Access to Care

Information for Our Community

By Joanna Sickler

Lesbians’ difficulty accessing the healthcare system cannot be traced to any one source. Instead it is a number a factors acting together creating barriers to quality health care. In order to solve the problem, providers need to receive education and training to understand the healthcare concerns and needs of the lesbian population.  Spousal benefits need to be made available to lesbians in order to make healthcare financially accessible. Additionally, federal programs need to acknowledge that women’s health extends beyond reproductive needs and tailor program that reach out to minority groups such as lesbians.

Talking Points:

  • Lesbians face structural, financial, personal, and cultural barriers when attempting to access health care services, which results in lowering the quality of care that they receive.1
  • Many groups encounter barriers when trying access the healthcare system.  Race, ethnicity, socioeconomic status, disability, and sexual minorities have all been marginalized and are often “hidden.”  This means that lesbians who also identify with other marginalized groups such as being African American face even greater barriers when trying to access the healthcare system.2 Many healthcare providers have not been educated about the health issues that face the lesbian community and have not been trained to take personal histories.3,4  This lack of knowledge is compounded by lesbians’ fears of experiencing discrimination from the healthcare system, which prevents them from coming out to and being honest with their physician.5
  • The barriers that lesbians face when accessing the healthcare system act as a deterrent that precludes them from seeking preventative care, care for acute health conditions, or exacerbated chronic conditions.6
  • There are many structural barriers in place that prevent lesbians from accessing the healthcare system including a lack of insurance.  Lesbians are less likely than heterosexual women to be insured which is generally attributed to their inability to access to spousal benefits.7 Additionally, federal health services tend to focus on reproductive care and as a result most lesbians are not included.8
  • Lesbian youth also experience additional barriers to accessing care because adolescents are the most under or uninsured group.  This in addition to the fear of coming-out and losing confidentiality, makes lesbian youth hesitant to access the health care system.9

    1. Millman, M. Access to Health Care in America.  National Academy Press, Washington, D.C, 1993
    2. Healthy People 2010, p 2
    3. Diamant, A.L.; Schuster, M.A.; McGuigan, K.; and Lever, J. Implications of taking a sexual history. Archives of Internal Medicine 159:2730-6, 1999.
    4. Harrison, A.E. Primary care of lesbian and gay patients: Educating ourselves and our students. Family Medicine 28(1), 57-58, 1996
    5. American college of Preventive Medicine. 1998 National Prevention in Primary Care Study. Washington, DC: American College of Preventive Medicine, 1998.
    6. Healthy People, 2010, 145-146
    7. Diamant, A.L.; Wold, C.; Spritzer, K.; and Gelberg, L. Health behaviors, health status and access to and use of health acre: A Population-based study of lesbian, bisexual and heterosexual women. Archives of Family Medicine 9(10): 1043-1051, 2000.
    8. Healthy People 2010, 51.
    9. Ryan C., and Futterman, D. Lesbian and Gay Youth: Care and Counseling. New York, NY: Columbia University Press, 1998.

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