An already awkward scenario is made more uncomfortable when, sitting on the crinkled exam table paper in an ill-fitting medical gown, the following conversation with a doctor occurs:

“Are you sexually active?”

“Yes.”

“Are you on birth control?”

“No.”

“Are you trying to get pregnant?”

“No.”

And the loaded pause ensues. This all-too-common conversation is one which most queer women know—and dread, forcing them to outright state their sexuality to their provider (and then be required to take a pregnancy test, “just in case”). But what is an unpleasant interaction on the surface, has deeper implications when understood in the broader context of LGBTQ+ medical care. 

With the field of medicine being steeped in a history of racism and misogyny, it’s no surprise that issues of unequal care continue to plague marginalized Americans, including queer people. According to the Center for American Progress, as of 2018 LGBTQ+ people surveyed reported…

• 8% were refused care because of their (real or perceived) sexual orientation 
• 9% had a health care provider use harsh/abusive language
• 6% had a healthcare provider refuse them care related to their orientation 
• 7% experienced unwanted contact (rape, assault, etc.)

For trans patients, these statistics are more grim, reporting…

• 29% had been refused care because of their gender identity
• 12% were refused transition-related care
• 23% were misgendered 
• 21% had a provider use harsh/abusive language
• 29% experienced unwanted contact (rape, assault, etc.)

Per an NBC article, as of 2022, more than one in eight queer people live in states where health care providers have the legal right to deny them treatment, on grounds of “religious freedom.”

Due to this discrimination, some queer people avoid seeking medical care at all. Finding an alternative provider after a negative experience is no small feat, especially if the care is specialized, or the patient is located in a rural area. 

Even if a doctor does not outright deny a patient care (or worse), queer individuals may still experience a lower standard of care. This may be in the treatments they receive, or their interactions with staff. Gay men who don’t inform their doctor of their sexuality are less likely to be screened for anal cancer. Similarly, lesbian women who aren’t comfortable with their providers are less likely to receive mammograms, colonoscopies, or pap smears.

While the earlier conversation might not seem malicious or dangerous to a cisgender heterosexual observer, it can feel invasive. Your relationship with your doctor, including how safe you feel expressing your concerns, needs, and experiences, is a medical issue—and an issue of receiving equal care. 

But many health care providers will NOT corner you into an uncomfortable conversation, forcing you to thwart their cis-het standard of care. Databases of queer and queer-friendly doctor’s offices have been organized, making equal care more accessible to LGBTQ+ people across the nation. Here are a few of our favorites we suggest checking when looking for a provider:

1. OutList LGBTQ+ Affirming Healthcare Directory
2. Human Rights Campaign Healthcare Equality Index 
3. World Professional Association for Transgender Health Provider Directory 
4. LGBTQ+ Healthcare Directory

It should be noted that even with the aid of resources, equal care may be difficult to come by. You may not live near one of the providers listed, they might not accept new patients, or your insurance may not be accepted. It’s always a good idea to ask friends and family, especially if they are queer or work in healthcare. Utilize social media communities, such as Facebook and Instagram (or Reddit for anonymous posting), to find recommendations. 

If your community has a local LGBTQ+ center, or is host to any queer nonprofits, check to see if they have a list of local queer-friendly providers. If you are comfortable, ask potential providers about their experiences and services before attending an appointment, including inquiring about whether they regularly work with queer patients, have gender-neutral bathrooms, or are willing to prescribe HIV-preventative medicines. 

Ensuring that queer patients have access to medical providers who are conscious of differences in care is essential as it is a matter of safety. As the field of medicine continues to make advances in equitable care, be aware that this issue is still prevalent, and utilize the thriving local LGBTQ+ community that can be found right in your backyard.