How to improve healthcare experiences for LGBTQ students

There are many challenges that LGBTQ college students face at home and on campus. Stigmas in society regarding their gender and sexual identities play a large role and can impact their interactions with others as well as their self-esteem and mental health.

These stigmas can take the role of discrimination, family disapproval, harassment, rejection and more. According to the CDC, this puts LGBTQ youth at increased risk for negative health outcomes. Their data^1-3 shows that:

1. Young gay and bisexual males have disproportionately high rates of HIV, syphilis, and other sexually transmitted diseases (STDs).¹
2. Adolescent lesbian and bisexual females are more likely to have ever been pregnant than their heterosexual peers.²
3. Transgender youth are more likely to have attempted suicide than their cisgender peers.³

Since the college environment can have a strong influence on their students, administrators and staff have a great opportunity to create a positive environment for LGBTQ students. But before we dive into some ways they can help mitigate these challenges, it’s best to identify and elaborate on some of the issues facing LGBTQ students.

Challenges Of LGBTQ Students

LGBTQ stands for – Lesbian, Gay, Bisexual, Transgender, and Questioning.⁴ According to the 2021 National Survey on LGBTQ Youth Mental Health  report, while there has been encouraging progress over the last two decades in acceptance of the LGBTQ youth community, significant challenges remain. Here are some of the challenges outlined in the report⁵:

• Gender discrimination: It is very common for others to discriminate against LGBTQ students due to how they identify gender-wise, or how they choose to orient themselves sexually.
• Racial discrimination: LGBTQ students of color are victims of racial discrimination often.
• Suicide ideation: 42% of LGBTQ youth contemplated suicide due to the constant discrimination and lack of acceptance.⁶
• Food insecurity: 30% of LGBTQ students experienced food insecurity in some capacity.
• Sexual harassment: LGBTQ students face a higher rate of sexual harassment than those who are not LGTBQ.
• Verbal harassment: As many as 85.2% of LGBTQ students experience verbal harassment at school, and they are more likely to be bullied by their peers. The word “gay” can often be used in a negative sense in many settings.
• Family rejection: Some LGBTQ are not accepted by their parents and other family members. Unfortunately, this leads to more suicidal ideation and difficulties surrounding their identity.
• Access to medical care: LGBTQ students may have trouble with access to care for a variety of reasons, including lack of adequate coverage, or even lack of providers with adequate knowledge. Further, they may avoid preventative care due to a negative experience or experienced prejudice from healthcare staff. What’s more is that they are more likely than other communities to put off healthcare until it becomes worse. When looking at the facts on health risks for LGBTQ people the numbers are troubling:⁶
  • LGBTQ youth are 2 to 3 times more likely to attempt suicide.
  • LGBTQ have a higher risk of becoming infected with HIV and other sexually. transmitted diseases (STDs).
  • LGBTQ people are much more likely to smoke.
  • LGBTQ have higher rates of alcohol use, other drug use, depression, and anxiety.
  • LGBTQ people are less likely to get preventive services for cancer. 
  • LGBTQ people have higher rates of behavioral health issues.

How To Support LGBTQ Students

To help improve healthcare for LGBTQ students, here are a variety of options to foster a caring and supportive environment:

• Post safe space signs: Posting a safe space sign can put LGBTQ students at ease, knowing they are in a space where they will be respected. Often, LGBTQ youth have to question whether or not an area is safe for them, or if they can trust the person in charge of the space. Posting safe space signs eliminate any doubt that the student may have. It also helps to have LGBTQ-affirming materials. ⁷

• Improve access to healthcare: Due to previous negative experiences students may be apprehensive in seeking care. So, it’s important to provide a means for them seek the care they need in a trusting environment. Work with local providers and student health center staff to ensure there are LGBTQ care specialists available for students.⁶ It’s also important to have resources that allows students to seek care on their terms. Provide access to telehealth programs like virtual doctors visits, at home STI testing or 24/7 behavioral health care services like CareConnect. These programs help put them in control and can help improve the odds of seeking the care they need.

• Empower staff to provide support: A simple way to help LGBTQ students is to simply lend a listening ear. Train faculty and staff to be supportive and let the student know they are willing to help. Support through actions, not just words can make a world of difference for the student. Provide LGBTQ resources – like below to – faculty, staff and students.⁸

• Explore and provide LGBTQ resources. Some excellent LGBTQ resources to reference and share are:
  • Gay-Straight Alliances (GSA): This group offers support and activities for LGTBQ youth.
  • The Trevor Project: The Trevor Project provides a 24/7 hotline for LGTBQ students, and it has an online community and educational programs.
  • International Lesbian, Gay, Bisexual, Transgender People, and Queer Youth and Student Organization (IGLYO): IGLYO hosts conferences that can provide places with resources and educational resources.
  • It Gets Better Project (IGB): This organization has a plethora of resources and educational videos.
  • Attic Youth Center: This program offers mental health resources and social activities.

