Study: Lesbians
face barriers to health care access

A new study by researchers at Columbia University shows that sexual orientation can be a significant barrier to access to health care services and that lesbians face particularly significant barriers to adequate medical care. Scientists from Columbia's Mailman School of Public Health conducted a nationwide survey to measure health care access among gays, lesbians, and bisexuals. Writing in the American Journal of Public Health, the researchers examined four key health-care criteria: having insurance coverage, having a regular source of medical care, having seen a health care provider in the prior year, and having unmet medical needs. They report that lesbians were far less likely to have insurance, a regular provider, or to have seen a physician in the previous year--and much more likely to have ongoing, unmet medical needs--than their age-matched heterosexual peers.

"Women in same-sex relationships have lower rates of coverage than those in opposite-sex relationships," explains researcher Julia Heck in a press release. "This may be at least partially attributed to the inability of same-sex couples to marry or form legal partnerships in most states. More than 40% of insured women in the U.S. are covered through another person. Women are also less likely to be employed in professions that provide an insurance package."

Gay men in relationships also were shown to have less insurance coverage than men in heterosexual relationships, report the researchers. But gay and straight men were equally as likely to report unmet medical needs, and gay men were 40% more likely to have a regular health care provider and were two thirds more likely to have seen a provider in the previous year than were partnered heterosexual men.

The researchers believe health-care access is better for gay men than for lesbians because the HIV epidemic revolutionized health care in gay male communities, making it more likely for gay men to have a regular provider and to be open with health care professionals about their sexual orientation. Health risks for lesbians, on the other hand, have not received the same level of exposure, the researchers say. They also note that many lesbians may be less inclined to see a health care provider--or to reveal their sexual orientation if they do seek care--because of stigma and concerns about discrimination.

The researchers say programs are needed for health care providers that sensitize them to the needs of lesbians and to raise awareness of the access barriers lesbians face. They also encourage government and industry to offer health coverage for individuals in domestic partnerships so that more lesbians and gay men can receive adequate health insurance and access to regular care. (The Advocate)