LGBTQ+ Health Disparities

Health disparities are differences in health between different groups of people. LGBTQ+ people experience a number of health disparities. They're at higher risk of certain conditions, have less access to health care, and have worse health outcomes. These disparities are seen in the areas of behavioral health, physical health, and access to care.

Behavioral health. Behavioral health includes mental health, substance abuse, and addiction. LGBTQ+ people are at greater risk of:

• Suicide and suicidal thoughts
• Mood disorders and anxiety
• Eating disorders¹
• Alcohol and substance abuse¹
• Tobacco use²

Physical health. LGBTQ+ people are at greater risk for certain conditions, diseases, and infections:

• Gay and bisexual men are more likely to have HIV/AIDS.³
• Transgender Women, Black/African American and Hispanic/Latino men have the highest risk for HIV infection.⁴
• Older LGBTQ+ adults are more likely to rate their health as poor and report more chronic conditions while having less social support.⁵
• Lesbian and bisexual women are more likely to be obese.⁶
• LGBTQ+ people are less likely to have a regular health care provider.⁷
• Lesbian and bisexual women have higher rates of breast cancer, and transgender men and women are at greater risk.⁸
• LGBTQ+ people have higher rates of HPV infection and related cervical or anal cancers.⁹

Access to care. LGBTQ+ people have less access to the health care they need. They are:

• Less likely to have health insurance.⁹
• More likely to delay getting care, especially in older LGBTQ+ adults.⁵
• More likely to report lack of cultural competence by health care providers.⁵
• More likely to report poor quality of care and unfair treatment by healthcare providers.¹⁰

What causes these disparities?

There are many causes of the health disparities faced by LGBTQ+ people. These include:

• The minority status of LGBTQ+ people.
• A lack of specific education and training for health care workers.
• A lack of clinical research on LGBTQ+ health-related issues.
• Restrictive health benefits.
• Limited role models.
• Fear due to stigma, discrimination, and institutional bias in the health care system.

What is Cigna Healthcare doing to reduce these disparities?

Cigna Healthcare^SM understands the importance of addressing health disparities facing the LGBTQ+ population and is working to close these gaps. We are working internally to educate, train, and support our team members. And we’re working externally to support our customers, clients, and our network of health care providers.

Here are a few of the steps we’re taking to address LGBTQ+ disparities:

• We’ve created a National Medical Director for LGBTQ+ Health and Well-Being role.
• We’re expanding in-network access to transgender care.
• We’ve provided specific training on LGBTQ+ health issues to over 600 Cigna Healthcare clinicians, and resources are available to all in-network health providers on the Cigna Healthcare website.
• We’re educating our employees on LGBTQ+ health disparities, and have formed a LGBTQ+ Colleague Resource Group.
• We participate in and support organizations and events such as the Gay and Lesbian Medical Association, Mautner project, Hetrick-Martin Institute, Philadelphia Transgender Health Conference, Hartford Gay & Lesbian Health Collective, Pride, and Out and Equal.

Finding the Right Health Care Professional

Finding a health care professional you’re comfortable with is important. Cigna Healthcare members are offered tools to help search for in-network health care professionals by specialty and view health care professional details such as cost or quality information. You can also call the health care professional’s office to find out more information, including if they participate in your health plan’s network.

Cigna Healthcare customers may go to myCigna.com to search for an in-network health care professional or facility.

LGBTQ+ Provider Resources

Other health care professionals may or may not participate in your health plan. Please check your plan’s directory or call the health care professional to find out if they participate in your health plan’s network.

• The Gay and Lesbian Medical Association’s (GLMA) mission is to ensure equality in health care for lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ+) individuals and health care professionals. Visit www.GLMA.org for more information.

¹ Wilson, C., Cariola, L.A. 'LGBTQI+ Youth and Mental Health: A Systematic Review of Qualitative Research", https://link.springer.com/article/10.1007/s40894-019-00118-w, last accessed June 2, 2021.

² Tobacco Education Resource Library. “Tobacco Use in the LGBT Community: A Public Health Issue" https://stage-digitalmedia.hhs.gov/tobacco/webpages/18272, last accessed March 3, 2023.

³ Centers for Disease Control and Prevention. “HIV Among Gay, Bisexual, and Other Men Who Have Sex With Men”. (2018). https://www.cdc.gov/hiv/library/reports/hiv-surveillance/vol-31/content/msm.html, last accessed June 2, 2021.

⁴ HIV.gov, "Who is at Risk for HIV?” https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/who-is-at-risk-for-hiv, last accessed June 2, 2021.

⁵ SAGE. “The Facts on LGBT Aging”. (2018) https://www.sageusa.org/wp-content/uploads/2018/05/sageusa-the-facts-on-lgbt-aging.pdf [PDF]

⁶ Azagba, S., Shan, L., & Latham, K. (2019). “Overweight and Obesity among Sexual Minority Adults in the United States”. International journal of environmental research and public health, 16(10), 1828. https://doi.org/10.3390/ijerph16101828, last accessed June 2, 2021.

⁷ Stimpert, Tyler. “‘Coming out’ against Cancer: How Local Outreach to the LGBT Community Can Reduce Cancer Disparities.” Journal of Clinical Oncology, vol. 38, no. 29_suppl, 2020, pp. 131–131., https://ascopubs.org/doi/abs/10.1200/JCO.2020.38.29_suppl.131, last accessed June 2, 2021.

⁸ Baker, Kellen. “Cancer in LGBT Populations: Differences, Disparities, and Strategies for Change.” Oral Presentations - Invited Abstracts, 2020, https://cebp.aacrjournals.org/content/29/12_Supplement/IA12, last accessed June 2, 2021.

⁹ Human Rights Campaign Foundation. The Lives & Livelihood of Many in the LGBTQ Community are at Risk Amidst COVID-19 Crisis. (2020) https://www.hrc.org/resources/the-lives-and-livelihoods-of-many-in-the-lgbtq-community-are-at-risk-amidst-covid-19-crisis, last accessed June 2, 2021.

¹⁰ Jennings, Linn, et al. “Inequalities in Lesbian, Gay, Bisexual, and Transgender (LGBT) Health and Health Care Access and Utilization in Wisconsin.” Preventive Medicine Reports, vol. 14, 2019, p. 100864. https://pubmed.ncbi.nlm.nih.gov/31011518/ last accessed June 2, 2021.