6 Ways Healthcare Still Fails The LGBT Community

Decades after it was put in place, the FDA lifted the ban on blood donations donations for gay and bisexual men — well, kind of. Across the nation, some celebrated the move as a sign of improved attitudes toward gay and bisexual men after the HIV/AIDS epidemic prompted the hurried ban 30 years ago. At the time, little was understood about the disease, save for the fact that it was spreading rapidly among men who had sex with men (MSM). In the face of mounting evidence showing HIV/AIDS could be transmitted through blood transfusions and no reliable way to test for the disease yet, the FDA instituted a prohibition preventing MSM from donating blood in an effort to contain the spread of HIV/AIDS. It was unfortunate, but it made sense given the lack of available data at the time.

What didn't make sense was the FDA's continued implementation of the ban for the next 30 years, despite improvements in both understanding of the disease and safer sex practices in the LGBT community. Finally, after years of lobbying by activists and research showing that an ironclad ban isn't necessary to prevent HIV transmission, the FDA has finally lifted the rule against blood donations from MSM... for the most part. While the previous ban prohibited men from donating blood if they had had sexual contact with a man since 1977, the current guidelines reduced that restriction to a year. Today, MSM can donate blood as long as they haven't had sex with other men in the past 12 months.

"Similar data are not available for shorter deferral intervals," the FDA told Reuters.

However, not everyone is happy with the partial lifting of the ban. "It is ridiculous... that a married gay man in a monogamous relationship can't give blood, but a promiscuous straight man who has had hundreds of opposite sex partners in the last year can," Democratic Congressman Jared Polis said, according to Reuters.

Whether you're focusing on the positives or the negatives of the FDA's decision, the ban on donating blood is hardly the only way the healthcare system has struggled to keep up with the LGBT community. Let's take a look at six ways LGBT individuals are failed by the current healthcare system.

1. LGBT Health Needs Are Lumped Together

The LGBT community may be connected based on sexual orientation and gender identity, but each identity has its own needs. Important healthcare concerns for a gay man differ greatly from those of a bisexual woman, and so on. Unfortunately, not all doctors receive training for the diverse needs of the LGBT community, if they receive training at all.

2. Trans Health Isn't Well Understood

Transgender individuals face some of the worst discrimination in the healthcare system; in fact, many report knowing more about their own healthcare than their doctors do. This is exacerbated by medical school curricula, which may consider LGBT health an elective rather than a core class. Fortunately, medical schools around the nation are scrambling to rectify this as soon as possible, and networks like My Trans Health help individuals find trans-friendly providers. In the meantime, though, trans individuals are trapped in a healthcare system that knows less about their bodies than they do themselves.

3. Insurance Can Be A Nightmare For Trans Individuals

Despite federal policies against discrimination based on sex and gender identities, many forms of insurance specifically exclude transgender and non-conforming individuals from their policies according to GLAAD, and they can continue to experience discrimination even if they have insurance. "[Discrimination is] a constant feature in many transgender individuals' dealings with doctors and insurance companies — from being refused basic services such as blood tests to not being reimbursed for health care screenings such as Pap smears or prostate exams," Mother Jones explained earlier this year.

For a list of healthcare-related trans rights, check out the National Center for Trans Equality's page on the subject.

4. Doctors Can Refuse LGBT Patients Care

The American Medical Association prohibits discrimination based on sexual orientation, and in almost half of the United States, refusing LGBT patients care based on their sexual orientation is illegal. However, the reverse is also true: Half of the states have no such laws in place, or even pass laws allowing doctors to refuse care for religious reasons. This is reflected in the discrimination faced by LGBT patients, eight percent of whom report being rejected outright by a doctor according to a report by Lambda Legal; furthermore, in the same report, the numbers worsen when it comes to those living with HIV/AIDS.

5. LGBT Patients Can Face Discrimination From Providers

Even when LGBT patients get in to see a doctor, they often face discrimination from doctors who may have preconceived notions of how sexuality affects health, whether it's verbal harassment or unnecessary testing: According to a study published in the American Journal of Public Health in July of 2015, healthcare providers often show a bias in favor of those who share their sexual identity — that is, the study found that heterosexual providers have a preference for heterosexual patients. As a result, LGBT patients frequently hide their sexuality from providers, even though such information can be vital.

6. Mental Illness Is Still Stigmatized

Mental health is one of the largest issues facing the LGBT community, from the staggeringly high suicide rate of trans individuals to the disturbing number of bisexuals dealing with depression and substance use. However, mental health services can be difficult to obtain, especially without insurance, and as we've discussed, many LGBT individuals don't have insurance in the first place.

When listed all together like this, the healthcare system can seem nightmarish for the LGBT community, and for good reason. That being said, the situation is improving, and hopefully it will continue to improve along with attitudes toward LGBT individuals.