Evolving attitudes, policy strides critical for advancing LGBT healthcare

Although there has been significant progress in advancing LGBT rights in recent years, there are still barriers that prevent LGBT individuals from fully experiencing the American dream, such as healthcare inequality.

Health and safety concerns

Dr. Michael Kauth, professor of psychiatry and behavioral sciences at Baylor College of Medicine, has been involved in trying to better understand sexuality and the healthcare needs of LGBT people during his career. Kauth, who is also director of the national LGBT program for the Veterans Health Administration in Washington DC, says a combination of societal and cultural norms can contribute to health and safety concerns among the LGBT community.

“There are a number of reasons why LGBT people experience greater health concerns than others. A lot of it has  to do with our culture and the fact that LGBT people experience stigma, prejudice and discrimination for who they are,” he said. “That makes it difficult for people to feel good about themselves and get access to appropriate care. If they can get access to healthcare, they may not be able to find healthcare providers who understand their particular needs.”

The medical community’s growing interest

In 2014, the Association of American Medical Colleges released its first guidelines for training physicians to care for individuals who are LGBT, gender nonconforming, or born with differences of sex development. Kauth says interest in LGBT healthcare among medical professionals and students has increased significantly in recent years.

“It’s true that many healthcare providers don’t get a lot of training in LGBT issues. However, I am very happy to say that is changing and there has been increased attention at medical schools around providing more LGBT content in the curriculum.”

Kauth says he has also seen growing interest in LGBT healthcare from Baylor students.

“When I first arrived in Houston, the main sexuality or gender identity curriculum at Baylor was the human sexuality course, and I normally struggled to get 40 people in the course,” he said. “However, for the past two years, 50-60 students have enrolled. We also have a new LGBT health course at Baylor that is specifically targeted to the unique healthcare needs of LGBT people.”

The LGBT health course provides a wide-range of perspectives and gives students a broad scope on health issues, Kauth says.

“We have the students meet with a panel of LGBT people who talk about their health experiences in the community. They share with the students what they would like their future doctors to know about treating people like them. It’s a very powerful experience for medical students.”

Although opportunities to learn more about LGBT healthcare continue to grow, Kauth says there is still progress to be made.

“Many healthcare providers are not comfortable asking about gender identity or sexual orientation. Literature shows that healthcare providers believe that patients should bring up issues of sexuality or gender identity if they feel it is important. Patients say they want to talk about these issues and believe their healthcare providers will bring it up.”

The role of recent policy changes and legislation

The 2015 Obergefell v. Hodges Supreme Court decision, which legalized same-sex marriage, had an overwhelmingly positive effect on members of the LGBT community, Kauth says.

“It really affected people at a personal level. I saw veterans at the VA feeling proud in saying: “I am marrying my same sex partner,” he said. “The other effect it’s had is increasing access to health insurance. If you are legally married, you can get access to your partner’s health insurance.”

Kauth says recent legislation such as North Carolina’s Public Facilities Privacy and Security Act and the repeal of the Houston’s HERO act have done more harm than good for transgender individuals.

“These events have increased the level of fear and anxiety in the transgender community. I’m hoping that there will be some rational discussion around this topic at a societal level and we can come to terms with the fact that this is a made up issue – and recognize that transgendered people have to use the bathroom like everyone else.”

Resources for LGBT youth

Although societal acceptance of LGBT individuals continues to grow, Kauth says youth still experience alienation from family members.

“We know there is greater acceptance of LGBT people in society in general – but the individual young person may not feel accepted and may worry what will happen if family members find out they are LGBT. A large percentage of homeless youth are LGBT.”

Kauth says LGBT youth should seek encouragement from those who are open and knowledgeable.

“I encourage youth to talk to somebody who can be supportive and help them figure out what’s going on in their life and who they are. One place where they can find support and help is the Montrose Center.”

Additional Resources

Learn more about the Michael E. DeBakey VA Medical Center’s LGBT program.
View CDC resources for LGBT youth.

-By Nicole Blanton