Social conditions affect the health of GLBT people in many ways, ranging from the direct impact of stigmatization and prejudice (e.g. exposure to violence, stress, poor access to care) to the failure to adequately address special needs of LGBT populations (e.g. gay specific sexually transmitted disease, fertility challenges, genital reassignment surgery.)


Barriers to care for GLBT people include systemic bias in health insurance and public entitlements which historically routinely fail to cover gay and lesbian partners or to provide for reimbursements for procedures of particular relevance to GLBT populations (e.g. fertility services for lesbians, care for transsexuals, etc.)


Research and public health studies have not included GLBT populations, resulting both in a lack of data about specific health concerns or needs but also delays in the discovery of any trends or associations of specific illnesses with members of this population.  Examples of this are the association of sexual orientation with incidence and natural history of cancer (e.g. breast cancer in lesbians or anal cancer in gay men); mental health of gender variant adolescents; and sexually transmitted disease (STD) rates among gay men.


Because of negative attitudes prevalent in the US public as well as among physicians and other medical staff, LGBT individuals are subject to discrimination and bias in medical encounters. Moreover they are likely to receive substandard care, or remain silent about important health issues because of fear of stigmatization.  Bias from healthcare professional (or the perception of bias) has been identified in research as a leading barrier to care leading to a reduction in help-seeking and quality of care.  Stereotyping or lack of education also leads health providers to ignore known special preventive care and treatment needs of GBLT people.  Medical forms and the format of medical intake and history/assessment processes are often insensitive to the experience of GLBT clients/patients and are likely to discourage disclosure of sexual orientation and behavior.


Lack of sensitivity and fear of stigma in mental health settings results in GLBT people have a reluctance to seek care as well as substandard care when they are unwilling or unable to disclose aspects of their lives that are germane to treatment planning and goals.  

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