Improving Access to Care for the LGBTQIA+ Community

Access to the necessary care is already a critical issue for teens and adults in the CHD community. But for members of the LGBTQIA+ Community, the added uncertainty over stigma can lead to inappropriate care and even avoidance of treatment altogether. In this week’s guest blog, Joseph Lindsey, a public health professional, discusses the hurdles this community faces within the healthcare system.

Individuals living with congenital heart defects (CHDs) require specialized medical care that is often complex and inclusive of many members of the health care team to ensure complete, competent care. Another group that needs specialized care that may often not be thought about is people who identify as members of the LGBTQIA+ community. Both groups require such niche health care because they do not fit the mold of the American health care system as it stands today, and this must be addressed head-on. CHD is often associated with childhood and adolescence, which often runs in parallel to the period when people begin figuring out who they are, what they like, who they like, and how they will identify. As a result, CHD and this developmental period often intersect, creating the need for both CHD-competent and LGBTQIA+-competent care. 

One of the largest ways in which individuals who identify as LGBTQIA+ face gaps in health care is a complete lack of access which can be challenging, and often life-threatening, for individuals who may be also navigating a CHD. Ensuring that someone living with a CHD who also identifies as a member of the LGBTQIA+ community has access to health care is quintessential to survival, and because of this, conversations about proper care for children, adolescents, and teenagers living with CHDs cannot be had without this community also in mind. 

15 percent of LGBTQ Americans report postponing or avoiding medical treatment due to discrimination

Center for American Progress – 2020

Another common way some of the members of the LGBTQIA+ community may receive less-than-ideal care is the experience of stigma. When members of this community visit their health care providers (HCPs), it is often reported that these individuals experience some form of stigma. This experience often leads to the individual being untruthful with their provider for fear of being stigmatized. The HCP may then be unable to provide adequate care without a clear picture of the patient. Some HCPs are openly uncomfortable when treating members of this community, which expands on the feelings of stigma experienced by the patient. It is especially important that the HCP is cognizant of things like sexuality, gender identity, pronouns, preferred name, etc. when conducting exams or another diagnostic testing to ensure that patients who lie at this intersection feel comfortable enough to continue with their cardiac care after leaving home.

HCPs must be trained on how to deliver competent LGTBQIA+ care, and providers fighting CHD are no different. Providing various training sessions and continuing medical education opportunities will help ensure HCPs are delivering LGBTQIA+ competent care. This, in turn, will ensure that CHD patients feel comfortable with their providers, are able to be honest, and remain in care.

Joseph (Joey) was born with aortic stenosis and a bicuspid aortic valve that required open-heart surgery during his junior year of high school. Originally from Texas, Joey moved to Washington, DC after undergrad to pursue an MPH from George Washington University. After graduating in 2020, he moved to Brooklyn, New York for a job with the New York City Department of Health – Division of TB Control. In his free time, he enjoys going to spin class, hanging out with his dogs, and traveling with his partner. Growing up with a CHD has inspired him to one day attend physician assistant (PA) school and practice public health-based medicine, with a special emphasis on LGBTQIA+ competent primary care.

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