Sexual health is key to overall health and well-being. However, for people who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ), discrimination, social stigma and civil and human rights violations often result in poor sexual health outcomes.
For the best possible health outcomes in all aspects of their lives, LGBTQ individuals require medical care and sexual health services tailored to their specific needs. This means that LGBTQ people need access to comprehensive identity- and gender-affirming reproductive health care and services, including contraception, abortion, assisted reproductive assistance and other fertility options, treatment for HIV and sexually transmitted infections, pregnancy care, parenting resources and treatment for issues related issues to sexual violence.
The health care system has largely overlooked and ignored the needs of LGBTQ people. A huge barrier to quality medical services for LGBTQ people is fragmented care. The failure of medical providers and organizations to coordinate patient care increases health risks and the likelihood of poor outcomes. What’s more, discrimination by care providers, insurance issues—for example, in the United States, 27 states have no laws that provide inclusive insurance protections for LGBTQ people—racial disparities and health inequities can make it difficult for LGBTQ individuals to navigate the system.
Research has shown that individual and chronic discrimination can increase the risk for mental health conditions and substance use disorders among LGBTQ people. This can often lead to risky sexual behavior, which jeopardizes sexual health. According to the National Institute on Drug Abuse, intravenous drug use and high-risk sexual behaviors place LGBTQ people at an increased risk for HIV.
Many LGBTQ individuals delay seeking health care because they fear being mistreated. However, there are culturally competent health professionals who are trained to understand the experiences and unique clinical needs of LGBTQ people and can provide them with unbiased comprehensive care in inclusive medical settings.
Insurance barriers must also be addressed. Reports show that even among LGBTQ patients with insurance, traditional definitions of gender and insurance policy guidelines can result in denials of coverage for health services.
Despite these obstacles, there are signs of progress. In the past few years, state policymakers and LGBTQ advocates have pushed for schools to implement inclusive sex education programs. Since the beginning of 2020, various national information systems have been collecting data about sexual and gender identity to address LGBTQ health care needs and disparities.
Additionally, family planning providers have started to offer LGBTQ patients gender-affirming hormone therapy, according to the Guttmacher Institute, a research and policy organization that advocates for sexual and reproductive health and rights worldwide and supports the elimination of all barriers to health care faced by LGBTQ individuals.
In spite of these steps in the right direction, experts agree that policymakers and medical professionals have much more work to do. Until all obstacles to care are eliminated, LGBTQ people should take charge of their health and find a provider who understands their needs. (Check out the LGBTQI Health Resource Guide by the American Library Association or the American Sexual Health Association for more information.)
As a state of physical and emotional well-being, sexual health affects everyone’s quality of life, regardless of their sexual and gender identity.
Last Reviewed: June 1, 2021