Reprinted from the spring 2018 issue of The Ohio Family Physician
By: Ramona Peel, Leader Trainer, Equitas Health
Have you ever asked someone who has never been to Ohio to describe the Buckeye State? If you have, you may have heard words like “corn,” “football,” “rural,” or “rust belt.” These descriptors aren’t wrong, but they paint an incomplete picture of a state that, like the rest of the country, is becoming more diverse at an astronomical rate.
One aspect of this increasing diversity is the growth of the lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) community. In the United States, research from Gallup, Inc., has shown the percentage of the population that identifies as LGBTQ grew from 3.5% in 2012 to 4.1% in 2016. Since comprehensive studies focused on the LGBTQ community are lacking, the size of this population is likely understated.
The same study indicates that Millennials (those born between 1980 and 1998) account for almost all of this growth. Millennials now outpace Baby Boomers as the largest generational cohort in the United States, with the LGBTQ population driving an increasing demand for health and wellness services in the coming decades.
In Ohio, 3.4% of the state’s population is LGBTQ (about 394,000 individuals), exceeding the populations of both Dayton and Akron combined.1 According to the Williams Institute at the University of California Los Angeles (UCLA), 28% of LGBTQ Ohioans have children. This growing population also has a crucial need for unmet health and wellness services, and presents a unique learning opportunity for family physicians.
The LGBTQ community suffers from a range of significant health disparities.2 According to the National LGBTQ Health Education Center, among LGBTQ individuals, tobacco use is prevalent at twice the rate of the general U.S. population. In addition, this community experiences elevated rates of depression, anxiety, and suicidal ideation. Also, rates of substance use and abuse are above average for LGBTQ Americans.3
These disparities are strongly (though not exclusively) driven by minority stress. LGBTQ people face significant prejudice from both individuals and institutions, and currently have no statewide protections against discrimination on the basis of sexual orientation or gender identity in Ohio.
LGBTQ people often face additional barriers to care. The Williams Institute found that LGBTQ Ohioans have higher unemployment rates, are more likely to live in poverty, and are less likely to be insured than other Ohio residents. Even with accessible care, services are far-too-often delivered alongside discrimination and harassment.2
- Being refused needed care
- Healthcare professionals refusing to touch them or using excessive precautions
- Healthcare professionals using harsh or abusive language
- Being blamed for their health status
- Healthcare professionals being physically rough or abusive.
Ohio is no exception to these national trends.4 In 2015, the National Center for Transgender Equality conducted a survey that included more than 900 Trans Ohioans, and found that 26% avoided going to a doctor because of fear of discrimination. Furthermore, 32% reported at least one negative experience in a health care setting related to their gender identity.5
The loss of linkage to care is the most damaging result of discrimination in healthcare settings. This reluctance to see physicians and other healthcare professionals exacerbates health disparities and contributes to worsening health outcomes over time.
The Equitas Health Institute for LGBTQ Health Equity is committed to its mission which is educating healthcare professionals on how to achieve cultural humility. Our trainers have decades of accumulated experience and bring insights from their own lived experiences being LGBTQ into training environments. Training can be delivered across the state on a wide variety of topics and tailored to providers’ needs.
In addition, we are certified providers of continuing education credits across a variety of disciplines. Together, we can work towards a future in which people associate “healthy,” “forward-thinking,” and “compassionate” with our great state.
About Ramona Peel
As the Lead Trainer for The Equitas Health Institute for LGBTQ Health Equity, Ramona collaborates on creating the institute’s training programs, and leads the delivery of training to internal and external audiences. Ramona is also a political science lecturer at the Newark, OH, branch of The Ohio State University. Her lived experience as a Trans woman informs and enriches her work. For more information about Equitas Health, and providing care to the LGBTQ community, email her or call her at 614.643.6847.
- In U.S., More Adults Identifying as LGBT – Gallup News
- LGBT and Same-Sex Couple Demographics in the U.S. – The Williams Institute
- Understanding the Health Needs of LGBT People – National LGBT Health Education Center
- When Health Care Isn’t Caring – Lambda Legal
- Findings of the National Transgender Discrimination Survey