If you or someone you love is part of the LGBTQ+ community and managing a chronic illness, it’s important to find a health care provider who respects and understands LGBTQ+ identities. Feeling comfortable enough to share your identity with a supportive provider can significantly enhance the care you receive and could positively affect overall health outcomes.

Derek Schmitz, a chronically ill, multiply disabled, nonbinary, queer young adult advocate and accessibility consultant, highlights the importance of finding a supportive health care environment. In their first experience with a rheumatologist, Schmitz felt relieved when their doctor’s first question was about their pronouns. “That immediately set my mind at ease, and I was comfortable disclosing my nonbinary and queer identities,” says Schmitz.

In addition to this comfort, finding a trusted health care professional who respects and understands LGBTQ+ identities can help you access more tailored support and resources. For instance, in health care areas like sexually transmitted infections (STIs), understanding your sexual history allows providers to do appropriate screenings and treatments.

“A lot of people use a heteronormative standard of a urine test and blood test to check for STIs,” says Thomas Carlton, MD, a board-certified gastroenterologist. “But a lot of doctors across the entire country fail to do rectal swabs to check for rectal gonorrhea and chlamydia, or oral swabs to check for oropharyngeal gonorrhea and chlamydia, so those infections get missed.”

Moreover, people in the LGBTQ+ community are more than twice as likely as heterosexual individuals to face a mental health disorder in their lifetime, per the American Psychiatric Association, so disclosing your identity may help ensure that your provider integrates mental health into your overall care.

While these examples show that disclosing your identity can lead to better health care outcomes, it’s normal to feel nervous about these conversations. Despite many positive interactions reported by LGBTQ+ adults with health care providers, a recent GHLF survey of over 245 LGBTQ+ participants with inflammatory bowel disease found that more than 18 percent of those who hadn’t shared their gender identity and/or sexuality with their doctor believed doing so would negatively impact their care.

When deciding whether to share your identity, prioritize your safety and access to care,” advises Schmitz. “If this discussion is likely to result in your loss of care access or safety, I’d unfortunately recommend not broaching the subject or having that conversation.”

If you are hesitant for any other reason, Schmitz recommends asking how your provider supports members of the LGBTQ+ community. “If they react positively to your question, you know they’re likely a ‘safe’ provider,” says Schmitz. “If not, I’d again recommend that you place your safety and access to care first and evaluate your decision from there.”

Preparing for Your Conversation

Preparing for and guiding this conversation can empower you to advocate for your health care needs.

Research Your Doctor’s Office

“Talking to your friends locally about who they go to for their health care can be a good way to find a provider you’re comfortable with, or you can speak to people online or via apps about their favorite doctors,” says Dr. Thomas.

If you’re in a rural area and can’t find doctors who are the right fit, online health care may be an option, depending on your needs. You can also check GLMA.org for LGBTQ+-friendly doctor’s offices.

Ask About the Patient Population

You can also call ahead to get a sense of the office, or ask a friend to if you’re nervous to do so. “They don’t have to say a name, but can ask, ‘Do you have a queer and trans population?’” says Julius Joi Johnson-Weaver, MD, a Black, neurodivergent, trans, non-binary physician.

Check the Office Environment

Look for more clues that you’re in an LGBTQ+ friendly office when you first visit or check it out online.

“Looking for affirming language can also be helpful,” says Dr. Johnson-Weaver.  For instance, an example of affirming language might be the doctor asking how you can be addressed rather than assuming “Mr.” or “Mrs.” — or asking what your gender identity is, rather than asking “Are you male or female?”

If the doctor’s office asks for your pronouns and sexual orientation, that can go a long way in showing they’re mindful of treating LGBTQ+ patients.

The imagery an office displays is also important in creating an inclusive environment. “It should show patients who are diverse ethnically, in body size, and in sexuality,” adds Dr. Johnson-Weaver.

Initiating the Conversation

If you can, having an open and honest discussion about your LGBTQ+ identity with your health care provider is essential for receiving more personalized and comprehensive care. Here are some strategies to initiate this important conversation.

Be upfront and honest

Once you feel like you’re in a safe environment to do so, be as upfront about your identity as you can when speaking with your doctor.

“If you’re going for general health check-ups, this is part of who you are and an important part of your social history,” says Dr. Thomas. “I tell people to just be honest — for instance, ‘I’m a man who has sex with men’ or ‘I’m a trans person with these sexual experiences.”

