High Stakes for the Health of Sexual and Gender Minority Patients of Color

Abstract

As clinicians, educators, and researchers, our ability to provide the best possible care to our patients who are sexual and gender minority (SGM) people of color is increasingly challenged. Relative to the general population, SGM patients often have worse health outcomes, and among SGM patients, racial and ethnic minorities are particularly vulnerable. Healthcare policies proposed by the current administration, along with an increasingly hostile and dangerous social climate, have the potential to seriously harm SGM patients of color. In this paper, we discuss these key policy issues impacting the health of SGM patients of color. We then suggest questions for clinicians to consider to help them decide which advocacy activities are right for them, recommending self-examination, skills development, and political action. We end by outlining concrete, actionable steps to advocate for SGM patients of color in patient care, healthcare organizations, medical education, research, and public policy.

Lessons for achieving health equity comparing Aotearoa/New Zealand and the United States

“…The U.S similarly has a difficult time discussing race, class, and social inequities, worsened recently with divisive rhetoric by elected national leaders. 24 Implementing recommendation 1 to have a strong, explicit equity lens in quality of care and payment policies requires honest discussions about the drivers and nature of health inequities, 163 and a commitment to dismantling systems of racism and colonialism.…”

“…Intersectionality, the combination of intersecting systems of oppression that perpetuate discrimination and disadvantage based on factors such as race/ethnicity, class, sex, and gender identity, 23 is frequently associated with worse outcomes than any one dimension of disadvantage. 24 Systems of discrimination and oppression cannot be completely understood in isolation. 25 Therefore, our paper will especially highlight issues for indigenous peoples and racial/ethnic minority population groups as they are more likely to experience disproportionate socioeconomic deprivation.…”

Mapping the Landscape of Support and Safety Among Sexual Minority Women and Gender Non-conforming Individuals: Perceptions After the 2016 US Presidential Election

“…The recent 2016 presidential election represents an important political event that has led to significant shifts in policy and social climate on both national and local levels (Gonzales & McKay, 2017;Williams & Medlock, 2017). These shifts have included efforts to impede and retract policies designed to protect the rights of marginalized citizens, including LGBTQ people, and have created a growing wave of concern about the health and well-being of LGBTQ communities (Gonzales & McKay, 2017;Tan, Baig, & Chin, 2017). Emerging studies exploring the impact of the election on SGM health and well-being have documented increased concerns about health and safety and reports of violence, hate speech, and discrimination as well as increased anxiety, depression, alienation, and reduced self-disclosure (Garrison, Doane, & Social support and safety after 2016 U.S. election Page 6 Elliott, 2018; Gonzalez, Ramirez, & Galupo, 2018;Haimson & Hayes, 2017;Veldhuis, Drabble, Riggle, Wootton, & Hughes, 2018a;Veldhuis, Drabble, Riggle, Wootton, & Hughes, 2018b).…”

Healthcare Experiences of Transgender People of Color

“…The limited literature suggests that individuals who are both transgender and racial/ethnic minorities suffer from poorer health outcomes, compared with their single minority counterparts. [8][9][10] For instance, the US Transgender Survey (USTS), a 2015 nationwide survey with 27,715 transgender respondents, illuminates important health inequities. For example, black transgender women reported higher HIV prevalence rates compared with the overall transgender sample, and TPOC reported higher rates of attempted suicide and lack of health insurance.…”