KRAKOW, POLAND - 2020/08/29: A participant wears a surgical mask with a rainbow-coloured heart ... [+]
Throughout the pandemic, health organizations across the country have struggled to stretch limited resources to help as many patients as possible. These stressors emphasize existing health disparities and present new obstacles for LGBTQ+ health centers.
LGBTQ+ people have less access to health insurance than do their cisgender or heterosexual neighbors. Additionally, LGBTQ+ people cope with disproportionally high rates of poverty, chronic illness, and mental illness. These lived experiences create a dangerous combination. While LGBTQ+ individuals are at risk for violence and illness, they also may not have the insurance and access to healthcare that they need. And even for those LGBTQ+ patients who have the means to seek medical treatment, health discrimination poses an additional barrier to wellness. According to reporting from the Center for American Progress, almost thirty percent of transgender patients report being assaulted by their doctors. Another 29% of transgender individuals have been turned away from clinics, hospitals, or doctors’ offices.
Because of these deep health inequalities, many queer and trans-friendly health organizations have been vulnerable long before the pandemic hit. There are around 200 LGBTQ+ health centers in the United States; a limited number of facilities to meet LGBTQ+ health needs. These centers tend to have a high patient load because many patients may not feel safe seeking treatment elsewhere. Unfortunately, LGBTQ+ health organizations have become increasingly strained during the pandemic.
NBC News reports that LGBTQ+ health organizations like the Callen-Lorde Health Center have experienced financial difficulties. During 2020, Callen-Lorde faced a 60% revenue decline.
Why are LGBTQ+ centers struggling during the pandemic? In general, healthcare workers are feeling the stress of working during a global health crisis. Throughout 2020 and into 2021, hospitals and clinics have coped with depleted PPE supplies, routine exposure to Covid-19 patients, expenses from new telehealth equipment, and overloaded emergency facilities. Many LGBTQ+ centers also experience similar pressures as they try to protect their staff and purchase expensive new PPE and telehealth technologies. These additional demands weigh heavily upon LGBTQ+ organizations that may have already been struggling to alleviate healthcare disparities in their communities.
Covid-19 has emphasized existing health issues for LGBTQ+ people, and health advocates are straining to fill the gaps. The Center for Disease Control has found that LGBTQ+ people are more likely to contract Covid-19 and to experience complications from the disease. This increased risk emerges from a variety of factors, including the fact that because of poverty, discrimination, or violence in their home, LGBTQ+ people may not have secure housing in which to quarantine. While LGBTQ+ wellness includes a variety of mental, physical, and financial needs, health organizations have especially noted delays or discrepancies in STI testing and mental health treatments during Covid-19.
Across the country, many patients have avoided medical treatments like walk-in STI tests. According to the National Coalition of STD Directors, 83% of STI testing programs have halted or reduced their services. Such testing can provide important health information to LGBTQ+ people, who are at increased risk of developing STIs Since LGBTQ+ couples may have reduced access to reproductive care supplies and inclusive sexual education, sexual health programs provide vital information and supplies like condoms or dental dams. The Philadelphia Inquirer quotes Eric Paulukonis, the prevention services director of the Mazzoni Center: “"Over a three-month period, we would usually identify anywhere between 150 and 250 cases of syphilis and gonorrhea, for example. When our testing stopped, those individuals potentially don't know that they're infected with something."
The Mazzoni Center distributes take-home testing packages and condoms, but Paulukonis and representations from other organizations worry that a year of quarantine may have long-term impacts for STI spread.
Another public health concern for LGBTQ+ people during the pandemic is mental illness. LGBTQ+ individuals, especially youth of color, face high rates of suicidal ideation, depression, addiction, and anxiety. The pandemic has worsened mental health for patients of many different identities, LGBTQ+ or not. In fact, some psychiatrists have referred to Covid-19 as “America’s loneliness pandemic”. But these mental health burdens weigh especially heavy on the LGBTQ+ community. Many LGBTQ+ people are facing the additional tension from the loneliness of quarantining, job loss, and other stressors.
Health centers and apps are grappling to address this mental health crisis. Therapy apps like TalkSpace provide a platform for telecounseling. Many of the biggest apps in the therapy business, including TalkSpace, also encourage patients to select from professionals who specialize in LGBTQ+ health. However, such services have been overwhelmed by more users than they can serve at one time. The increased demand in mental healthcare has led to long waits for psychiatric care and counseling. These delays can be detrimental to the LGBTQ+ community. For example, some insurance companies require transgender patients to consult with a psychiatrist or therapist before beginning hormone treatments. With mental health centers swamped, these transgender individuals may find their transition interrupted.
LGBTQ+ organizations like the Callen-Lorde Health Center and the Mazzoni Center pursue new options to help LGBTQ+ people during Covid-19. From telehealth appointments to take-home STI tests, health advocates are adopting innovative strategies. But many of these LGBTQ+ organizations need help to continue their operations. Readers may consider donating to or volunteering with an LGBTQ+ health centers. Readers may also contact their health department to inquire about local efforts to support LGBTQ+ people during the pandemic.
