How health care leaders can prioritize health equity for the LGBTQIA2+ community

In an era of increasing awareness and acceptance of LGBTQIA2+ identities, the healthcare sector has a critical role to play in ensuring equitable access and quality care for these communities. As leaders in the field, we have a moral and professional obligation to address the persistent disparities that LGBTQIA2+ individuals face within the healthcare system.

Numerous studies have documented the unique challenges and poorer health outcomes experienced by LGBTQIA2+ patients. This population faces elevated rates of mental health conditions, substance use disorders, HIV/AIDS, and other chronic illnesses – often as a result of minority stress, discrimination, and barriers to care. Transgender and non-binary individuals in particular report alarmingly high levels of unmet medical needs, with many avoiding seeking care out of fear of mistreatment or lack of provider competency.

At the same time, LGBTQIA2+ people are less likely to have health insurance coverage and more likely to delay or forgo needed care due to cost. Intersecting identities such as race, socioeconomic status, and disability can further compound these inequities. The COVID-19 pandemic has only exacerbated these disparities, with LGBTQIA2+ communities experiencing disproportionate health, economic, and social impacts.

As healthcare leaders, we must take bold and sustained action to address these unacceptable disparities. Prioritizing LGBTQIA2+ health equity should be a key strategic priority for all healthcare organizations. Here are some critical steps we can take:

  1. Promote LGBTQIA2+ inclusive policies and practices. This includes ensuring non-discrimination protections, equal benefits coverage, gender-affirming care, and the use of correct names and pronouns. Healthcare workforces should also reflect the diversity of the communities they serve.
  2. Implement comprehensive LGBTQIA2+ cultural competency training. All staff, from front-line clinicians to administrative personnel, should receive training to build knowledge, skills, and awareness around LGBTQIA2+ identities and experiences. This training should go beyond the basics to address complex issues like gender identity, pronouns, and trauma-informed care.
  3. Collect comprehensive sexual orientation and gender identity (SOGI) data. Systematically gathering SOGI data allows us to better understand the healthcare needs and experiences of LGBTQIA2+ patients. This data can inform quality improvement efforts, resource allocation, and targeted outreach and engagement strategies.
  4. Partner with LGBTQIA2+ community organizations. Meaningful collaboration with local LGBTQIA2+ groups can help healthcare organizations better understand community needs, build trust, and develop tailored, culturally responsive programs and services.
  5. Advocate for inclusive policies and funding. Healthcare leaders must use their platforms and influence to advocate for LGBTQIA2+-affirming legislation, regulations, and public/private funding streams that support LGBTQIA2+ health equity initiatives.

The road ahead will not be easy, but the moral imperative is clear. By centering the needs of LGBTQIA2+ individuals and communities, healthcare organizations can help dismantle longstanding barriers, promote more inclusive and affirming care, and ultimately, save lives. It is time for all of us in the healthcare sector to step up as champions for LGBTQIA2+ health equity. The health and wellbeing of our patients depend on it.

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