Running head: HEALTH CARE DISPARITIES IN THE GAY POPULATION 1

Health Care Disparities in the Gay, Lesbian, Bisexual and Transgender Population
William G. Russell
Ferris State University






HEALTH CARE DISPARITIES IN THE GAY POPULATION.
Abstract
The author of the paper will attempt to document actual disparities in the delivery of health
care to the Gay, Lesbian, Bisexual and Transgender populations. While these populations are
frequently referred to as one population, the author will attempt to describe the health needs and
disparities of each of these groups as separate entities. The author will attempt to provide factual
information, without personal or societal influence and present evidence in the disparities for
these populations. The author will, however, describe what he has felt when while he perceived
disparity. The purpose of this paper is to illustrate the disparities that do exist in health care for
these populations and to provide education to those who may now that such disparities are a part
of current practice.

Keywords: GLBT, perceptions, current practice.












HEALTH CARE DISPARITIES IN THE GAY POPULATION.
About the Members of the Populations
The members of the GLBT populations have unique health care needs, one of which is the
need for the patient to identify him or herself as a member of one of these populations. Myriad
reasons exist for patients to be uncomfortable to self-disclose. Reasons include fear of
embarrassment, fear of being outed to members of his/her community and or his or her
opposite sex significant other. The author is not aware of any other minority group that faces
such risk of consequences by the admission of his or her minority status. Many states, including
Michigan, still have laws allowing termination of employment based solely on sexual
orientation. These are some real threats and can keep some patients silent about being a member
of the GLBT population. While it seems acceptance for the GLBT populations grows in the
United States, and other countries around world, real dipartites and consequences still exist.
Health care providers with GLBT clients need to understand that not all of these people are
openly out of the closet and that confidentiality is extremely important in light of
discrimination (Harkness & DeMarco, 2012 p.346.)

Unique Health Concerns
Homosexual populations have unique and specific cultures, psychosocial characteristics,
health issues and disparities that are currently ignored or ignored in nursing education. (Sirota
T, 2013). The author also would like to mention that the same disparities exist in medical
education as well. Some providers may not feel comfortable treating those in theses populations
and or are not comfortable asking patients about sexuality or issues of being or feeling
transgendered. While this is understandable, especially as illustrated above in the current
education system, this represents a huge disparity in the health care for these people. LGBT

HEALTH CARE DISPARITIES IN THE GAY POPULATION.
adults had a higher risk of disability, poor mental health, smoking and excessive drinking than
did heterosexuals. Lesbians and bisexual women had a higher risk of cardiovascular disease and
obesity, and gay and bisexual had a higher risk of poor health and living alone than did
heterosexuals. (Fredriksen,K). Many other concerns also are at issue. The rates of suicide,
addiction and certain types of cancers are also higher for these people. The author was
hospitalized more than 20 years ago for his own addiction to alcohol. He was in a hospital detox
unit for 2 weeks before transferring to a long-term residential program. While hospitalized he
divulged his homosexuality to his physician and his therapists. The authors goal was to really
come clean about his life and leave the hospital with a much healthier feeling about himself and
make the most of his treatment. The author was advised to not mention this information in the
multiple therapy sessions while in the hospital because that fact might make other patients
uncomfortable. He was advised to just not bring that part up. The author was not given any
financial discount on the hospital stay for not being able to avail his whole being to the treatment
as the other patients did. He did as instructed and just said he was single during the group
therapy sessions. The author has not, and will not, forget this absolute health care disparity he
suffered. Fortunately, the author was encouraged to bring his sexual orientation to the forefront
at the long-treatment center he attended. The author is pleased to report he has been sober for
more than 21 years and is quite well adjusted in his sexual orientation.
Separate Populations.
The author would like to address the differences in the GLBT populations themselves. The
author needs to point out that not all members of the transgendered population feel like they fit in
to the GLBT label and in addressing of their health care needs. Post gender reassignment surgical
patients have a whole host of issues than those others in the GLB populations do not. This

