LGBTQ Health Inequities

Anderson: The COVID-19 pandemic and the economic crisis it left behind has sent shockwaves throughout the country, affecting all communities, but some are more vulnerable than others. Hello, and welcome to "Comcast Newsmakers." I'm Tetiana Anderson. Data from the Kaiser Family Foundation suggests that LGBT populations may be disproportionately impacted by COVID-19, and joining me to talk about why is Dr. Scott Nass, president of GLMA health professionals advancing LGBTQ equality. And Scott, thanks for being here.

Nass: Thanks for having me, Tetiana. I'm very excited to be here.

Anderson: So this Kaiser Family Foundation report shows that the LGBT population is increasingly impacted by COVID-19. But that's something that we hear about people of color. That's something that we hear about the elderly community. What is going on in the LGBT community that makes this just so much more stark?

Nass: Yeah, unfortunately, we know that LGBTQ community suffer from a number of conditions that put them at higher risk for certain other conditions, like COVID-19. For example, there's a higher rate of smoking among LGBTQ communities, very significantly higher. And so with COVID-19 being a respiratory illness, one that affects the lungs directly, we just imagine that there's going to be a higher risk for LGBTQ populations. Additionally, HIV and certain cancers like breast cancer occur more frequently among LGBTQ communities. And so when folks are living with these conditions, it puts them at higher risk for other conditions like COVID-19 to sneak in and do some damage, as well.

Anderson: And it's not only that, it's a reluctance to actually seek healthcare in general. Explain that briefly.

Nass: Yeah, historically, there has been a long distrust of the healthcare system by LGBTQ communities. LGBTQ folks have been vilified and mistreated in many ways by the healthcare system, and so folks are reluctant to engage in having a routine primary care relationship or seeing medical providers or healthcare professionals of any kind, and people are afraid sometimes of going to the emergency department because of ways they've been treated before or the fear that they're going to be mistreated because of their identities or what they look like. And so that's pretty significant in terms of getting folks to seek care when they're having COVID-19 symptoms, for example.

Anderson: And part of identifying what the problems are, whether it's to do with COVID-19 or anything else, is collecting the data, and that's so important. But we also know at the same time that there are a lot of states, most states, as a matter of fact, that don't collect information on sexual orientation, gender identity. Why is that so problematic from your point of view?

Nass: Yeah, when it comes to looking at healthcare conditions and outcomes, data is everything. We know, as I said before, that there's a higher rate of smoking and certain cancers among LGBTQ communities. But what ultimately does that mean, especially in the context of COVID-19? Does that mean that folks are going to suffer more because of the condition and have worse outcomes, disability, or death, and especially for folks living at the intersection of their sexual orientation and gender identity and their ethnicity or race, other factors that do put them at risk within the healthcare system for worse outcomes. So data is really everything.

Anderson: And we also know that certain populations generate different kinds of scrutiny than other populations. And when it comes to the LGBT community, something as simple as giving blood, for example, is not so simple. Explain what can happen.

Nass: This is another question of needing to look at the data. We've long known that HIV risk is all about behaviors and not identity, and historically, it's been the gay male identity that's been used to eliminate folks from being able to donate blood. And so now looking at the science, though, we know that we can detect HIV very soon in the blood after someone has contracted HIV. And we know that it's all about the behaviors. And so really focusing our screening around blood donation on behaviors and using the faster testing systems that we have now available for blood really make that more of a data-based issue rather than an LGBTQ issue. So we really need to get the FDA on board with moving forward and allowing people who can donate blood to donate blood. We desperately need blood in our supplies these days.

Anderson: So all of this is sort of making me think about what's the the larger solution here. And part of it seems to me it's about freedom to be who you are, freedom to live as you want, and that would move towards dismantling some of the institutional barriers that we just talked about. But how do we get there?

Nass: Yeah, that's great. We are seeing more and more folks in on the media, in leadership positions who are living out and proud as LGBTQ individuals. But what really remains a big challenge is the institutions, as you were saying. We just aren't learning in medical schools and other health professional schools that these inequities, that these disparities exist, and we aren't really teaching students and trainees how to work with LGBTQ folks to ensure a more equitable experience. So it really starts with organizations like medical schools and other health professional schools really integrating culturally competent, humble curricula that teach future healthcare providers how to partner with populations that need them the most.

Anderson: And Dr. Scott Nass, if people want to find out more about GLMA, what's the website?

Nass: Website is GLMA.org -- G-L-M-A.org. And we'd love to have folks stop by.

Anderson: And thank you for joining us.

Nass: Thank you.

Anderson: Thanks to our viewers, as well, for watching. For more great conversations with leaders in your own community and across the nation, log on to ComcastNewsmakers.com. I'm Tetiana Anderson.