The Centers for Disease Control and Prevention (CDC) define health equity as “the state in which everyone has a fair and just opportunity to attain their highest level of health.” However, for members of the LGBTQIA2s+ community (which we’ll collectively refer to in this article as LGBTQ), this has been a considerable challenge, and one that compromises emotional, mental, and physical health for everyone.
Constant Historical Struggle
The complicated medical history for LGBTQ people across the world extends back decades, with some countries even considering them criminals. According to LGBTQ+ Studies: An Open Textbook, “perhaps no theories of sexual identity have been more influential than psychoanalytical theory and behaviorism,” and the rise of medical scrutiny of the LGBTQ community began in the 1800s.
The National Library of Medicine states that when the American Psychiatric Association (APA) first published the Diagnostic and Statistical Manual (DSM-I) in 1952, “it listed all the conditions psychiatrists then considered to be a mental disorder…including ‘homosexuality’ as a ‘sociopathic personality disturbance.’ In DSM-II, published in 1968, homosexuality was reclassified as a ‘sexual deviation,’” and looked upon as something to be “cured” and returned to a heteronormative state.
Consequently, generations of medical practitioners, psychiatrists, and other healthcare professionals operated under extreme prejudice with their LGBTQ patients who suffered from various conditions—if they treated them at all.
Finally, in 1973, the APA reversed its decision. However, NLM also indicates that it wasn’t until 1990 that the World Health Organization removed homosexuality from the International Classification of Diseases. “As a consequence, debates about homosexuality gradually shifted away from medicine and psychiatry and into the moral and political realms as religious, governmental, military, media, and educational institutions were deprived of medical or scientific rationalization for discrimination.”
Unfortunately, health equity rights have only regressed since then. At press time in 2023, approximately 650 anti-LGBTQ legislative bills were introduced in 46 states. In fact, USA Today reported that “a record number of hostile bills—315—were introduced in state legislatures in 2022. Now, in just the first few months of 2023, there have been more anti-LGBTQ bills introduced than in all of 2012-2015 combined.” Lawmakers ushered in these bills, the news agency noted, “despite nearly 80 percent of Americans saying they support nondiscrimination protections for LGBTQ people.”
The Need for Equitable Access
There are numerous substance abuse challenges for LGBTQ individuals, many of which stem from a lack of proper health care, generational trauma, and mental and emotional health resources.
The CDC states that “achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and healthcare disparities.”
But what’s the difference between equality and equity? Here’s how the Robert Wood Johnson Foundation defines them, which we provide verbatim:
- Equality: everyone gets the same, regardless if it’s needed or right for them
- Equity: everyone gets what they need, understanding the barriers, circumstances, and conditions
The foundation further notes that “The determinants of health include living and working conditions, education, income, neighborhood characteristic, social inclusion, and medical care. An increase in opportunities to be healthier will benefit everyone but more focus should be placed on groups that have been excluded or marginalized in the past.”
Health equity means supporting affordable, accessible care for all people, taking into consideration notable cultural differences, but regardless of:
- Ability
- Age
- Ethnicity
- Geographical location
- Gender identity or expression
- Nationality
- Race
- Sex
- Sexual orientation
- Socioeconomic status
Members of the LGBTQ community in the U.S. make up nearly 10 percent of the population, and are often denied proper care on one or more of the above factors. The Movement Advancement Project also points out inequities in healthcare laws and policies, as well as residual discrimination and institutional bias in the healthcare system that further compound issues.
Additionally, the CDC indicates that full health equity “reduces health disparities among populations disproportionately affected by HIV, viral hepatitis, sexually transmitted diseases, tuberculosis, and other related conditions.”
Where to Turn for Help
There are a few organizations with a mission to provide equity care access to members of the LGBTQ community including, but not limited to:
The Gay and Lesbian Medical Association
GLMA is “the world’s oldest and largest association of lesbian, gay, bisexual, transgender, and queer and allied health professionals.” Individuals can find providers, participate in research, and seek out other resources.
This national initiative launched in September 2013 to “connect our communities—LGBT people and our families, friends, and allies—with the new health insurance coverage options available under the Affordable Care Act.”
This next-generation organization focuses on LGBTQ racial and gender justice through the advocacy of queer, trans and allied youth leaders for safer schools and healthier communities.
A project of the Tegan and Sara Foundation, this organization “fights for health, economic justice and representation for LGBTQ girls and women.”
National Minority Health Alliance
NMHA, part of the Make Well Known Foundation, mobilizes numerous resources to address the leading causes of morbidity and mortality in “Black, Hispanic/Latino, Asian/Pacific Islander, and American Indian communities.”
QSpaces
This community-driven site of patients and providers promotes LGBTQ health equity by allowing people to “rate and review their health and wellness providers to help others.”
Fair Oaks: An Ally for Healing
The core philosophy of our addiction treatment center in Sacramento is to honor the human dignity of every person we work with, and we feel privileged to support a process of change with our safe space of inclusion. Our professionals acknowledge collective challenges, but also strive to embrace each individual’s background and provide customized solutions for their future success as a whole person—mind, body, and spirit. Ask a member of our admissions team how we can help you.