Consider writing it down

If the above conversation makes you nervous, you can write what you want your doctor to know ahead of time. “It can have your pronouns, chosen name, sexuality, trans status, and so forth, and you can just hand it to the provider,” says Dr. Johnson-Weaver.

Don’t wait for the provider to ask

Unfortunately, not every doctor will ask you about your LGBTQ+ identity, particularly if it’s not a very affirming office or they don’t have much background knowledge on the LGBTQ+ community.

In this case, bring it up to them. ”If this is a doctor you want to disclose those things to, it can be empowering,” says Dr. Johnson-Weaver. “You’re telling them right away, ’This is who I am.’”

What to Do If You Face Discrimination

If you experience discrimination once you disclose your identity, you can contact your state’s medical board to take action on what happened.

The vast majority of hospitals are required to have patient grievance processes in place that allow patients to address concerns. You can learn how to file a complaint by checking your hospital’s Patient Bill of Rights.

You can also contact the Joint Commission (a nonprofit group that accredits about 80 percent of the nation’s hospitals and reviews quality of care complaints) at 1-800-994-6610, via email, or file an online complaint.

Complaints of discrimination can also be filed online or via email with the United States Department of Health and Human Services.

“We all know there are some battles we choose and others we don’t, where we just choose to go somewhere else,” says Dr. Johnson-Weaver. “But knowing your rights and having the backing of the local community can be helpful.”

Real Patient Stories

Schmitz was met with open-mindedness during their second disclosure experience with a primary care provider. However, because they were not asked about their identity, it proved to be a more nerve-wracking experience.

“I was extremely nervous, but slightly hopeful, with my primary care provider since I had to bring up the topic and lead the discussion without being able to gauge her response before I disclosed,” says Schmitz. “With my rheumatologist, I was immediately at ease because he broached the topic and opened the door.”

That said, Schmitz says both doctors seemed to value their trust in them and understand the gravity and power of their disclosure. Even for doctor’s visits where identity may not be as pressing of a topic, knowing your provider understands your identity can put you at ease as a patient.

“It doesn’t really affect my rheumatology treatments, but I am appreciative of the fact that my rheumatologist has never once misgendered me since I disclosed,” says Schmitz.

For Kelsey Feng, a disabled queer demisexual non-binary person, they will only disclose their identity if they see multiple indicators that it is safe to do so — such as asking for pronouns on intake paperwork, LGBTQ+ flags displayed, and gender-inclusive pronouns.

“I’ve always felt anxious; I think because it’s a matter of safety,” says Feng. “I don’t truly know how someone will react until it’s out in the open. Since I can sometimes pass as a less visibly queer person, I get the privilege of being better protected because of that, but many queer people don’t get this privilege.”

In Feng’s experience, very few providers have been truly knowledgeable and sensitive to LGBTQ+ health care needs. “Most providers are not educated about the specific health care needs of LGBTQ+ people,” says Feng. “For example, I have polycystic ovary syndrome (PCOS) and every provider I’ve seen regarding it always assumes I want to get on birth control to bring back my menstrual cycle, so that I can have kids one day.”

Feng says that while their honest answer is they do not know if they want kids one day, they’ve been shamed and judged for hesitating with their answer. “What I want is to manage my PCOS symptoms to improve my overall health and have a provider be knowledgeable about managing it in a nonbinary patient,” says Feng.

To find an affirming doctor, Feng recommends reading patient reviews, seeking out recommendations from trusted sources, and looking for clear signs that a doctor’s office is LGBTQ+ friendly.

“Over the years, I’ve gotten better at determining which providers are more open-minded and inclusive,” says Feng. “Whenever I go to a university health system, they are much better about my identity. They make fewer assumptions about my health goals and collaborate with me to find solutions that work for both of us.”

On the other hand, Feng says they’ve had providers who invalidated them and made them fear for their safety — underscoring the importance of finding the right doctor that you can have a trusted relationship with.

Sources:

Diversity & Health Equity Education: Lesbian, Gay, Bisexual, Transgender and Queer/Questioning. American Psychiatric Association. Accessed June 18, 2024. https://www.psychiatry.org/psychiatrists/diversity/education/lgbtq-patients.

Interview with Thomas Carlton, MD, a board-certified gastroenterologist.

Interview with Julius Joi Johnson-Weaver, MD, a Black, neurodivergent, trans, non-binary physician.

LGBT Adults’ Experiences with Discrimination and Health Care Disparities: Findings from the KFF Survey of Racism, Discrimination, and Health. KFF. April 2, 2024. https://www.kff.org/report-section/lgbt-adults-experiences-with-discrimination-and-health-care-disparities-findings/.