HEALTH CARE DISPARITIES IN THE GAY POPULATION.
writing does not attempt to address of the needs of the transgender population but does mention
the fact that this population has its own set of health care disparities.
Disparities Based on Social Norms and Attitudes.
Most states in the United States prohibit same sex marriage which allows companies in those
states to not address the health care needs of employees chosen family. Domestic Partners of
GLBT employees, in many instances, or not eligible for corporate benefit packages. Many GLBT
couples fall under the label of Domestic Partners because the states in which they live do not
allow same sex marriage. This causes a disparity. While heterosexual employees may come to
work knowing that the health care needs their families are being taken care of through the
company health care plan, the GLBT may not. The GLBT employee may have a Domestic
Partner at home who may be suffering from illness and not be able afford health care. This is
factual information. By pointing out this information, the author hopes to bring to fact that laws
based on societal norms and feelings of what is right and wrong, have real human
consequences to those being discriminated against. In this particular example, the disparity that
exists is access to care. Prior to the legalization of same sex marriage in the state of
Massachusetts, the Massachusetts Department of Public Health formed a group to address the
health care needs of the GLBT population. The Gay, Lesbian, Bisexual and Transgender Health
Access Project were formed in 2009. (Harkness, p. 349.2012). This effort was created to make
health care accessible to this group. Populations that do not suffer disparities in health care need
no such efforts or projects.
Policies
As mentioned previously in this paper, many states and countries have laws prohibiting same
sex marriage, which in turn, decrease access to health care based on lack of employer provided

HEALTH CARE DISPARITIES IN THE GAY POPULATION.
health benefits for domestic partners of employees. This is law in most states in the United
States. In some countries is illegal to be GLBT period. In the states where same sex marriage is
prohibited, employers are free to offer health benefits to the domestic partners if they so choose.
Based on the perceptions of community norms and or the whims of those in charge of
organizations they may choose to offer all employees benefits to cover their families, as the
employee defines family, or not. Bronson Healthcare Group in Kalamazoo, Michigan offers
Domestic Partner benefits. Spectrum Health, West Michigans largest employer, does not. The
author worked for many years for Bronson Hospital earlier in his life and now is employed by
Spectrum Health. The author is quite active in lobbying Spectrum Health to provide Domestic
Partner health benefits. He will not stop until this policy is changed. The policy has impact on
the health of GLBT employees of Spectrum Health by not allowing them the peace of mind that
those they love have insurance coverage based on decisions made by the organization in which
they work.
Contributing Factors
Most of Spectrum Health is located in Grand Rapids, Michigan. Grand Rapids and the
surrounding area has been traditionally a very conservative area. Some of the wealthiest
benefactors to Spectrum Health hold very strong opinions on matters that affect the GLBT
community and especially same sex marriage. These attitudes may play a major role in why
Spectrum Health is reluctant to provide domestic partner benefits. Attitudes towards health care
access must change to serve all and cannot be based on local attitudes or norms (Gay Lesbian
Medical Association, 2012). The author realizes that he lives in a conservative area, but still sees
progress in the Grand Rapids Area. He hopes that justice in providing health care to all will soon
prevail.

HEALTH CARE DISPARITIES IN THE GAY POPULATION.

References
Bronson Healthcare Group.org
Frederiksen-Goldsen, K., Kim, H., Barkan, S,. Muraco, A. (2013) Health disparities among
lesbian and bisexual older adults: results from a population based study. American
Journal of Public Health. 103(10) 1802-9. doi:10.2105/AJPH.2012.301110.
Gay Lesbian Medical Association.org
Harkness, G. & DeMarco, R. (2012). Community and public health nursing: evidence for
practice. Philadelphia, PA. Lippincott Williams & Wilkins.
Sirota, T. (2013) Attitudes among nurse educators toward homosexuality. Journal of
Nursing Education. 52(4) 219-27. doi: 10.3928/01484834-20130230-01
Spectrum Health.org