Reflecting on PRIDE Month: Health Care Disparities

July 27, 2020 · NCQA Communications

People and organizations everywhere celebrated PRIDE month in June–a time to honor and support the LGBTQ community.

PRIDE month was also an occasion to acknowledge the health care inequality and disparities that this community faces.


Disparities affecting the LBGTQ community are complex. They intersect with race, ethnicity, age and gender. Some LGBTQ cohorts experience greater discrimination and health inequities than others:

  • LGBTQ communities of color endure a disproportionate share of social risk factors, including violence, with trans women of color accounting for four out of five anti-trans homicides.[1]
  • Lesbian and bisexual women who are African American are at greater risk for, diabetes and hypertension than their white counterparts.[2]


LGBTQ youth are disproportionately impacted by social determinants of health. These include homelessness and behavioral health issues such as substance use disorder.

This population is more likely to have felt sad or hopeless compared to their heterosexual peers (60% v. 26%), seriously considered suicide (43% v. 15%), or attempted suicide (29% v. 6%).[3]LGBT youth also have a 120% higher risk of reporting homelessness.[4]


The LGBTQ community also faces increased barriers to health care access and discrimination in treatment. Seventy percent of trans and gender non-conforming people reporting experiences with discrimination in care, such as being refused needed care.[5] And despite being at higher risk for HIV, 56% of gay and bisexual men say that a doctor has never recommended they get tested for HIV.[6]

Through our work to identify and address health care disparities and the social determinants of health within the LGBTQ community, we see potential for greater data collection on sexual orientation and gender identity to help inform the creation of targeted interventions and quality improvement initiatives.

We invite everyone we work with—health plans, medical practices, employers, states and the federal government—to contribute to the conversation and find ways to examine current practices and create meaningful change.

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