June 19, 2025
Americans who identify as lesbian, gay, bisexual, transgender, queer, or another non-heterosexual orientation (LGBTQIA+) continue to face many disparities in both health outcomes and access to good health care. These disparities are often the result of systemic discrimination and social stigma, which can affect everything from mental health to chronic disease risk.
Here’s a look at what those disparities are, why they exist, and how health care providers are attempting to address them.
Health disparities occur when one group of people has worse health outcomes than others. For LGBTQIA+ people, this often means higher rates of mental health issues, substance use, and some diseases. These differences exist largely because of the discrimination LGBTQIA+ people face.
Health care disparities are different but connected. They happen when LGBTQIA+ people aren’t treated fairly by doctors or health care staff, making it more difficult for them to get quality care. These negative experiences can keep people from going to the doctor at all, which can make health problems even worse.
It’s common for LGBTQIA+ adults to encounter discrimination. Sixty-five percent said they’d experienced at least one form of discrimination in their daily lives in the past year, according to KFF’s 2023 Racism, Discrimination, and Health Survey. That kind of constant stress can lead to higher rates of anxiety, depression, and other mental health issues. In fact, 67 percent said they needed mental health care in the past two years.
Substance use is also more common. Around 25 percent of LGBTQIA+ adults show signs of alcohol dependency, which is much higher than the general population. Smoking rates are also higher, which may explain why LGBTQIA+ adults face greater risks of heart problems.
Suicide rates are significantly higher among young transgender people than those who are not transgender, and increasing numbers of trans teenagers have attempted suicide as a result of recent anti-trans laws affecting minors.
Not all LGBTQIA+ people experience the same health disparities. For example, gay and bisexual men have a higher risk of getting sexually transmitted infections (STIs), most notably the human immunodeficiency virus (HIV). Men who have sex with men accounted for 67 percent of all new HIV diagnoses in the U.S. in 2022.
Lesbian and bisexual women, meanwhile, are more likely to have breast cancer or cervical cancer than heterosexual women. The greater risk for breast cancer may be due to higher rates of substance abuse, obesity, and stress among lesbian and bisexual women. Some studies also suggest that fewer lesbian and bisexual women get screened for cervical cancer.
The 2023 KFF survey found that more LGBTQIA+ adults than non-LGBTQIA+ adults said they’d had a negative health care experience in the past three years that:
• Caused their health to get worse (24 percent compared to 9 percent)
• Made them less likely to seek health care (39 percent compared to 15 percent)
• Caused them to switch health care providers (36 percent compared to 16 percent)
On top of that, six in ten LGBTQIA+ adults said they prepare for insults from health care providers or staff or feel they need to be careful about their appearance to be treated fairly. Only 39 percent of non-LGBT adults said the same thing.
These experiences can have real health consequences. For example, a study of 92 sexual and gender minority patients diagnosed with breast cancer found that 38 percent of them declined conventional treatments recommended by their oncologist, compared with only 20 percent of gender-conforming heterosexual patients, possibly because they trusted their doctors less.
Patients who decline conventional cancer treatment are known to have worse outcomes. The sexual and gender minority patients who took part in the study were nearly three times as likely as their gender-conforming heterosexual peers to experience a recurrence of their cancer.
Some health care systems are now trying to do better. Inclusive health care means treating LGBTQIA+ patients with the same respect and attention as anyone else.
That includes things like using inclusive language, having policies that protect against discrimination, training staff to be respectful, and encouraging patients to take an active role in their care.
The Human Rights Campaign Foundation puts out an annual report called the Healthcare Equality Index that’s meant to help LGBTQIA+ patients and their families find health care facilities with welcoming policies and practices.
The most recent one awarded the LGBTQIA+ Healthcare Equality Leader designation to 384, or 36 percent, of the healthcare organizations that agreed to be surveyed for the report. Of those organizations, 32 are in New Jersey and 30 are in Pennsylvania.
LGBTQIA+ people face many challenges when it comes to staying healthy and getting fair treatment in the health care system. Fortunately, change is happening. Awareness is growing, and more health care providers are working to close these gaps. It’s a step in the right direction, but more still needs to be done to ensure everyone gets the care they deserve.
