Confronting Healthcare Disparities in the LGBTQIA+ Community


Members of the LGBTQIA+ community face higher rates of discrimination in healthcare settings, from judgment and harassment to being refused care.

Fear of discrimination from healthcare providers makes many LGBTQIA+ individuals reluctant to get the care they need. And when they do seek services, they’re often treated with hostility and judgment—or worse, verbal and physical harassment. Not surprisingly, unwelcoming environments contribute to poorer healthcare outcomes among LGBTQIA+ populations, which experience higher rates of substance abuse, mental health issues, and certain cancers.

As part of our Pride Month celebration in June, Walden hosted a panel discussion called “Walden Pride, for Pride: A Discussion on Culturally Competent Care” to shed light on this critical topic. The event featured educator and consultant Lee Westgate, MBA, MSW, LCSW-C; Bettina Straight, director of diversity, inclusion, and organizational effectiveness at Walden; and Dr. Mark Leggett, LPC, a core faculty member in Walden’s School of Counseling and a private-practice clinician for more than 21 years.

Westgate, a transgender man, knows all too well the healthcare barriers LGBTQIA+ people face every day. “We are routinely required to interface with healthcare systems that are hostile to our identities, that do not receive modernized training about how to assess and engage around our healthcare needs, and that lack innovation in how to provide affirming care,” he explains. “The failure to provide affirming care causes significant harm and effectively dismisses the intrinsic worth and value of our patients.”

As a gay man who lived in Alabama for many years, Leggett recalls being worried about sharing his sexual identity and relationship status with his primary care physicians. “My experiences were mostly funny looks, no response, or just changing the subject. There was a real lack of concern, respect, and compassion,” he says.

The Way Forward

According to Westgate, members of the Walden community can harness their influence to raise awareness of LGBTQIA+ healthcare disparities and effect change. Making real progress, he says, will require training emerging professionals in best practices in LGBTQIA+ care, opening access to modernized training and educational resources, and promoting practices that deliver compassionate, whole-person care.

Straight stresses that misinformation is abundant, and that practitioners must proactively work to understand the unique needs of LGBTQIA+ patients. This is particularly true for the transgender community, whose members encounter unique roadblocks in seeking healthcare. “Clinicians who have not been trained on culturally competent care can truly do more harm than good in their interactions, even if it is not done intentionally,” she explains.

Disclosing one’s sexual orientation to a new caregiver can create extra stress and uncertainty during an already vulnerable moment. Simply using inclusive language with LGBTQIA+ patients, Straight adds, can make a world of difference. “Having a provider use language that indicates awareness and inclusivity can minimize this additional tension. It’s one of the simplest but most effective techniques a healthcare professional can employ.”

Leggett believes that educators play a key role in facilitating open, well-informed classroom discussions that address disparity issues. “For example, in Walden’s School of Counseling, we are actively training and preparing students on how to respond to the needs of these individuals in a counseling setting with respect, empathy, and professionalism,” he says.

From Westgate’s perspective, it’s up to all of us to move the needle on LGBTQIA+ healthcare disparities and create a more equitable healthcare system. “One never expects someone to know what it can be like to walk in another’s shoes, doing the mundane things that many take for granted,” he says. “However, we can practice the radical act of imagination and use our own power and privilege to improve the lived experience for others.”

“LGBTQIA+ communities routinely must depend upon systems that were not built for them.”