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Health-care providers discriminate, survey shows

NEW YORK _ The LGBT community along with HIV-positive and AIDS patients are being discriminated against frequently by health care providers, a Lambda Legal national survey finds.

"The results of this survey should shock the conscience of this nation and make clear that the system is broken when it comes to health care for many lesbian, gay, bisexual and transgender people and those living with HIV," said Beverly Tillery, director of Community Education and Advocacy and one of the authors of the report.

"No one should be turned away or face discrimination when they are sick or seeking medical care."

In spring 2009, Lambda Legal and more than 100 partner organizations distributed a survey to about 5,000 LGBT people and people living with HIV across the country. The survey, When Health Care Isn't Caring: Lambda Legal's Survey on Discrimination Against LGBT People and People Living with HIV, provides a powerful snapshot of the experiences of a diverse cross-section of members of the LGBT and HIV communities all over the country.

The survey included questions about the following types of discrimination in care:

• Being refused needed care.
• Health care professionals refusing to touch patients or using excessive precautions.
• Health care professionals using harsh or abusive language.
• Being blamed for one's health status.
• Health care professionals being physically rough or abusive.

According to the results, almost 56 percent of lesbian, gay or bisexual respondents had at least one of these experiences; 70 percent of transgender and gender-nonconforming respondents had one or more of these experiences; and nearly 63 percent of respondents living with HIV experienced one or more of these types of discrimination in health care.

Not only did sexual orientation affect the respondents' access to quality health care, but transgender or gender-nonconforming respondents faced discrimination two to three times more frequently than lesbian, gay or bisexual respondents.

In nearly every survey category, people of color and/or low-income reported experiencing higher rates of discriminatory and substandard care. Close to 33 percent of low-income transgender and gender-nonconforming respondents reported being refused care because of their gender identity and almost a quarter of low-income respondents living with HIV reported being denied care.

In addition to instances of discrimination, respondents also reported a high degree of anticipation and belief that they would face discriminatory care.

Overall, 9 percent of LGB respondents are concerned about being refused medical services when they need them and 20 percent of respondents living with HIV and over half of transgender and gender-nonconforming respondents share this same concern.

Nearly half of LGB respondents and respondents living with HIV and almost 90 percent of transgender respondents believe there are not enough medical personnel who are properly trained to care for them. These barriers to care may result in poorer health outcomes because of delays in diagnosis, treatment or preventive measures.

In the report, Lambda Legal provides key recommendations for health care institutions, government, individuals and organizations to combat these issues. They recommend comprehensive cultural competency, inclusive policies, research and training for medical personnel, stronger laws, as well as advocacy and community education.