LGBTQ African-Americans face multiple health care hurdles

Latonya Riddle-Jones writes the LGBTQ Health View column.

As we celebrate Black History Month and honor the contributions of African-Americans to our history, the nation continues to battle serious issues regarding equal treatment of disenfranchised individuals, including in health care.

For African-Americans identifying as LGBTQ, like many of Corktown Health Center’s patients, the barriers to successful physical and mental health treatment can get even higher. Biases come from multiple angles and hinder progress or even discourage treatment.

Mental health struggles of the Black LGBT population are exacerbated by forces such as racism and poverty.

Approximately 1.2 million Black LGBTQ adults living in the United States face barriers to quality health care. Many are underinsured while dealing with discrimination and lack of understanding from health-care providers about their needs. This is why properly trained staff at health centers like Corktown are leading efforts to overcome these biases and improve care for all people.

Disparities persist

A January 2021 report by the Williams Institute at UCLA studied the mental health, physical health and social and cultural experiences of the Black LGBTQ population.

Data in this report remind us of the harsh health-care disparities faced by many Black LGBTQ adults — even more than non-LGBTQ Black adults:

• Of Black LGBTQ adults, 26 percent have been diagnosed with depression, compared to 15 percent of Black non-LGBTQ adults.

• People in this population are less economically secure — nearly 40 percent of Black LGBTQ adults have a household income below $24,000 per year.

• Seventy-nine percent of Black LGBTQ adults reported experiencing verbal insults or abuse, and 60 percent were threatened with violence — all discriminatory actions that can severely impact mental health.

Lack of access, structural racism

Lack of health insurance and limited access to care is at the core of health disparities. For example, 20 percent of Black LGBTQ women and 18 percent of Black LGBTQ men are uninsured.

Nearly half of Black LGBTQ adults reported being fired from or denied a job because of their identity. Often, they hide their identities from co-workers for fear of losing their job and income, which causes additional anxiety and stress.

A 2017 national survey of U.S. adults found that LGBTQ people of color were twice as likely to report discrimination because of their LGBTQ identity when applying for jobs and when interacting with police, compared to white LGBTQ people.

These worries extend to the health-care field, where too few doctors are trained properly to treat people of all sexual and gender identities. This often leads to uncomfortable experiences and ultimately less quality care.

Even attempts to schedule a mental health visit with a new provider are less likely to result in receiving successful treatment.

Ending race-based medicine

One way we can address the barriers to health care facing the Black LGBTQ population — and all Black patients — is by ending the concept of race-based medicine. Combining this historically inaccurate system of care, which uses racial assumptions to predict medical treatment based on race, with issues surrounding gender identity leads to even worse health disparities.

As social justice advocate and law scholar Dorothy Roberts powerfully says, race-based medicine is bad medicine.

Care providers should not use race as a medical shortcut, to predict things like pain tolerance and kidney function, instead of medical observation and measurement. Human beings are, regardless of race, more than 99.9 percent the same.

Black LGBTQ individuals deserve the same access to quality health care as everyone else, yet many obstacles remain. Black History Month shines a spotlight on the needs of this group, and how both societal changes and more training at medical staff and health centers are needed to provide them the proper care they deserve. With the proper training, an age of competent, cultural care for this population, and all minority communities, can begin.

Dr. Latonya Riddle-Jones is medical director at Corktown Health Center in Detroit, the only health clinic in Michigan focused on the needs of LGBTQ patients. Visit corktownhealth.org.

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