When it comes to access to healthcare, there are large differences between theory and practice.
Theoretically, medical practitioners and facilities in the American healthcare system should no longer discriminate against or antagonize lesbian, gay, bisexual, transgender or queer (LGBTQ) people. But as we all know, that discrimination exists—and as most LGBTQ people are intimately aware, the outcome gap between theory and practice can result in poor health, bad advice, and at times, even illness or death.
Lighthouse, a queer and trans healthcare website, notes some of the more alarming trends: More than 50% of people who identify as LGBT have been discriminated against when seeking medical care, and one in five trans people have been denied coverage because of their gender identities.
And of course, the outgoing Trump administration worsened the LGBTQ healthcare gap in ways the United States will be grappling with for years to come. Ensuring that the Biden administration works to reverse those losses is a key priority for advocates.
While healthcare discrimination and outcomes remain a pressing issue for LGBTQ communities and their allies, many groups have sprung up to close the gap and help queer and trans Americans access the affirming care they need.
National LGBTQIA+ Health Education Center
As its name suggests, this project of the LGBT-focused Fenway Health research and advocacy center out of Northeastern University is dedicated to ensuring optimal healthcare for lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other sexual and gender minority people. Its focus is on educating healthcare providers with training, resources and consultancy so that they can provide LGBTQIA+ people with care that is of high quality and cost-effective, as many queer and trans people face financial barriers to care.
GLMA: Health Professionals Advancing LGBTQ Equality
The GLMA has technically existed since 1981, but it didn’t exist as an LGBTQ-focused organization until 1994, when it “came out of the closet.” Before that, it was the American Association of Physicians for Human Rights, and its name change from the Gay and Lesbian Medical Association to its current iteration highlights the ways the group has evolved with changing conceptions of gender and sexuality.
Though on the smaller side with just under $300,000 in donations in 2017, and giving $35,000 in grants that year, GLMA considers itself the “world's largest and oldest association” of LGBTQ healthcare professionals and tackles a number of issues facing queer and trans communities. Its earliest iteration worked on HIV/AIDS and supporting doctors as they came out at work, but it now offers more holistic focus areas such as substance abuse, cancer, mental health and transgender-specific healthcare. It also has a policy advocacy arm and offers membership to LGBTQ healthcare professionals and queer and trans patients and families.
National Queer and Trans Therapists of Color Network
It’s no secret that LGBTQ people and people of color face unique mental health issues. This group works at the intersections of race, gender and sexuality by focusing on social-justice-oriented mental healthcare for queer and trans people of color (QTPOC) and support for QTPOC therapists themselves.
Part practitioner directory, part fundraiser, the NQTTCN’s work suggests that the divide between patient and therapist is not as sharp as in mainstream mental health practice when both parties are members of queer and trans communities of color. The network counts the Social and Environmental Entrepreneurs donor collaborative as a foundational sponsor.
World Professional Association for Transgender Health
Like the GLMA, the World Professional Association for Transgender Health (WPATH) has also changed with the times. It was initially founded as the Harry Benjamin International Gender Dysphoria Association in 1979—a name that reflected the predominant understanding of transgender identities at the time, which today is considered offensive.
Like most of these organizations, WPATH, which brings in just under $650,000 annually and counts groups like the Open Society Foundations as donors, focuses on educating professionals and helping people find care. Membership is open to any professional who works with transgender people, including all medical and mental health practitioners as well as lawyers, social workers, nurses, and even anthropologists and sociologists.
People who don’t work in these professions can become members but are not granted voting privileges when the group votes on such important documents as its Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People.
The National LGBT Cancer Network notes that although we don't have good data collection in these areas, there is "reason to believe that LGBT people are carrying a disproportionate cancer burden."
Educating these communities about heightened cancer risks is a key tenet of the network's mission, as are promoting early detection and screening, training healthcare providers on the unique cancer risks LGBTQ patients face, and advocating for queer and trans cancer survivors. The Providence, Rhode Island-based organization reported about $290,000 in revenue in 2017.
Honorable mention: The National LGBTQ Task Force’s push toward “queer” reproductive justice
Though not an organization unto itself, the National LGBTQ Task Force’s reproductive justice campaigning provides an essential voice in a movement that does not often center the voices of queer and trans people. Its work aims to move the reproductive justice industry away from focusing solely on cisgender, straight women, and recognize that queer and trans people need access to reproductive care and face unique hurdles when trying to access it—even from otherwise affirming practitioners. As a whole, the task force brings in about $6.9 million in revenue.