* Any views expressed in this opinion piece are those of the author and not of Thomson Reuters Foundation.
Doctors must understand the needs of their queer patients, particularly as LGBTQ+ rights are going backwards in the United StatesTraci Keen is chief executive of Mate Fertility, a US-based fertility company bringing inclusive, high-tech, affordable clinics to underserved markets.
I will never forget the obstetrics and gynecology (OB-GYN) doctor who told me at an annual checkup that I didn’t need tests for sexually transmitted infections, a cervical cancer smear, or other regular care after learning that I identified as a lesbian.
Even in my early 20s, I knew this went against medical evidence. I wanted to take preventive measures about my health, but the doctor’s assumptions were getting in the way. After feeling confused and frustrated, I was able to find other physicians who were more aware of LGBTQ+ reproductive health. But I know others are not always so lucky.
Sadly, I also know this experience is all too common.
Many studies show that LGBTQ+ Americans are more likely to report negative experiences with healthcare providers than our non-LGBTQ+ peers. In a national survey, 12% of LGBTQ respondents reported having to teach healthcare providers about their identity in order to get adequate treatment.
Even more concerning, another survey found that 8% of lesbian, gay, bisexual and queer respondents and 29% of transgender respondents said that a provider refused to see them in the past year because of their identity. A major factor in this discrimination is the lack of education that physicians receive about LGBTQ+ health.
While this has been an issue for years, our country’s current political climate makes the situation more dangerous than ever. In 2023, states have introduced more than 500 bills targeting the LGBTQ+ community. At least 17 states have passed laws restricting or banning gender-affirming care. At least 14 states have banned all or nearly all abortions, which affects queer people who can become pregnant and threatens to make it more difficult for providers to offer infertility services, an important lifeline for many LGBTQ+ people who want to build families.
Fertility care is an important part of reproductive justice — the idea that everyone should get to choose if, when, and how they build their family — that presents particular barriers for LGBTQ people. Not only are many providers unfamiliar with queer people’s reproductive needs, but the services are often too expensive and too far away for people to use them.
In addition, many insurance plans don’t cover LGBTQ+ couples seeking fertility services, while others impose infertility requirements that don’t apply to queer patients.
I don’t believe most medical providers act out of malice. But we know that many doctors still don’t receive sufficient training on how to treat LGBTQ+ patients.
A 2017-18 report from the Association of American Medical Colleges found that while most schools included some LGBTQ+ information in their curriculums, half of schools reported three or fewer lectures, group discussions or other activities.
While some schools have added coursework since then, another survey of OB-GYN medical residents in Illinois published in 2021 found that 50% felt unprepared to care for lesbian or bisexual patients and 76% felt unprepared to care for transgender patients.
Now is a time when all medical providers, especially those involved in any kind of reproductive health care, need to step up to protect the rights of their queer patients. Doctors, health systems, physician groups and other providers not only need to accept LGBTQ+ patients, but they also must educate themselves so they can fully care for people with respect and support.
Fortunately, as a society, we’ve seen some major progress already. Queer medical student groups have advocated for more inclusive training for new generations of doctors. LGBTQ-focused digital health companies such as Folx Health and Plume now prioritize queer patients and broader telehealth startups like BetterHelp and TalkSpace that have expanded their LGBTQ+ offerings. And professional groups for many medical specialties have created continuing medical education opportunities for providers to learn about designing more inclusive practices.
But making conscious decisions to use inclusive language, avoid assumptions, and proactively learn about a large sector of the population is something that all medical providers can do.
It doesn’t have to take significant resources to be truly inclusive of LGBTQ+ patients, but it is necessary if we want to help all Americans build the families they want and deserve.
