A recent study in the online journal BMJ Open suggests that LGBTQ people in the United States are less likely to be employed or have health insurance compared to straight people. This, the study’s researchers suggest, is due to anti-LGBTQ bias.
“Discrimination, along with other social and economic barriers, can lead to unemployment, and subsequently lack of health insurance and healthcare access. All of these factors may contribute to poor health-related quality of life…which is a critical measure of health status,” the article states.
The study’s data comes from a 2013 follow-up survey that was part of an ongoing U.S. research project that began in 1996 called Growing Up Today. The project participants were mostly white and came from middle to upper-class backgrounds, and their ages ranged from 18 to 32 years. About 10,000 people participated.
The study’s authors acknowledge that there are limitations to this specific sample — like the lack of low economic class participants or elderly ones — which may lead to an underestimation of unemployment and those without insurance. It also solely examines sexual orientation.
“It is striking that these sexual orientation disparities are pervasive among participants who predominantly hold high social status. Given this high social status we may have underestimated levels of unemployment, being uninsured, and having poor health-related quality of life,” Brittany Charlton, the lead author of the study and an assistant professor at T.H. Chan School of Public Health at Harvard University, told Reuters.
According to the research team’s conclusions, women and men who identify as LGBTQ are about twice as likely to have been unemployed and uninsured in young adulthood. LGBTQ young adults also reported worse health than straight young adults. Other conclusions were made comparing subgroups within the sample. For instance, bisexual women were more likely to be uninsured than lesbian and mostly heterosexual women. They were almost four times as likely compared to heterosexual women.
Gay men had a 50 percent higher chance of being unemployed because of an illness or disability. Lesbian women were 84 percent more likely.
Twenty-eight states in the U.S. still have no employment non-discrimination law that covers sexual orientation, with three states actually having laws overriding local anti-discrimination laws. The authors explain that their paper could assist policymakers in crafting legislation that decreases health inequalities.
“Previous research has shown that nearly half of all sexual minorities experience employment discrimination in their lifetime, which can lead to disparities in health insurance coverage, and ultimately to health-related quality of life,” Charlton said.
Her team wanted to see if these findings could be seen in a much larger sample.
“Our findings highlight the ubiquity of sexual orientation inequalities in the employment and health care systems,” she explained to Reuters.
A Center for American Progress report in 2017 showed that LGBTQ people have faced discrimination in health care settings and that such discrimination prevents them from seeking the care they need.
This included eight percent of LGBTQ respondents saying a medical professional refused to see them because of their sexual orientation, six percent refusing medical care, and nine percent being verbally mistreated. Seven percent reported unwanted physical contact.
For trans people, the treatment is worse. The same report found 29 percent of trans respondents say that a doctor or health professional refused to see them because of their gender identity.
Because of this discrimination, many in the survey said they avoided returning for medical assistance.
“The expansion of legislation, lawsuits, and administrative rule-making allowing for broad religious exemptions from providing services puts another impediment in the way of LGBTQ people receiving medical care,” according to the Center for American Progress. If people are turned away then there may not be other alternatives, especially in rural areas and for treatment for mental health care.
A recent example of discrimination in the health-related services includes the treatment of a trans woman at a CVS in Arizona. A pharmacist refused to fill Hilde Hall’s hormone prescription. The CVS employee was terminated and CVS apologized to Hall.
“I felt like the pharmacist was trying to out me as transgender in front of strangers. I just froze and worked on holding back the tears,” Hall wrote in a blog post for ACLU.
She added, “When I asked for my doctor’s prescription note, the pharmacist refused to give it back, so I was not even able to take it to another pharmacy to have my prescription filled. I left the store feeling mortified.”
Hall’s doctor was able to call the prescription in to a local Walgreen’s store, she wrote.
But just like in healthcare, employment has also been a location of discrimination for many LGBTQ people.
The Human Rights Campaign found that many LGBTQ people are not out at work and face an increasingly hostile environment in the workplace over the past year, as INTO reported earlier. Though many companies are working on creating inclusive policies, LGBTQ workers are still facing prejudice in the office.
Charlton and her colleagues specifically call for better treatment in order to protect health care for minority groups.
“Until all people, regardless of sexual orientation, are treated equally in the eyes of the law, including with non-discrimination laws protecting employment as well as housing, public accommodations, and credit/lending,” Charlton and her team write, “sexual orientation-related health disparities will persist.”
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