A Doctor Who Looked Like Me Still Didn’t Solve Everything

In 2021, I had finally gone to my first in-person GYN visit after almost two 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. I had shared before that I was gay and in a monogamous relationship with my girlfriend of two years. Gathering all the confidence I could, I said, “That won’t be necessary. I am a lesbian, and I would like that noted in my chart for future reference, please.” At the time, I naively believed my discomfort in healthcare settings would disappear once I had a physician who looked like me. I thought she could relate to my experiences as a Black woman. But I quickly learned that representation alone did not solve everything. My queerness and my racial identity are equally important and what makes me, me.

Navigating a System That Wasn’t Made for Us

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. This leaves 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. This 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. They are at greater odds of being diagnosed with several serious health conditions, including asthma, heart attack, and cancer, compared to Black non-LGBT adults.

The Impact of Bias in Healthcare

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. We must also discuss the blatant homophobia that exists in our society today. 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. By comparison, 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

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. It does this by promoting and implementing equitable change in healthcare settings that are 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. It also examines progress toward more inclusive LGBTQIA+ care, 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. These individuals should also feel empowered to be vocal about any discrimination, bias, or ill-treatment faced. This helps ensure 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