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Even with health insurance, lesbian, gay and bi adults more likely to delay medical care

A study shows bisexuals have among the greatest need for regular health care, but are the least likely to get it. And even if they have a high-quality insurance plan through an employer, health equity is far from a reality for many LGBTQ patients.

Photo by Marcelo Leal from Unsplash.com

Even when lesbian, gay and bisexual adults have rates of health insurance coverage on par with or better than that of straight men and women, they are still more likely to wait to see the doctor when they need medical care. This is according to a policy brief by the UCLA Center for Health Policy Research

According to Susan H. Babey, a co-author of the study, Disparities in Health Care Access and Health Among lesbians, Gay Men, and Bisexuals in California, one reason cited in other research is that sexual minorities sometimes experience discrimination when they seek health care.

“Sexual minorities who have had a bad experience with a medical provider because of their sexual orientation may try to avoid repeating it,” said Babey, who is also co-director of the Chronic Disease Program at the Center.

The UCLA study looks at differences in access to care, behaviors that negatively affect health (such as smoking or not exercising) and health problems that can result from those behaviors (such as developing hypertension or being overweight), based on people’s sexual orientation. The findings show that 24% of bi men and 22% of straight men say they do not have a doctor they regularly see, compared with only 13% of gay men; but 20% of gay men and 21% of bi men delayed seeking health care in the past year, compared with 13% of straight men.

Thirteen percent of straight women and 15% of lesbians reported that they do not have a doctor they regularly see, while a higher percentage of bisexual women, 22%, said they do not have one. However, 29% of lesbians and bisexual women said they delayed seeking medical care in the past year compared with just 18% of straight women.

The study uses data from the combined 2011 to 2014 California Health Interview Survey. Data on transgender people is not included because the survey only began collecting transgender data in 2015-16. More than one million California adults, 4.5% of the state’s adult population, identify as lesbian, gay, homosexual or bi, according to the survey.

Other key findings from the research:

  • Bi people have the worst overall access to a doctor they see on a regular basis and high rates of unhealthy behaviors. Among lesbian/gay, bi and straight adults, bi men and women are the least likely to have a regular source of care, are most likely to delay care and are mostly likely to seek care in an emergency room. Bi men have higher rates of unhealthy behaviors in four of the five categories analyzed in the study. Among women, bi in the study have higher rates of smoking and binge drinking, and are more likely to eat fast food two or more times a week.
  • Gay men report better overall health and fewer behaviors that lead to obesity and hypertension than straight men. Sixty-one percent of gay men said they considered themselves to be in excellent or very good health, compared to 52% of straight men and 44% of bi men. Gay men are less likely to drink sugary beverages daily and were less likely to binge drink than straight and bi men. Twenty-seven percent of straight men in the study were obese, compared with 21% of gay men and 20% of bi men.
  • Straight women have the best access to a doctor they see on a regular basis, overall health and the lowest rates of unhealthy behaviors. Half of straight women said they were in excellent or very good health, versus 44% of lesbians and 45% of bi women. Twenty-seven percent said they had engaged in binge drinking within the previous year, compared to 50% of bi women. Ten percent of straight women were smokers, compared with 23% of bi and lesbian women. Lesbians had the highest rate of obesity, 35%, compared with 26% of  bi women and 24% of straight women.

“Our study shows bisexuals have among the greatest need for regular health care, but are the least likely to get it,” said Joelle Wolstein, a research scientist at the Center and the study’s lead author. “Even if they have a high-quality insurance plan through an employer, health equity is far from a reality for many LGBTQ patients.”

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