insurance companies were not required to extend domestic partner benefits to same-sex couples. Moreover, the stigma that surrounds homosexuality prevents many patients from disclosing their sexual orientation to doctors. Because the LGBTQ community faces higher rates of certain conditions, including depression and substance abuse, failing to discuss sexual activity can lead to inadequate treatment.
One of the U.S. health care system’s most serious shortcomings is its failure to prepare doctors to work with LGBTQ patients. Young doctors are emerging from medical school ill-equipped to deal with the specific needs of the LGBTQ community. A 2006 study published in Family Medicine surveyed 248 medical students, finding that the vast majority of students held positive attitudes toward LGBTQ patients and hoped to provide them top-tier care. Unfortunately, the same group of students failed spectacularly when tested on LGBTQ-specific health concerns. Another study revealed that most medical schools throughout the United States and Canada devote minimal (if any) instructional time to LGBTQ issues, and that the quality of such instruction varies drastically across institutions. And significantly, many doctors report that they feel uncomfortable discussing sexual behavior with LGBTQ patients. Continue reading