When it comes to the health care and concerns of LGBTQ individuals, we still have a long way to go.
“I was in college when my doctor told me I didn’t need need to have an STI test despite being sexually active,” Anna K., a 29-year-old cis lesbian, says. “When I asked him why, he said that it was unlikely for another woman to [pass on an STI] to another woman. I had to insist and threaten to get a new doctor before he’d do it. I was so frustrated… it was like I had to teach him.”
Anna K. went on to add that she knew of several LGBTQ friends that had experienced similar treatment from doctors, experiences that ranged from simple misunderstandings or assumptions to downright poor treatment due to “ignorance about queer people.”
How does this differ from cisgender heterosexual women’s experiences with doctors? Aimee Uchytil, a nurse practitioner at Callen-Lorde Health Center in New York City, which focuses on LGBTQ health care, says queer women are more prone to experience “assumptions and invisibility” from their health care professionals, adding, “For heterosexual women, there’s no real barrier in being honest about who you’re having sex with.” These assumptions from doctors that cause feelings of invisibility can make queer women afraid, sometimes preventing them from going to the doctor at all.
Cis queer women are far from the only ones that meet opposition when going to the doctor’s office. We spoke with a bisexual trans woman, who wished to remain anonymous, about her experiences with doctors after she transitioned.
“The forms I had to fill out for my doctor [as a new patient] only had “male” or “female” identities, so I picked female because, you know, I’m a woman,” she says. “But when my doctor asked when I’d had my last Pap [smear and] I told him I didn’t need one because I was trans, he got really mad… [he] didn’t understand why I didn’t pick the male box on the form. He said I wasted his time. I never went back there.”
Places like Planned Parenthood train their staff to be inclusive and sensitive to LGBTQ people, including offering many LGBTQ-specific medical necessities, like hormone therapies, STI testing and information on mental health, support groups and more. Unfortunately, more and more Planned Parenthoods are closing across the country, making accessible health care for queer people even more limited and difficult to come by. It makes sense that cuts would have a negative impact on lesbian, bisexual and trans women given how many use Planned Parenthood as their primary care facility.
According to Gallup, even after the Affordable Care Act passed, LGBTQ adults are still less likely to have health insurance than straight people, likely keeping them from visiting the doctor due to rising health care costs in the United States. On average, lesbians, bisexual women and trans women were unable to even afford to see the doctor. On top of that, 29 percent of lesbian and bisexual women and 31 percent of trans people reported that in the last year, they were unable to afford health care compared to 19 percent of straight women, 21 percent of LGBTQ men and 15 percent of straight men.
Not going to the doctor for any number of reasons can have huge implications for queer women. According to the National LGBT Cancer Network, a “cluster of risk factors” — including but not limited to homophobia from the health care industry, the prominence of alcohol use among lesbian and bisexual women and not giving birth before age 30 — can double a cis queer woman’s chances of cancer. There is currently limited data on cancer in queer women, but it is a solid conclusion that any of these factors put LGBTQ people “at a greater risk of late stage cancer diagnosis.”
Doctors’ assumptions about cis lesbians and bisexual women, especially those dating or married to another woman, actually have a direct impact on their cervical cancer risks. The reason? The human papillomavirus is most commonly passed during intercourse between cis men and women, so many doctors mistakenly assume lesbians have never had sex with cis men in the past. It is also possible to pass HPV from skin-to-skin contact or sharing sex toys, something that occurs in many relationships between women.
Joachim Voss, a professor at the University of Washington School of Nursing, says, “If we are serious about reducing the rates of cervical cancer in lesbians, an unbiased health assessment by a provider” is necessary. This assessment would assume that not everyone is straight, not everyone is cis and not everyone’s partner is straight or cis. It would make a huge difference in the way queer women feel about doctors and improve the overall health of queer women — and there’s definitely a lot of room for improvement.