The LGBTQ+ Health Guide: Key Health Considerations for All

Did you know that more than 7% of U.S. adults identify as LGBTQ+?

As acceptance of LGBTQ+ individuals continues to grow across the U.S. and around the globe, more attention is being paid to the health of the LGBTQ+ community.

Though the healthcare system of decades past was not highly accommodating to the community, today’s healthcare providers are working to build a more inclusive and diverse industry that provides care for people of all backgrounds.

Caring for your physical and mental health is the key to living comfortably in your body. In this article, we look at the specific health considerations for members of the LGBTQ+ community to showcase the importance of personal health for LGBTQ+ individuals.

Read on to discover how LGBTQ+ individuals can better care for their health and well-being.

Overview: Health Considerations for All LGBTQ+ People

Regardless of how you identify, all LGBTQ+ people should maintain a broad awareness of their physical, mental, and sexual health. Staying healthy and ensuring your body is properly cared for can be crucial not only for your physical well-being but also for building confidence and self-assuredness.

Before diving into the important health considerations for people of different gender identities and sexualities, let’s first examine some general health guidelines for everyone to follow:

• Sexual Health Screenings: Regular screenings for sexually transmitted infections (STIs) are essential for all people, regardless of sexuality or gender. According to the CDC’s Sexually Transmitted Disease Surveillance report, there were more than 2.5 million cases of gonorrhea, chlamydia, and syphilis in 2021 alone. Testing for conditions like HIV, syphilis, gonorrhea, chlamydia, and hepatitis should be routine. Additionally, LGBTQ+ people should seek out healthcare providers they feel comfortable being fully transparent with when discussing their personal sex lives and sexual experiences.
• Mental Health: The LGBTQ+ community faces unique mental health challenges due to societal stigma and discrimination. SAMHSA reports that lesbian, gay, and bisexual adults are more likely to experience substance abuse, mental health conditions, and thoughts of suicide than straight adults. This makes prioritizing mental health essential for LGBTQ+ individuals, as the risk is higher for mental health conditions to worsen or develop without the proper resources. Seeking support from therapists, support groups, and other counseling providers can be a fundamental component to improving your mental health.
• Discrimination and Healthcare Access: While many healthcare providers are working to build a more inclusive and open-minded healthcare industry, many LGBTQ+ people still face tremendous discrimination when seeking care. The Center for American Progress reports that at least 8% of LGBTQ+ people have been outright refused service by healthcare providers due to the patient’s sexual orientation. Additional barriers, such as financial constraints and lack of knowledgeable providers, can further diminish the community’s access to fair healthcare.
• Physical Fitness and Nutrition: Maintaining a healthy diet and regular exercise routine contributes significantly to your overall health and can reduce the risk of various health conditions. Yet, traditional fitness spaces can be challenging for the LGBTQ+ community — according to one 2020 study published in the Journal of Eating Disorders, half of the participants reported feeling uncomfortable in public gyms as a direct result of their sexual orientation. For LGBTQ+ people who may be struggling to find a reliable healthcare provider, focusing independently on improving your fitness and nutrition can be a great first step to addressing any physical or mental health problems you may be experiencing. Additionally, working to improve your physical fitness and nutrition can help you identify areas in which you struggle, such as with self-image or recurring pain.
• Sexual Practices: Along with regularly performing sexual health screenings, LGBTQ+ people can take additional measures to protect themselves from sexually transmitted diseases (STDs) and infections (STIs). Being informed about safe sex practices — such as using condoms and dental dams — can make a major difference in preventing the spread of STDs and STIs. Free public resources make a huge difference in ensuring LGBTQ+ can access adequate sexual education content, such as The Trevor Project’s Resources for Sexual Health Support. Moreover, being aware of potential risks associated with different sexual activities can help LGBTQ+ people to make safe choices and know when to seek help for a potential health issue related to sex.

• Family Planning and Fertility: In a 2019 Family Equality report, 63% of LGBTQ+ millennials (ages 18 to 35) were considering expanding their families by either having more children or becoming first-time parents. A further 63% of all LGBTQ+ people surveyed in the report stated they plan to use assisted reproductive technology, foster care, or adoption to become parents. For those interested in starting a family, discussions about fertility options, reproductive technologies, and family planning should be part of your healthcare conversations. Whether you plan on using a donor, adopting, or fostering children, knowing how your health overlaps with your role as a parent is crucial. If you do plan on having a biological child and are above the age of 35 (or plan on waiting until later in life), researching how to preserve your eggs and/or sperm is an important first step.

One of the best things any LGBTQ+ person can do for their health is to find a healthcare provider they trust and attend routine check-ups. During routine visits, your healthcare provider can discuss any concerns you may have regarding your health and help you create a plan for reaching your health goals that aligns with the demands of your busy schedule and social life.

Now that we have covered the basics of healthcare for LGBTQ+ people, let’s dive into the specifics for each gender identity and sexuality.

Health Considerations for Cisgender Gay and Bisexual Men

For cisgender gay and bisexual men — as well as for anyone engaging in anal intercourse — the most crucial added health consideration to keep in mind is HIV and AIDS prevention.

Although HIV and AIDS can affect people of all genders and sexualities, the disease has a long history of within gay communities. Due to discriminatory healthcare practices that often led to mistreatment, many gay and bisexual men lost their lives during the HIV and AIDS epidemic that began in 1981.

Today, the disease remains incurable, but two key medical advancements have helped to slow the spread and even prevent new infections:

• Pre-Exposure Prophylaxis (PrEP): Pre-Exposure Prophylaxis (PrEP) is a vital preventive measure that involves taking medication (usually Truvada or Descovy) daily to significantly lower the risk of contracting HIV. According to the CDC, PrEP can reduce the risk of contracting HIV from sex by around 99% when taken as prescribed. It is essential to consult healthcare providers to discuss its usage, effectiveness, and potential side effects.
• Post-Exposure Prophylaxis (PEP): Post-Exposure Prophylaxis (PEP) involves taking antiretroviral medications after potential exposure to HIV to prevent the virus from establishing itself in the body. The CDC states that starting PEP as soon as possible, preferably within 72 hours of exposure, is crucial for it to be most effective.

Both PrEP and PEP require prescriptions, making it all the more important for gay and bisexual men to have access to a primary healthcare provider. Early intervention is often the key to preventing HIV, and discussing your options with your doctor is a great first step for protecting your sexual health.

Aside from PrEP and PEP, the third vital health consideration for gay and bisexual men is substance abuse. SAMHSA reports that one-third of gay men, bisexual men, and bisexual women have dealt with a substance abuse disorder (SUD) within the past year.

Additionally, SAMHSA reveals the prevalence of serious mental illness is three times higher among bisexual men and more than twice as high among gay men when compared to straight men.

Health Considerations for Cisgender Lesbians and Bisexual Women

Cisgender lesbians and bisexual women face both physical and mental health challenges that are critically important to address properly. Mental health and substance abuse tend to be particularly prevalent problems among this group, along with reproductive health risks that all women must consider.

Let’s take a look at the unique health considerations for cisgender lesbians and bisexual women:

• Reproductive Health: Even if your risk of pregnancy is low as a lesbian or bisexual woman, biological reproductive processes can still disrupt your health if not properly cared for. Regular gynecological check-ups, including Pap smears and screenings for sexually transmitted infections (STIs), are crucial. Discussions about contraceptive options, menstrual health, and any reproductive concerns should be part of your routine healthcare.
• Breast Health: Breast cancer is a particular type of cancer that affects women specifically more than men. Cisgender women, regardless of sexual orientation, should be aware of their breast health and perform regular self-exams to check for lumps and irregularities. The American Cancer Society states that lesbian and bisexual women have an increased risk of breast cancer due to higher substance use, excess body weight, and either never having children or having children later in life.
• Cervical Cancer Screening: Alongside breast cancer, the next major form of cancer for lesbians and bisexual women to consider is cervical cancer. Regular Pap smears or HPV tests are vital for detecting any abnormalities in the cervix that may lead to cervical cancer. Vaccination against HPV, which can cause cervical cancer, is also recommended.

It is crucial for cisgender gay and bisexual women to engage in open and honest discussions with healthcare providers about their specific health needs, including reproductive health, unique cancer risks, and mental health concerns.

Regular check-ups and health screenings based on individual risk factors and healthcare provider recommendations are essential for maintaining overall health and well-being.

Health Considerations for Transgender & Non-Binary People

Transgender men and women — as well as non-binary people — face unique healthcare challenges.

Depending on the type and degree of gender-affirming care a transgender or non-binary person seeks out, there may be specific complications or side effects to consider. Additionally, transgender and non-binary people tend to face greater healthcare discrimination compared to their cisgender counterparts, which can contribute to mental health issues faced by the transgender community.

Here are the top health considerations for transgender individuals to keep in mind:

• Gender-Affirming Care: Access to gender-affirming healthcare, including hormone therapy and surgeries, is often paramount for the happiness and overall well-being of transgender people. However, discrimination or lack of access to knowledgeable healthcare providers can impede this care, impacting mental and physical health. As such, it is crucial for transgender people to perform thorough research on different healthcare providers to find the practice that best suits their long-term goals and needs.
• Mental Health Support: Transgender individuals often face higher rates of mental health issues like depression, anxiety, and gender dysphoria due to societal stigma, discrimination, and a lack of acceptance in their personal lives. According to the Center for American Progress, transgender adults are more than twice as likely as cisgender adults to be diagnosed with a depressive disorder. Additionally, transgender adults report more than twice the amount of poor mental health days compared to cisgender adults. Access to mental health services and support groups is essential for ensuring better mental health for transgender and non-binary individuals.
• Hormone Therapy Risks: Hormone therapy, while vital for many transgender individuals, comes with potential risks. These hormone therapy risks include cardiovascular issues, as well as changes in cholesterol levels and increased risks of blood clots. Regular monitoring by healthcare providers is necessary to mitigate these risks. Additionally, should a transgender person choose to stop hormone therapy, doing so requires medical supervision to avoid unwanted side effects.
• Cancer Screenings: Transgender individuals might have specific cancer risks and screening needs. For instance, transgender women may still have a prostate and require prostate cancer screenings if they haven’t undergone surgery. Additionally, transgender men might need cervical cancer screenings if they haven’t had a hysterectomy. Finding a healthcare provider that is knowledgeable in these kinds of needs and how gender-affirming care impacts your needs is key.

Creating inclusive healthcare environments, training providers in transgender healthcare, and addressing systemic barriers to care are crucial steps in ensuring the holistic well-being of transgender individuals.

Encouraging open and respectful communication between healthcare providers and transgender patients is fundamental in addressing their unique health considerations.

Health Considerations for LGBTQ+ Youth

When considering which sub-group within the LGBTQ+ community is at the greatest overall risk, LGBTQ+ youth often come to mind.

While adults have the freedom and autonomy to seek out healthcare providers independently, minors must typically rely on their parents or guardians to obtain such care. Depending on the mindset of a minor’s parents, this may or may not be a realistic option for a minor to get the care they need.

Additionally, unless a minor is living in a highly LGBTQ-friendly environment, they likely will not have access to the necessary resources and support to learn more about safe health practices.

With this in mind, let’s look at the specific health considerations for LGBTQ+ youth:

• Mental Health & Suicide Prevention: LGBTQ+ youth often experience higher rates of mental health challenges such as depression, anxiety, and higher risks of suicidal thoughts or behaviors due to stigma, discrimination, and social rejection. According to the Trevor Project, roughly 41% of LGBTQ+ youth have considered suicide, while 14% have attempted suicide. For adults looking after LGBTQ+ kids, understanding the warning signs of deteriorating mental health in minors and creating safe environments where minors feel supported are two extremely important steps to take to help prevent mental health crises amongst the LGBTQ+ youth.

