A barrier is anything that will impede progress. Each and every person in society will one day face some type of barrier in their lifetime. It could be inequality, racism or discrimination, which are among every social class, gender, religion, nationality, and sexuality. These barriers are sometimes seen in healthcare.
Even with the implementation of the Affordable Care Act (ACA), there has been a specific community that continues to face barriers – the LGBTQI (Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex). Even with a rapid growth within this community, the barriers continue because of the lack of training and knowledge from physicians and their staff, marriage inequality.
Sexual minorities face barriers in routine and emergency care, disease prevention, and transgender-related services. Such barriers are called healthcare disparities and refer to differences in the access to or availability of facilities and services.
Although immense lengths have been taken to reduce health disparities in the LGBTQI community, there is still more emphasis needed in the areas of marriage, healthcare equality, and adequate training for physicians and frontline staff.
The first area of significant importance for eliminating healthcare disparities in the LGBTQI community is marriage that is connected to the acceptability or bans of same-sex marriages. This sphere can be perceived from two perspectives: legal (passing appropriate legislation and implementing adequate support programs in healthcare) and social (making effort to turn same-sex marriages into a socially acceptable phenomenon).
The problem of same-sex marriage bans is associated not only with significant psychological distress but also severe barriers in the healthcare sectors, such as the inability to make medical decisions for a child being brought up in a same-sex family, reduced access to healthcare services, and the lack of protection, resulting in lower healthcare outcomes (Daniel & Butkus, 2015; Hatzenbuehler, O’Cleirigh, Grasso, Mayer, & Safren 2012).
In this way, in order to help eliminate healthcare disparities, it is critical to guarantee that same-sex laws are not only passed but also supported by the community and their provisions are followed by healthcare facilities. It means that the development and implementation of adequate control measures aimed at protecting rights to the access to healthcare for everyone belonging to the LGBTQI community is critical (Daniel & Butkus, 2015; Hatzenbuehler et al., 2012).
Except for passing and supporting the same-sex marriage laws, it is imperative to pay special attention to taking steps aimed at enhancing equality in the healthcare sector. As in the first case, this one is connected to inadequate or limited access to professional medical care because of one’s sexuality – the invisibility of sexual minorities’ special needs (Ard & Makadon, 2012).
This area is institutional in its nature, as it is associated with internal changes within any healthcare facilities. The motivation for this statement is the fact that healthcare equality is stated in most healthcare legal documents as well as statutes of healthcare facilities because non-discrimination is, basically, the foundation of the operation of this sector.
Nevertheless, in practice, this provision is commonly violated. In order to cope with the challenge of healthcare disparities, it is paramount to promote control measures as well as enhance the participation of healthcare facilities in various nationwide initiatives aimed at support of sexual minorities.
For instance, the promotion of LGBTQI-inclusive services measured by Healthcare Equality Index would help to overcome the problem of disparities because the participation in similar measurement initiatives (and higher index indicators) are helpful for improving the image of a healthcare facility, not to mention benefits for sexual minorities (Harley & Teaster, 2016).
More than that, adequate training for physicians and frontline staff is inseparable from the elimination of healthcare disparities in the LGBTQI community because neither the adoption of laws and regulations nor institutional changes can help to reduce inequality without the involvement of professional human resources.
The foundation of these steps is training staff in compliance with some basic principles, such as equality of patients without regard to their sexuality, the existence of sexual minorities special care needs (especially in case of transgender patients), understanding the identity of LGBTQI patients, etc. (National LGBT Education Center, 2013).
It is essential to note that training should focus on making professionals both clinically and culturally competent when it comes to specific needs of minority patients (Hatzenbuehler et al., 2012). In this case, not only future staff should be trained.
Instead, healthcare facilities should as well invest in developing adequate training programs for helping currently employed physicians and frontline staff to eliminate disparities. What is even more critical, both clinical and non-clinical staff should be trained in order to reduce the risks of maltreatment and discrimination of LGBTQI patient to the maximum extent (National LGBT Education Center, 2016).
Finally, it is essential to note that including different types of training programs (lectures, video materials, and webinars) would potentially increase the effectiveness of staff training due to the versatility of approaches and presented materials.
To sum up, healthcare disparities in the LGBTQI community is still one of the most critical challenges in achieving overall equality to healthcare services.
Nevertheless, implementing well-developed initiatives in the areas of marriage, enhancing equality, and training physicians and frontline staff are among the most important steps for overcoming the challenge. Still, institutional and legal improvements will not make a substantial difference if the dominant members of the community do not engage actively in solving the problem.
Ard, K. L., & Makadon, H. J. (2012). Improving the healthcare of lesbian, gay, bisexual, and transgender (LGBT) people: Understanding and eliminating health disparities.
Daniel, H., & Butkus, R. (2015). Lesbian, gay, bisexual, and transgender health disparities: Executive summary of policy position paper from the American College of Physicians.
Harley, D. A., & Teaster, P. B. (2016). Handbook of LGBT elders: An interdisciplinary approach to principles, practices, and policies. New York, NY: Springer.
Hatzenbuehler, M. L., O’Cleirigh, C., Grasso, C., Mayer, K., & Safren, S. (2012). Effect of the same-sex marriage laws on health care use and expenditures in sexual minority men: A quasi-natural experiment. American Journal of Public Health, 102(2), 285-291.
National LGBT Education Center. (2013). Affirmative care for transgender and gender non-conforming people: Best practices for frontline healthcare staff. Retrieved from http://www.lgbthealtheducation.org/wp-content/uploads/13-017_TransBestPracticesforFrontlineStaff_v6_02-19-13_FINAL.pdf
National LGBT Education Center. (2016). Introduction to LGBT Health. Retrieved from https://www.lgbthealtheducation.org/topic/lgbt-health/