Pride Month: Healthcare Self-Advocacy for LGBTQ Patients
As alesbian, gay, transgender, non-binary, queer, intersex or asexual (LGBTQIA+)patient, you have, at some point, probablyhad troubleaccessing health care.Experiences of stigma ordiscrimination may have prevented you from seeking medical treatment. The prospect of finding a provider who specializes in LGBTQIA+health may be overwhelming.Or,you mayԴdzbe out to your family andunable toafford treatment without theirhelp.
Such barriers to care and treatment can take a serious toll on your physical and mental well-being. That’swhy it is important tounderstand your health needs and risks, and to learn how to advocate for your ownbestcare.
Being Your Own Patient Advocate
Start byestablishinga trusting relationship with a gender affirming primary care providerwith whomyou cancomfortablydiscussall aspects of your health,advises Gregory McWilliams, MD, an attending internal medicine physician specializing inLGBTQIA+ health.“It’s important to establish a good relationship with a primary care doctorwhoyou can be frankwith, andwho you trustwillkeep your conversations confidential,” Dr. McWilliams says.
Next, make sure that you are benefiting from comprehensive screeningfortypicalchronic conditions, such as,hypertension, diabetes, and obesity,as well asspecifichealthissues andneeds thatmay bedifficult to discuss.“Comprehensive care requires us to make sure we’re screening theLGBTQIA+the same as we would the non-LGBTQIA+dzܲԾٲ,”Dr. McWilliams says.
Among gay men, for example,HIV treatment and preventative medicinerequire particular attention.“The vast majority of our practice is preventive,” Dr. McWilliams says, referring to thepre-exposure prophylaxisknown asPrEPthatreduces the risk of HIV infection.
Preventative Care is Important for LGBTQ Patients
Preventative health, such asscreening for cervical cancer, is alsocritical--andoften overlooked--inlesbianhealth. “Lesbians oftenfeelthatthey arenotat risk for cervical canceror findpap smear screeningtriggering,” Dr. McWilliams says. “That’s how these corepreventativehealth measuresgetput ontheback burneror disregarded,”hesays.
Trans patientswill want a provider who can speak about surgical as well as non-surgical options,like hormonal replacement therapy (HRT),Dr. McWilliams says.“Surgery for trans patients is oftenthefinal stepbut manypatients don’t want to go throughsurgery and need a provider who can manage HRT.”
Screening and preventative health also applies tocomprehensive mental health care,which is especially important for LGBTQIA+ people,who may havesignificant trauma in the form of negative reactions,stigma and discrimination,depression, and anxiety aftercoming out to family,friends, oremployers,”
Suchtrauma--which may even includenegativeinteractionswith physicians--commonly translates into higher rates of depression, anxiety,substance use, orsuicidality,according toJessZonana, M.D. Assistant Professor of Clinical Psychiatry. “A lot ofLGBTQIA+people have had negative experiencesinteracting with healthcare providers,which is an access barrier in itself,” Dr.Zonanasays. “Forthosewho have had negative experiences seeking health care as a result of their identity, eitherbybeing misgendered if they’re trans or outright denied care, there’s overt stigma, and stigma has a huge impact on the risk for mental health conditions.”
Make sure, therefore, that your provider takes the time to ask you about how you are feeling emotionally, screensforand monitorssubstance use disorders.
Health Services Available to LGBTQ Patients
If you are anLGBTQIA+person of color from an under-resourced community,under- or unemployed, orlack health insurance,the care you need may seem out of reach. But you can findsupportive and sensitive healthcareresourcesatWeill Cornellѱ徱Ա’sthe first student-run clinic focused on addressing mental health disparities among New York City’s lesbian, gay, bisexual,transgenderand queer (LGBTQ+) communities. TheQlinicprovides free mental health care to members ofthesepopulations, including those with substance use disorders. Another resource is, which provides a range of comprehensive mental health services for transgender and gender-diverse children and adolescents.
Finally,WCM providesLGBTQ+friendlyhealthcareservices, including:
Specific programs,treatmentsand specialty services: