LGBTQIA+ couple holding hands on a walk in the parkShare on Pinterest
FG Trade/Getty Images

If you’re reading this, hopefully you agree with that statement full-heartedly. Unfortunately, members of LGBTQIA+ communities do not always receive that kind of care.

“Despite the progress we have made as a country toward granting equal rights to those who identify as LGBTQ+, this community continues to experience worse health outcomes and reduced access to care when compared to their heterosexual and cisgender counterparts,” says Brentton Lowery, PA-C.

Lowery is an AAHIVS certified specialist in HIV prevention and a sexual health and medical provider with Nurx.

There are a number of factors at play, such as higher rates of behavioral health issues, lower rates of insurance coverage, a lack of cultural competence in the medical setting, and, sadly, even outright discrimination on the part of some medical professionals, he says.

“These disparities are even more likely to impact LGBTQ+ individuals who are part of a racial or ethnic minority group.”

Here, a full breakdown on seven of the top health disparities facing LGBTQIA+ communities. Plus, insight on what you can do to navigate these disparities as an LGBTQIA+ person, as well as an LGBTQIA+ ally.

As you read through this guide, keep in mind that the Centers for Disease Control and Prevention (CDC) defines health disparities as “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.”

So to be very clear: LGBTQIA+ communities are not innately more prone to the issues discussed below.

LGBTQIA+ communities have higher rates of things like anxiety, depression, and substance misuse due to systemic inequalities. These inequalities lead to worse care and worse health outcomes for LGBTQIA+ people.

Across the board, LGBTQIA+ people have worse mental health outcomes compared to other communities. This includes anxiety.

The Anxiety and Depression Association of America (ADAA) estimates that somewhere between 30 and 60 percent of lesbians, gay men, bisexuals, or transgender people deal with anxiety and depression at some point in their lives.

That rate is 150 percent to 200 percent higher than that of their straight or gender-conforming counterparts, the ADAA says.

Why? A combination of discrimination, bullying, and lack of acceptance, according to mental health professional Dr. Kryss Shane, LSW, LMSW, author ofThe Educator’s Guide to LGBT+ Inclusion.”

What you can do to help as an ally

There’s no shortage of things you can do to support the well-being of LGBTQIA+ people. You can:

  • Create an atmosphere in which someone who is LGBTQIA+ feels safe sharing information about their identity with you.
  • Believe people when they share their identity with you.
  • Actively fight for the rights of your LGBTQIA+ friends.
  • Offer financial support to your queer friends, acquaintances, and family members — as well as the queer people you connect with through online fundraising and mutual aid requests.

What you can do as an LGBTQIA+ person who wants to prevent this

If it’s safe for you to do so, you might consider sharing this information with those around you.

Why? “Being ready to be open [about your sexuality] and not being able to be — due to family, society, career — can lead to having to live a double life,” says Shane.

“Having to keep that type of secret and having to always live in fear of being discovered can be exhausting and result in anxiety, depression, self-harm, and suicidality,” she says.

Other things you can do to reduce anxiety:

  • Work with a mental health care professional.
  • Practice mindfulness.
  • Engage in deep breathing techniques.
  • Explore anti-anxiety medications.

The National Institute of Mental Health says that out of the entire population, about 7 percent of people will have a bout of depression at least once in their life.

For LGBTQIA+ communities, that rate is much higher. The advocacy group Human Rights Campaign found that 28 percent of LGBTQ youth, and 40 percent of transgender youth, report depressive symptoms some or all of the time.

Kids may be especially prone to depression, according to educators, due to a combination of the below:

  • lack of representation in school, media, or peers
  • lack of access to language to name what they are experiencing and who they are
  • lack of access to community

What you can do to help as an ally

Ask yourself what you can do to unlearn the narrative that someone is cisgender and straight unless “proven” otherwise.

“Straightness and cis-ness are still assumed until an LGBTQ+ person announces otherwise,” says Jesse Kahn, LCSW, CST, director and sex therapist at The Gender & Sexuality Therapy Center in New York City. “For some people that means having to hide or shield parts of themselves in all, a variety of, or in certain situations.”

This can be painful, difficult, or fragmenting.

As an ally, you can do things like use gender-neutral language and pronouns until a person shares their gender and dating preferences with you.

You can also:

  • Implement clear policies against discrimination in your places of work and play.
  • Financially support LGBTQIA+ support groups.
  • Include LGBTQIA+ topics in your media consumption.

