Disproportionate share of LGBT Minnesotans are excluded from health care system

Researchers, physicians and community leaders met at the University of Minnesota earlier this week to discuss issues of public health and health care access in Minnesota’s LGBT community. The event, held in conjunction with Gay, Lesbian, Bisexual, Transgender Health Awareness Week, underscored a number of troubling disparities.

“In 2004, the Minnesota Health Access Survey indicated that 22 percent of LGBT Minnesotans do not have health insurance compared with 7 percent of the total Minnesota population,” said Gary Schiff, openly gay Minneapolis City Council member. “The fear of discrimination and stigma cause many LGBT Minnesotans to postpone or decline seeking medical care and once in care often withhold critical personal information from providers.”

Schiff said that this leads to poorer health outcomes and access to care: “We want to ask ‘why?’ And we want to eliminate the barriers to care.”

Dr. Simon Rosser, an HIV prevention researcher at the university said the top concern for gay and bisexual men remains HIV and added it will take new and innovative strategies to prevent an explosion in new cases.

For other segments of the community, there are other unique health issues. “For lesbians, we have a number-one health problem that includes disproportionately high breast cancer [rates], where at least part of the problem is lack of adequate screening,” said Rosser. “For transgender people, the problem is getting specialized services and competent service providers” who understand the unique health issues facing transgender Minnesotans.

Communitywide and among LGBT youth, “increased rates of depression, suicide, and alcohol and drug use” are prevalent problems, he said.

Dr. Eric Meininger, an internist and pediatrician, provided some perspective on the provider side of the problem. “When I completed my medical school training in 1995, most students got no cultural competency training on LGBT patients. The only context we learned about homosexuality was in the context of AIDS,” he said. “The [University of Minnesota] is a very progressive place. Students now get a number of trainings on LGBT issues.”

While Minnesota is on the cutting edge, “many students around the country still get minimal training,” he said.

But beyond provider responsibilities lie societal barriers to health care. “There are acts of legislation and policy to block our families from accessing health coverage, and as a result surveys of the LGBT community show lower rates of being insured,” said Meininger.

“Here’s the problem,” Rosser agreed. “When health care is tied to marriage and employment, the people least able to access and who end up not getting into health care are those for whom it is illegal to marry, such as gays and lesbians, and those who frequently find it more difficult to find jobs, such as transgender people transitioning.

“The people who most need the care and, from a public health standpoint, who we most want in care, are the people who the system disproportionately discriminates against,” he said. “We need to recognize our system is broken. We need to recognize health care is a right.”

Gay, Lesbian, Bisexual, Transgender Health Awareness Week was created by the National Coalition for LGBT Health and locally is sponsored by the Minnesota Department of Health, the Rainbow Health Initiative, University of Minnesota GLBTA Medical Students, the Queer Student Cultural Center, the University of Minnesota GLBTA Programs Office, and OutFront Minnesota.