In 2021 I had finally gone to my first in-person GYN visit after almost 2 years of tele-health visits. I was looking forward to seeing my Black female physician. I had been experiencing intense cramps and expressed my concerns during this visit. She replied asking if I could be pregnant and, before I could even get a word out, she said “we’ll do a pregnancy test anyway.” I immediately felt uncomfortable, since I’d expressed before I was very gay and in a monogamous relationship with my girlfriend of 2 years. I used all the confidence I could muster up to say, “that won’t be necessary, I am a Lesbian and want that noted in my chart for future reference please.” I naively thought that my discomfort at the doctor would disappear once I had a physician that looked like me and could relate to my unique struggles being a Black woman but, in fact, it didn’t solve everything. My queerness and my racial identity are equally important and what makes me, me.

My experience visiting the doctor wasn’t unique. Sadly, many members of the Lesbian Gay Bisexual Transgender Queer Intersex Asexual + (LGBTQIA+) community have difficulty navigating a health system that wasn’t made for us. Our health system, policies, structure, and medical education cater to heteronormativity and those that identify as cis-gendered, leaving it up to us in some instances to educate our providers about our sexuality and identity. Coupled with living in a world that perpetuates anti-blackness, Black LGBTQIA+ individuals are navigating through multilayered discrimination that has resulted in devastating health disparities. According to a 2021 study conducted by the University of California Los Angeles School of Law Williams Institute, approximately 1.2 million adults in the United States self-identify as Black and Lesbian, Gay, Bi-sexual, or Transgender and are at greater odds of being diagnosed with several serious health conditions including asthma, heart attack, and cancer compared to Black non-LGBT adults.

Despite these odds, 24% of LGBTQIA+ people of color have reported some form of negative or discriminatory treatment from a doctor or health care provider. 68% of Transgender individuals of color reported negative or discriminatory treatment from a doctor or health care provider, while 27% of white transgender respondents reported the same. We must speak in the same breath about the racist history that has made the Black community feel distrustful of the healthcare system while discussing the blatant homophobia that exists in our society today and how these compounding factors contribute to health disparities within the LGBTQIA+ community. More than 50% of medical schools do not offer formal training on LGBTQIA+ unique health concerns outside of HIV/AIDs. According to a nationally representative survey conducted in June 2020 by the Center for American Progress, 18% of LGBT individuals of color had to teach their provider about their sexual orientation to receive appropriate care while 8% of white LGBT individuals reported the same. Additionally, 10% of LGBTQ people of color had a doctor refuse to see them because of their sexual orientation.

Black LGBTQIA+ individuals deserve better; they have a right to receive patient- centered and gender-affirming care that allows them to be their healthiest and best version of themselves. The goal of The Health Equity Index (HEI) survey, created by the Human Rights Campaign is to address LGBTQIA+ health disparities by promoting and implementing equitable change in the healthcare setting that is more inclusive and welcoming to the LGBTQIA+ community. The survey looks to evaluate foundational protections such as appropriate training and policies implemented by a healthcare institution, progress toward more inclusive LGBTQIA+ care and support services offered, a demonstrated public commitment to the LGBTQIA+ community, and dedication to cultivating an inclusive workforce. Black LGBTQIA+ individuals are encouraged to utilize the HEI annual report to identify health institutions that are dedicated to providing patient-centered, gender-affirming care. Black LGBTQIA+ individuals should also feel empowered to be vocal about any discrimination, bias or ill-treatment faced, ensuring that health institutions are held accountable. Black LGBTQIA+ health matters; let’s start talking about it.

Resources for the Black LGBTQIA+ Community:

• Coming Out: Living Authentically as Black LGBTQ People
• Black LGBTQIA+ Therapy Fund
• The Trevor Project
• It Gets Better Project: Organizations Serving the Black LGBTQ+ Community