• Substance Abuse & Vaping: LGBTQ+ youth might be more likely to engage in substance use — including smoking cigarettes, vaping nicotine, smoking weed, or drinking alcohol — as a way to cope with stress or as a result of social factors. The Trevor Project reports that around 56% of LGBTQ youth have used alcohol in the last year, 47% of whom were under the age of 21. Additionally, smoking marijuana and misusing prescription drugs were prevalent among LGBTQ youth. Awareness campaigns and support programs aimed at reducing substance use within this population are crucial.
• Sexual Health Education: LGBTQ+ youth may not receive adequate sexual health education that is inclusive of their identities and needs. Providing comprehensive and inclusive sexual health education can empower them to make informed decisions and reduce the risk of STIs. However, without the right level of support from both parents and educators, LGBTQ youth can end up feeling on their own when learning about sex education.
• Supportive Environments: Creating safe and supportive environments in schools, families, and communities is essential for improving the health of LGBTQ youth. Not only are safe environments vital for alleviating mental health issues but they also help LGBTQ youth to feel accepted and willing to discuss any physical or mental health issues they may be dealing with.

Addressing these health considerations is paramount for helping LGBTQ youth experience life to the fullest without fear of discrimination or judgment. By providing safe and supportive spaces for LGBTQ youth to learn, you can ensure they have the resources needed to make smart decisions for their health.

Final Thoughts: Finding a Healthcare Provider as an LGBTQ+ Person

Finding a healthcare provider who is knowledgeable and sensitive to the needs of LGBTQ+ individuals is crucial for receiving affirming and inclusive care. If you are a member of the LGBTQ community, taking the time to research different providers and select the one that best fits your wants and needs is key.

To close out this guide, let’s cover seven essential steps for finding your ideal LGBTQ-friendly provider:

1. Ask for Referrals: Seek recommendations from friends, family, or LGBTQ+ community groups. They might know healthcare providers who are LGBTQ+-friendly or have experience in providing care to LGBTQ+ individuals.
2. Use Online Directories: Several online directories list LGBTQ+-friendly healthcare providers. Websites like GLMA (Gay and Lesbian Medical Association) have directories where you can search for healthcare professionals by location and specialty.
3. Call or Interview Providers: Contact potential healthcare providers’ offices and ask specific questions regarding their experience with LGBTQ+ patients. Inquire about their approach to LGBTQ+ healthcare, whether they provide hormone therapy or gender-affirming care (if relevant), and their general approach to patient care.
4. Ask LGBTQ+ Organizations: LGBTQ+ community centers or advocacy organizations might have lists of healthcare providers they recommend or partner with for LGBTQ+ healthcare. This can be especially important for people assigned female at birth (AFAB) to find comprehensive reproductive healthcare that aligns with their personal goals and needs.
5. Check Reviews and Feedback: Online reviews or testimonials from LGBTQ+ individuals about their experiences with healthcare providers can provide insights into the quality of care and how inclusive the provider is. If a provider claims to be LGBTQ-friendly but only has negative reviews from LGBTQ patients, it may be time to find a new provider.
6. Consider Specialized Clinics or Centers: Some clinics or healthcare centers specialize in LGBTQ+ healthcare. These centers often have healthcare professionals with expertise in LGBTQ+ health and provide comprehensive care, and may even offer providers and specialists who are also members of the LGBTQ+ community.
7. Trust Your Instincts: During your first visit, observe how the healthcare provider interacts with you and whether they are respectful and open. Trust your feelings about whether you feel comfortable discussing LGBTQ+ health concerns with them.

Remember, finding the right healthcare provider is about finding someone you trust and feel comfortable with. Don’t hesitate to ask questions about their experience, approach to LGBTQ+ healthcare, and their willingness to address your specific health needs. Your healthcare should be inclusive, respectful, and affirming of your identity.