What you can do as an LGBTQIA+ person who wants to prevent this

If you’re in a dark place, you can:

  • Reach out to a trusted friend, family member, or healthcare professional.
  • Call 911 or your local emergency number if you can’t get in touch with them.
  • Stay with a person you can be yourself with.
  • Ring a crisis or suicide prevention hotline like the National Suicide Prevention Lifeline at 800-273-8255.

And not by a small margin.

The Alcohol Rehab Guide says that 25 percent of the general LGBTQ community has moderate alcohol dependency, compared to just 5 to 10 percent of the general population.

Why is the rate of alcohol misuse higher? A number of reasons, including the fact that people use it as a coping mechanism for the stress of everyday discrimination.

The Center for American Progress adds that a lack of queer-competent healthcare services also fuels high substance use rates among LGBTQIA+ people. Another reason is the fact that the majority of queer-friendly and queer-specific spaces have a high usage of alcohol. (Think: gay bars, nightclubs, raves, and so on.)

Another factor is that recovery-based spaces are less queer-inclusive than they could be, notes sober sexpert Tawny Lara, co-host of Recovery Rocks Podcast. Recovery Rocks is a podcast that explores the issues impacting those who struggle and recover.

“Putting rainbows on a flyer just isn’t enough,” she says. “Regardless of the type of recovery space — peer support group, a sober event, AA meeting, et cetera — the recovery space needs to make sure that different types of people have the opportunity to speak and be seen.”

What you can do to help as an ally

Generally speaking, if you’re hosting an event of any kind, it’s a good move to make sure that nobody feels pressure to partake in substance use. That means not interrogating someone’s decisions not to drink, or judging anyone for what’s in their drink.

If you are a member of a recovery space, you might:

  • Introduce yourself with pronouns, or suggest that people write their pronouns on their name tags.
  • Use gender- and sexuality-inclusive language in your speech, marketing, and social media.
  • Create a diversity board.
  • Invite queer sober experts to speak on panels and events.

Finally, if you’re simply looking for a way to support queer people in recovery, Lara recommends volunteering.

“Over 40 percent of New York City’s homeless youth is queer-identifying,” she says. “This means that this large amount of people don’t have basic necessities like food and shelter provided for, so seeking help for substance use disorder is usually lower on their priority list.”

Volunteering at queer homeless shelters and providing resources for free support groups can truly save someone’s life, she says.

What you can do as an LGBTQIA+ person who wants to prevent this

Take comfort in the fact that there *are* queer-inclusive recovery spaces that you can access, if you so choose. Lara recommends checking out the following Instagram pages to find one near you:

Alcohol isn’t the only drug for which LGBTQIA+ people have higher misuse rates.

A 2016 report found that drug misuse may be more common among LGBTQIA+ individuals, as opposed to heterosexual men and women.

And a 2017 study published in the Journal of School Health found that transgender middle and high school students were nearly 2.5 times more likely to use cigarettes, tobacco, alcohol, marijuana, cocaine, and ecstasy, and to misuse prescription pain medications, diet pills, Ritalin, Adderall, and cold medications, than their cisgender peers.

The reason these rates are so high? Minority stress.

What you can do to help as an ally

According to the National Institute of Drug Abuse, the following have all been shown to effectively treat misuse issues:

  • motivational interviewing
  • social support therapy
  • contingency management
  • cognitive behavioral therapy
  • addiction treatment programs

To support larger LGBTQIA+ communities, you might:

  • Offer lower- or no-cost mental health care services.
  • Volunteer at an addiction treatment program.
  • Volunteer at an LGBTQIA+ support line.
  • Hang up fliers about queer-inclusive recovery spaces at the places that you frequent.

To support a specific queer friend through recovery:

  • Build their trust.
  • Respond compassionately.
  • Educate yourself.
  • Be patient.
  • Don’t enable them.

What you can do as an LGBTQIA+ person who wants to prevent this

The professionals with the SAMHSA National Helpline at 800-662-4357 can help you devise a game plan.

If you’re interested in becoming part of queer sober spaces, check out the Gay and Sober directory for online and in-person offerings.

The Lesbian, Gay, Bisexual & Transgender Community Center has a resource directory that may also be helpful.

You’ve probably heard that STI rates are at an all-time high.

Reports from the CDC showed a 19 percent increase in chlamydia, 56 percent increase in gonorrhea, and 74 percent increase in syphilis cases between 2015 and 2019.

