A new study shows that 47% of LGBTQ+ patients experience gaslighting from medical professionals when compared to 26% of their heterosexual, cisgender peers. The new research from Healthgrades and OutCare Health highlights the challenges LGBTQ+ people face when seeking all kinds of medical care, from emergency care to annual check ups.
OutCare Health is the nation’s most comprehensive resource for LGBTQ+ health equity and Healthgrades is a U.S. company that provides information about physicians, hospitals and health-care providers. Healthgrades has amassed information on more than three million U.S. health-care providers since it was founded in 1998.
Medical gaslighting is a too-common practice of physicians and other health-care personnel dismissing or downplaying a patient’s physical symptoms or attributing those symptoms to something else, like a mental health problem. Medical gaslighting is especially likely to happen to women and people of color. Black women are most at risk from medical gaslighting and queer and trans people — who are already wary of health-care settings due to fear of discrimination — are also at high risk for medical gaslighting.
Established research explicates how symptoms for women and people of color are less likely to be taken seriously than those of white men. Marginalized groups, like the LGBTQ+ community, also experience other disparities in the quality of the care they get from various healthcare venues.
The new research from Healthgrades and OutCare Health highlights the multiplicity of challenges LGBTQ+ people face when seeking medical care. This includes data showing that 18% of LGTBQ+ respondents reported experiencing medical trauma and that 10% have experienced some form of medical discrimination.
These experiences can have a serious impact on the health of LGBTQ+ people, leading many to delay addressing health care issues. In the past year, one in four LGBTQ+ adults did not have a health screening of any kind, putting them at risk for many health problems. And in the past 12 months, LGBTQ+ people were also two times more likely to skip an appointment because of a prior negative experience.
In the new study, Healthgrades and OutCare Health surveyed 952 adults who identified as being LGBTQ+ as well as 1,049 adults who identified as both cisgender and heterosexual.
Studies have shown that compared with men, women face longer waits to be diagnosed with cancer and heart disease, are treated less aggressively for traumatic brain injury, and are less likely to be offered pain medications. People of color often receive poorer quality care, too; and doctors are more likely to describe Black patients as uncooperative or non-compliant, which research suggests can affect treatment quality.
LGBTQ+ respondents were less likely than their cis and straight peers to have gone in for a health screening over the past year and were more likely to skip care altogether. The reasons given were consistent: LGBTQ+ people experienced less supportive and far more traumatizing and exclusionary treatment from providers.
When asked to agree with the following statement, “My doctor listens to me when I express concerns about treatments and prescriptions,” 49% of LGBTQ+ respondents agreed compared to 61% of straight and cis respondents. The survey shows that 47% of LGBTQ+ participants agree with the statement that they “feel confident communicating with their doctor,” compared to 63% of cis and straight people.
For the statement, “My doctor takes my opinions seriously,” 44% of LGBTQ+ respondents agreed compared to 57% of straight and cisgender participants. Additionally, less than half of LGBTQ+ people said they were satisfied with their doctor while only 37% said they “feel respected by them.”
LGBTQ+ people were almost three times more likely to skip an appointment due to poor mental health and twice as likely to avoid a health screening “due to a past negative experience,” compared to their cis and straight peers.
The survey shows that 29% of queer respondents felt dismissed and not taken seriously by their doctors, 15% were told their symptoms were “all in their head,” 18% reported experiencing medical trauma, and 10% said they have experienced “some form of medical discrimination.”
The survey reveals that 13% of LGBTQ+ people reported emotional medical trauma, 6% reported physical trauma, and 3% reported sexual trauma.
While 54% of LGBTQ+ people reported trusting their primary-care providers in the survey, compared to 70% of heterosexual participants, there was far less trust in other health-care providers. Only 50% of LGBTQ+ people trust specialists, only 17% trust the U.S. healthcare system as a whole, only 16% trust pharmaceutical companies and only 15% trust insurance companies.
What are the signs of medical gaslighting?
Medical gaslighting happens when health-care professionals dismiss the patient’s symptoms and fail to take their concerns seriously and when they don’t listen to the patient or constantly interrupt them.
Laughing at a patient’s concerns or suggesting that what they’re experiencing is “in their head” is another indicator of medical gaslighting.
Other gaslighting experiences include lack of empathy or sensitivity to a patient’s pain or concerns and/or blaming the patient for their condition. Attributing the cause of a medical issue to a mental health condition, such as anxiety or depression is another common form of gaslighting.
Health-care providers who treat women, people of color and LGBTQ+ people differently are likely doing so due to biases — racism, misogyny, homophobia and transphobia. A recent New York Times article in June on the issue garnered nearly 3,000 comments. Among those were stories of misdiagnoses that nearly cost patients their lives or that delayed treatment, leading to unnecessary suffering. In addition, patients with long COVID wrote about how they felt ignored by the doctors they turned to for help.
Healthline says, “The research gives a snapshot of the challenges members of the LGBTQ+ community face when seeking medical care — from medical gaslighting to trauma.”
They added, “Experts say spotlighting this kind of data can pave the way forward for making the healthcare experience safer and more equitable for LGBTQ+ people.”
PGN has previously reported on these issues of accessing care that is appropriate and safe in a series on the pandemic, elder care and Long Covid.
A tool called “I Want You to Know” provides cards to help patients begin a conversation with their provider about their identity and care preferences. Seeking out LGBTQ+ clinics and providers is the best choice, but if those are not available, knowing what you want from a provider and being aware of gaslighting will help. It is also helpful to have someone with you in an appointment who can advocate for you if medical gaslighting starts.
Dr. Jennie Goldenberg, a trauma specialist and social worker in private practice who previously worked with the Council for Relationships, told PGN, “Many LGBTQ+ people have trauma histories.” She advises being direct when dealing with health-care professionals who are gaslighting you and to “exit the conversation when it becomes targeted on who you are or whom you love. Your own well-being comes first,” she said.