In a study I did of Colorado transgender patients, 40% reported
delaying medical care due to cost, inadequate insurance, and/or fear
of discrimination. Many were depressed, had suicidal thoughts and
had even attempted suicide within the past year. Having a transgen-
der-inclusive provider resulted in much better care, significantly less
depression and one-half the number of suicide attempts.
3
Because so many LGBTQIA2S+ people are disengaged from the
healthcare system, many are misinformed. For instance, studies show
that a significant number of lesbian women may not realize that they
are at risk for sexually transmitted infections like chlamydia or her-
pes, and fail to seek Pap smears as a result. That results in a higher
cervical cancer rate for both lesbian and bisexual women. Many gay
men do not know that vaccinations for human papillovirus can reduce
their elevated risk for anal cancer. Lesbian women are also at elevated
risk for breast cancer, and yet anecdotal evidence suggests that they
seek breast exams less frequently than heterosexual women do.
Being inclusive is not just the right thing from an ethical standpoint.
It's also good for provider economics. Estimates vary widely, but in a
recent Gallup poll, 4.5% of Americans identified as LGBTQIA2S+.
Among millennials, the percentage was 8.1%, suggesting either that
the population will grow or perhaps that it is actually larger than the
survey shows.
This represents a significant opportunity, because inclusive
providers tend to be scarce in many areas. Here in Ann Arbor, Mich.,
such providers are usually available, but in the state's upper penin-
sula, some LGBTQIA2S+ people travel 6 to 7 hours just to see inclu-
sive therapists, and trans and non-binary people living in other rural
areas in the state travel 3 hours to get their hormone injections. I
can tell you that if my partner or I discover an inclusive provider
and post about it in one of our LGBTQIA2S+ Facebook groups, the
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