But while all populations can be and are at risk of STIs, figures show that LGBTQIA+ people — specifically gay and bisexual men — are at an increased risk of these infections.

“Despite what appeared to be a drop in STI rates during the COVID-19 pandemic, new data suggest that STI levels may have increased during 2020 and the numbers only dropped because people weren’t able to access testing,” Lowery notes.

What you can do to help as an ally

“It’s important for medical providers to offer a safe place for people of all genders and sexuality to be open about their sexual practices and work together to come up with a comprehensive testing and care plan,” Lowery says.

If you’re not a healthcare professional, you might:

  • Donate to Planned Parenthood.
  • Volunteer at a sexual health clinic.
  • Make safer sex information available in your community.

What you can do as an LGBTQIA+ person who wants to prevent this

Stay up to date on your own STI status, and become informed about how to have safer queer sex.

For information on where and how to get lower-cost STI testing in your state, check out this STI testing guide. And for information about safer sex, read this LGBTQIA+ safer sex guide.

According to the CDC, adolescent and adult gay and bisexual men made up 69 percent of the 36,801 new HIV diagnoses in the United States in 2019.

What you can do to help as an ally

If you’re a medical professional, Lowery says it’s important that you continue to educate yourself. Support your staff in finding ways to create an atmosphere that makes LGBTQIA+ individuals feel seen and heard.

“From the moment LGBTQIA+ people walk into the clinic doors to the time they leave the clinic,” she says. It’s important to have clear signals, from the registration paperwork all the way to the types of posters that are displayed in the exam room.

“Only when a patient is made comfortable will they disclose all the things that are so vital to their overall care, and will help us understand how often they should have HIV testing and whether they should be on PrEP,” she says.

“If we as medical providers continue to perpetuate the stigma around sexual health, then we will never be able to see an HIV-free world.”

What you can do as a LGBTQIA+ person who wants to prevent this

Know your STI status by getting tested regularly!

And talk with a healthcare professional about going on preexposure prophylaxis (PrEP). PrEP is a medication that helps HIV-negative individuals stay negative, if:

  • You have multiple sexual partners.
  • You have sex with someone who is living with HIV.
  • You use intravenous drugs or have a partner who does.

On the topic of sexual health: One of the consequences of not screening LGBTQIA+ people regularly is that doctors aren’t catching cases of human papillomavirus (HPV) early enough.

Some strains of HPV can evolve into cervical cancer, so the repercussions of not knowing your HPV status can be severe.

A 2015 study shows that heterosexual women have a significantly lower prevalence of cervical cancer (14.0 percent) compared with lesbian women (16.5 percent) and bisexual women (41.2 percent).

To be very clear: This is *not* because LGBTQIA+ people are innately more prone to HPV or cervical cancer! These differences are caused by unequal access to STI testing and to information about safer queer sex. According to a 2010 study, they may also be due to a lack of adherence to screening guidelines.

What you can do to help as an ally

Ultimately, it depends!

If you’re a healthcare professional, check out this American Medical Association guide on how to create a practice friendly toward LGBTQIA+ people.

If you’re a sexuality professional or parent who talks to (their) kids about sex, making sure that queer pleasure-seekers have accurate information about safer queer sex is a m-u-s-t.

The following resources can help:

What you can do as an LGBTQIA+ person who wants to prevent this

If you have a cervix, get HPV testing, a pap test, or screening for cervical cancer on a regular basis, says Lowery.

“For some trans men and nonbinary people with cervixes, getting a pelvic exam can be upsetting, so it’s important to see an affirming medical provider who can handle it with sensitivity,” he says. Ditto goes for anyone who has a history of sexual trauma or sexual pain, which is also known as dyspareunia.

“Nurx offers home HPV tests for cervical cancer screening, which can be a great option for trans guys and nonbinary people with cervixes who want to avoid the in-person exam,” he says.

Also: get the HPV vaccine! “If you didn’t get it as a teen it’s not too late,” he says. “Even if you’ve been infected with HPV, the vaccine can protect you from other strains of the virus.”

These seven health disparities are just the tip of the health disparity iceberg for queer people.

To continue learning more about the health disparities LGBTQIA+ individuals face, check out the following resources:

Gabrielle Kassel is a New York-based sex and wellness writer and CrossFit Level 1 Trainer. She’s become a morning person, tested over 200 vibrators, and eaten, drunk, and brushed with charcoal — all in the name of journalism. In her free time, she can be found reading self-help books and romance novels, bench-pressing, or pole dancing. Follow her on Instagram.