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2019 Southern LGBTQ Health Survey: More than 50 percent of LGBTQs find it difficult to access quality healthcare in the South

A study conducted with 5,600 community respondents from the southern states of the country has brought forth the struggles that LGBTQ members of society face when it comes to getting quality healthcare.
UPDATED FEB 20, 2020
(Getty Images)
(Getty Images)

The state of healthcare for lesbian, gay, bisexual, transgender, and queer (LGBTQ) persons, especially the transgender community in the south is dismal with more than 70 percent of LGBTQ persons experiencing emotional abuse due to their sexual orientation or gender identity and more than 50 percent finding it difficult to access quality healthcare because of who they were and the region they were living in. 

A study, conducted with 5,600 community respondents from the southern states of the country has brought forth the struggles that LGBTQ members of society face when it comes to getting quality healthcare. It is called the 2019 Southern LGBTQ Health Survey and was conducted by two Ashville-based organizations, The Campaign for Southern Equality and Western North Carolina Community Health Services.

Dr. Austin Johnson, Research Director at the Campaign for Southern Equality and Assistant Professor of Sociology, Kenyon College, said across the board, respondents were struggling with mental health, depression, anxiety, and suicidal ideation – and respondents who are transgender, non-binary, bisexual+, or rural, as well as those with lower incomes, reported worse health experiences by nearly every measure.

"Now we need to leverage this report to make the case to health care providers, lawmakers, funders, and individuals that it's time to dig deep and work to ensure that quality care is available to all LGBTQ people across the South, no matter who you are or where you live", Johnson told MEA World Wide.

The 174-page report that took 18 months to complete presents deep-rooted disparities in the south for the LGBTQ community that impact their bodies, health, and their lives. Home to more than a third of the LGBTQ population in the country, the rates of suicide ideation, self-harming behaviors, depression, anxiety, struggles with HIV are alarming. The survey found that rates of LGBTQ people living with HIV are more than 15 times higher than the national rate. This is the largest survey of its kind.

"The Campaign's Report on Southern LGBTQ health is an incredible resource for our communities. This detailed report includes a wealth of information on health disparities impacting LGBTQ Southerners, without even describing the impact of tobacco use - which remains our number one health risk", said Executive Director of National LGBT Cancer Network, Liz Margolies.  

Nearly a quarter of all Black or African American respondents (22 percent) said they were living with HIV, as did 13 percent of all gay male respondents. More than half of respondents in the total sample said they never or rarely get tested for HIV. 

Less than 50 percent of Southerners said they had access to satisfactory healthcare while they also had higher rates of depression, anxiety, and suicidal thoughts than cisgender LGBTQ respondents. "There are limited facilities that provide healthcare for persons who are undergoing hormone replacement therapy, getting an appointment takes months and usually a referral from a certified counselor to begin HRT", said Montgomery Pride United, an Alabama based LGBTQ advocate organization. 

Healthcare providers are often untrained in the HRT or hormone therapy care and specialized endocrinology that are crucial to transgender patients. "Persons who require injections for HRT may not receive the appropriate sizes of needles or syringes or receive a limited supply - adding to the discomfort and fear of self-injecting hormones - which a large percentage of transgender patients suffer with," Meta Ellis, activist and Director of Montogmery Pride said.

The financial burden becomes strong as they seek treatment hundreds of miles away, impacting childcare finances and time off work. In addition, some insurance companies will not cover HRT or Gender Affirming Surgery, she said. In addition, there is the issue of discrimination in staff and facilities and "deadnaming" due to fear of exposure.

The survey also found that those living in rural parts faced even more disparities in healthcare in both mental and physical health. Older patients may have never even disclosed their gender identity or sexual preferences in the fear of being "outed", especially in rural communities.

The advocates for LGBTQ rights are now calling for action. Rev. Jasmine Beach-Ferrara, Executive Director of the Campaign for Southern Equality, that while the findings were hopeful and heartbreaking, things need to change. "Access to healthcare is a basic right, but you need to understand a community’s health care needs before you can meet them. Now, armed with this new data, we must work harder than ever to accelerate change and build a South where LGBTQ people can finally access the health care they need in their hometowns", she said.

A big jump forward would be making healthcare accessible and affordable to all. "Until healthcare is accessible and affordable for everyone, disparities will continue to mirror broader and - sadly - enduring economic and class distinctions in the USA," said Darryl Mitteldorf, clinical social worker and the director of the gay men's cancer support network, Malecare, and chairperson of the National LGBT Cancer Project. 

He says that while the survey is excellent, there is a need to understand healthcare disparities in-depth - "The Report is brilliant but fails to investigate the barriers of LGBTQ inclusion in clinical trials", he said, "For example, we do not know why gay men initially diagnosed with low-grade prostate cancer are less likely to progress to high grade - and life-threatening - prostate cancer than heterosexual men." There is a need for the LGBTQ community to be included in the demographics in clinical trials. "In 2019, I continue to hear investigators and researchers wonder if asking someone if they are gay or straight will be harmful to their research. The next report should focus on homophobia among medical caregivers", he added.

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