• Respect pronouns and names: Some LGBTQ students prefer to go by different pronouns and/or names. Being respectful of what they’d like to be referred to helps them feel accepted and heard. This means not tolerating any remarks that are discriminatory or disparaging to those in the LGBTQ community, whether they come from other students or instructors. This also means to offer corrections when pronouns are not respected or a transgender student’s deadname is used.

• Allocate Resources to Building LGBTQ Community and Safe Spaces: Organizations like the Gay-Straight Alliance (GSA) can be a fantastic asset for any educational institution. By connecting them with peers and allies, the GSA can offer LGBTQ students the opportunity to feel like they are a part of a community. This builds camaraderie and can help boost mental health. Furthermore, the organizations are run by students, which can help support feelings of security and safety. ⁹

Improving the culture

There are many ways that colleges and universities can help make things easier for their LGBTQ students and their healthcare journeys. Colleges are uniquely qualified to shape and educate, by promoting inclusivity across disciplines, colleges can help promote equality and reduce discrimination. That’s why it’s so important that colleges continue to cultivate an atmosphere that rejects homophobic and transphobic attitude and is accepting and accommodating for all students.

Resources:

¹ Rasberry, C. PhD,. Lowry, R. M.D., et al. (2018, September 14). Sexual Risk Behavior Differences Among Sexual Minority High School Students — United States, 2015 and 2017. Retrieved on June 6, 2022 from https://www.cdc.gov/mmwr/volumes/67/wr/mm6736a3.htm?s_cid=mm6736a3_3).

² John, M. PhD., Lowry, R. M.D., et al. (2018, November 2). Violence Victimization, Substance Use, and Suicide Risk Among Sexual Minority High School Students — United States, 2015–2017. Retrieved on June 6, 2022 from https://www.cdc.gov/mmwr/volumes/67/wr/mm6743a4.htm?s_cid=mm6743a4_e).

³ John, M. PhD., Lowry, R. M.D., et al. (2019, January 25). Transgender Identity and Experiences of Violence Victimization, Substance Use, Suicide Risk, and Sexual Risk Behaviors Among High School Students — 19 States and Large Urban School Districts, 2017. Retrieved on June 6, 2022 from https://www.cdc.gov/mmwr/volumes/68/wr/mm6803a3.htm?s_cid=TW_DU032019015)

⁴ The Center. (n.d.). What is LGBTQ?. Retrieved on June 6, 2022, from https://gaycenter.org/about/lgbtq/

⁵   The Trevor Project. (2021). National Survey on LGBTQ Youth Mental Health 2021. Retrieved on June 6, 2022, from https://www.thetrevorproject.org/survey-2021/

⁶ National LGBT Health Education Center. (2020). Providing Inclusive Services and Care for LGBT People. Retrieved on June 6, 2022, from https://www.lgbtqiahealtheducation.org/wp-content/uploads/Providing-Inclusive-Services-and-Care-for-LGBT-People.pdf.

⁷ Cuadrado, M., Simons, J. (2019). Narratives of School Counselors Regarding Advocacy for LGBTQ Students. Retrieved on June 6, 2022, from https://www.schoolcounselor.org/getmedia/f196396d-e2b3-437c-9431-4d392b3ba158/Narratives-of-School-Counselors-Regarding-Advocacy-for-LGBTQ-Students.pdf

⁸ Joseph G. Kosciw, Ph.D., Clark, C.M. Ph.D., Truong, N.L. Ph.D., Zongrone, A.D. M.P.H. (2020). The 2019 National School Climate Survey. Retrieved on June 6, 2022, from https://www.glsen.org/sites/default/files/2021-04/NSCS19-FullReport-032421-Web_0.pdf.

⁹ Johns, M. PhD., Poteat, V.P. PhD., Horn, S. PhD., Kosciw, J. PhD. (2019, May 29). Strengthening Our Schools to Promote Resilience and Health Among LGBTQ Youth: Emerging Evidence and Research Priorities from The State of LGBTQ Youth Health and Wellbeing Symposium. Retrieved on June 6, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6551982/.