LOS ANGELES (CN) – Lesbian, gay and bisexual adults in California are more likely to delay seeing a doctor or visiting an emergency room even when their insurance coverage rates are similar to those of straight Californians, according to a study published Wednesday.
The UCLA Center for Health Policy Research found that about 20 percent of gay and bisexual men and 29 percent of lesbians and bisexual women delayed seeing a doctor in the past year, whereas only 18 percent of straight women and 13 percent of straight men said they’ve delayed care.
Gal Mayer, a physician and president of the organization GLMA: Health Professionals Advancing LGBTQ Equality, said in an interview that medical providers “may not have any appreciation” for the unique stress LGBTQ people face.
UCLA’s study found risk factors for chronic health issues – such as stress, smoking, lack of exercise and consumption of sugary drinks – is higher among lesbian, gay and bisexual Californians.
“This puts LGBTQ adults at potentially higher risk for related medical conditions, among them obesity, hypertension, cancer, and substance dependence,” according to the study.
The legalization of same-sex marriage has improved LGBTQ access to medical insurance. But while expanding insurance coverage is important, advocates say more should be done to understand why people who have insurance aren’t seeking medical care.
“Even if they have a high-quality insurance plan through an employer, health equity is far from a reality for many LGBTQ patients,” the study’s lead author Joelle Wolstein said in a statement.
Study co-author Susan Babey of UCLA added that reluctance to seek medical care is often tied to prior experiences of discrimination.
“Sexual minorities who have had a bad experience with a medical provider because of their sexual orientation may try to avoid repeating it,” Babey said in a statement.
Sean Cahill of The Fenway Institute — an advocacy group for LGBTQ health care — said in an interview that physicians and health center staff need more training to understand the way sexual and gender identity intersect with race, ethnicity and other factors.
“It’s really important to understand why the disparities exist and ensure healthcare is relevant and affirming to [LGBTQ people],” Cahill said, adding that some communities may distrust the medical establishment due to years of experiencing racism and other prejudice.
Cahill pointed to a 2016 Centers for Disease Control and Prevention report finding that while half of black men who have sex with men will be diagnosed with HIV during their lifetime, only a handful access treatment and prevention tools.
“What’s currently available is not meeting their needs,” Cahill said.
Mayer added that medical staff often make assumptions about LGBTQ people that may turn them away.
“Not every sexually active woman is at risk of getting pregnant,” Mayer said, listing one example of misguided assumptions about LGBTQ people in the medical community. On the other hand, he said some doctors may also wrongfully assume lesbians don’t need to talk about family planning.
If LGBTQ people feel they have to face “an unwelcoming environment where their dignity is compromised” on top of being sick, they will likely avoid seeking medical care, Mayer said.
“Access is about more than being insured. You have to feel connected. You have to trust that when you go there you’ll have a caring experience,” Mayer said.
More than 1 million California adults – 4.5 percent of the state’s adult population – identify as lesbian, gay, or bisexual, according to the California Health Interview Survey.
UCLA’s study did not include data on transgender people because it has only collected this data since 2015, whereas the data on gay, lesbian and bisexual Californians reaches back to 2011.