A new report sheds light on the health disparities this uniquely marginalized group face.
Several years ago while living in northern Virginia, Beth Sherouse went to an appointment with a new gynecologist. At the time, she was working in bisexual community advocacy and learned about the health disparities many bisexual people face. Research shows that bisexual people have higher rates of depression and anxiety than gay and lesbian folks, and are at higher risk for suicide.
That’s why Sherouse, who lives in Georgia now, made it a point to tell her new provider she was bisexual—something she’d never done before. She had never considered the importance of being out to her doctor, she told COURIER. “But once I started looking at the health disparities, [I realized I needed] to be out to my doctor because I’m at risk for some things just because of who I am.”
The doctor, however, “lacked any understanding” of what it meant to be bisexual, Sherouse recalled. “She literally said to me, ‘If you’ve been in a relationship with a man for five years, then how are you bisexual?’ Basically, implying that my identity as a bisexual person ceases to exist once I’m in a relationship.”
Sherouse said she talked to the gynecologist about the increased health risks bisexual individuals face, but ultimately never went back to her again.
“Even in more liberal areas of the South, providers that might think they’re culturally competent for LGBT people are really only LG culturally competent,” she said. “They’re also putting us in a place where we have to explain our own health needs to people who are supposed to be the experts.”
A new report from the Campaign for Southern Equality (CSE) and Western North Carolina Community Health Services (WNCCHS) suggests Sherouse’s experience isn’t unique. In a survey of 5,617 people who identify as LGBTQ and live in the South, more than half said they believed it was harder to access quality medical care because of the region in which they live.
“They’re also putting us in a place where we have to explain our own health needs to people who are supposed to be the experts.”
The 174-page report, which came out earlier this month, offers a wide look at the health and healthcare experiences and outcomes of LGBTQ Southerners. It also includes the largest known sample to date of respondents to a survey focused specifically on these issues in the South, where an estimated 35 percent of the country’s LGBTQ population live.
Participants were recruited via social media and through partnerships with various LGBTQ and allied advocacy groups throughout the region. They lived in Alabama (386), Arkansas (59), Florida (187), Georgia (366), Kentucky (94), Louisiana (99), Mississippi (366), North Carolina (927), South Carolina (404), Tennessee (552), Texas (179), Virginia (385), and West Virginia (28).
According to the report’s findings, participants generally said they were in good physical health and could access quality healthcare. A closer look at the data, however, found that transgender and low-income people reported higher rates of fair/poor health and more negative experiences obtaining care.
“We do see there are some positive health experiences,” Austin Johnson, one of the authors of the report and CSE’s research director, told COURIER. “We don’t want to gloss over them in the report because it tells us that it is possible for LGBTQ people to get excellent care in the South. But that care is not available to everyone in the LGBTQ community.”
“Even when I am able to find a medical professional that I am comfortable with, almost always the office support staff and nursing staff treats me with disrespect and makes me feel my health information is at risk because I am LGBTQ.”
Participants also reported “significantly high” rates of poor mental health. This, the report’s authors point out, is most likely a result of “their exposure to stigma and discrimination,” which may be “more pronounced” in the South.
Specifically, bisexual, pansexual, queer, and transgender participants were “significantly more likely” to experience worse mental health outcomes. More than half of transgender and nonbinary respondants said they’d thought about suicide, while “[l]arge majorities of bisexual (75 percent), pansexual (83 percent), and queer (80 percent) respondents said they have experienced or been diagnosed with depression, which is at least 15 percentage points higher than gay respondents (58 percent).”
Another telling data point focused on how comfortable respondents felt about seeking medical care within their community. While 51.5 percent of the total sample said being in the South “makes it always or often harder to access quality medical care,” this experience was even more pronounced for transgender individuals, of whom 73 percent reported feeling this way.
Such discomfort has real-life impacts: 11 percent of respondents said they delay seeing a healthcare provider because of their identity, and 7 percent said they deal with mistreatment when they do seek care.
One anonymous participant wrote: “Even when I am able to find a medical professional that I am comfortable with, almost always the office support staff and nursing staff treats me with disrespect and makes me feel my health information is at risk because I am LGBTQ.”
Certainly, Johnson said, the South has a reputation for LGBTQ intolerance. “When the narrative around the place you live says it is unsafe for you—when you have experienced rejection and have been turned away from providers, when you have been treated unfairly at work, at school, in your faith institution or in your family—it changes the way you relate to the place you live and how at home you feel in your own community.”
But, he added, their research shows it’s possible for LGBTQ people to have positive experiences in the South. “There are people who are educating themselves and reaching out to community leaders and really striving to be the change in their local community. … We’re seeing an LGBTQ South that is transforming itself.
“We just need to figure out how to get these high standards of care to those who are more on the margins in our community in the South.”