2022

UCLA study spotlights gaps in healthcare access among California’s LGBT community


There is difficulty finding providers and getting timely care among bisexual women and transgender adults, say researchers led by Dr. Ninez Ponce.

Doctor discussing with two patients

Lesbian, gay, bisexual, and transgender adults in California face significant barriers in accessing health care despite having similar or better rates of health insurance coverage than heterosexual or cisgender adults, a new UCLA report shows.

These barriers include a lack of timely access to needed care, not having a usual source of care, having trouble finding providers and experiencing unfair treatment, according to researchers from the UCLA Fielding School of Public Health's UCLA Center for Health Policy Research (CHPR) - led by Dr. Ninez Ponce, professor of health policy and management and director of the center - and Williams Institute who conducted the study.

Using data from UCLA CHPR's California Health Interview Survey from 2015 to 2020, the researchers tracked health care access and insurance coverage by sexual orientation and gender identity. They found that bisexual men and women were the most likely of all groups to report not having a usual source of health care (27% and 24%, respectively) and that rates of delaying or not getting needed medical care were considerably higher among bisexual women (33%) and lesbian women (23%) than straight women (16%).

The study also found that transgender adults experienced greater barriers to care than cisgender adults (those whose gender identity matches the sex they were assigned at birth) in a number of areas. Rates of delaying or not getting needed medical care, for example, were more than twice as high among transgender adults (33%) as cisgender adults (14%).

“Our study points out several of the health care access barriers the LGBT community in California faces, including greater difficulty finding providers who will see them and having to delay necessary health care,” said the study’s lead author Dr. Susan H. Babey, senior research scientist and co-director of the Chronic Disease Program at UCLA CHPR. “These findings emphasize the importance of looking more closely at differences within LGBT populations so that actions may be taken to close gaps in health care access and improve health outcomes for sexual and gender minorities.”

Other key findings from the report:

  • Gay men (57%) and lesbian women (54%) were more likely to have employer-sponsored insurance than heterosexual men (48%) or women (44%).
  • Transgender adults (37%) were more likely to have Medi-Cal or other public insurance than cisgender adults (21%).
  • Bisexual women (20%) were twice as likely as straight women (11%) to report having trouble finding a medical specialist.
  • Transgender adults were more likely than cisgender adults to report not having a preventive care visit in the past year (39% vs. 28%) and to have trouble finding a specialist (29% vs. 11%).
  • Bisexual men (22%) and gay men (18%) had higher rates than straight men (12%) of delaying or not getting needed medical care.

Among transgender adults, transportation problems and their insurance not being accepted or not covering the care were cited as the main reasons for delaying or not getting needed care, the researchers noted.

Members of the LGBT community were also more likely to experience unfair treatment when getting medical care, with higher rates of lesbian women (44%), bisexual women (45%), and gay men (32%) reporting such experiences than straight women (32%) and men (23%). Previous negative experiences or discrimination may add to some of the barriers reported by LGBT adults, the authors said.

“The findings show that LGBT Californians remain in need of clinical and structural interventions to improve access to health care. We also need more data to assess the different needs of the various communities within the LGBT population,” said study co-author Dr. Jody L. Herman, a senior scholar of public policy at the Williams Institute, which is based at the UCLA School of Law. “The report also provides further evidence that barriers remain to receiving gender-affirming care, and continued advocacy and support are needed to increase access.”

by Elaiza Torralba


The UCLA Fielding School of Public Health, founded in 1961, is dedicated to enhancing the public's health by conducting innovative research, training future leaders and health professionals from diverse backgrounds, translating research into policy and practice, and serving our local communities and the communities of the nation and the world. The school has 761 students from 26 nations engaged in carrying out the vision of building healthy futures in greater Los Angeles, California, the nation and the world.

Faculty Referenced by this Article

Dr. Ninez Ponce
Ninez Ponce
Health Policy and Management
Read Faculty Profile
Olivia Jung
Olivia Jung
Health Policy and Management
Read Faculty Profile
James Macinko
James Macinko

Professor of Community Health Sciences & Health Policy and Management, and Associate Dean for Research

Community Health Sciences Health Policy and Management
Read Faculty Profile
Dr. Dylan Roby
Dylan Roby
Health Policy and Management
Read Faculty Profile
Kadiyala, Srikanth
Srikanth Kadiyala
Health Policy and Management
Read Faculty Profile
Robert Kaplan
Robert Kaplan
Health Policy and Management
Read Faculty Profile
Clifford Ko
Clifford Ko
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Annette Maxwell
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Brennan Spiegel
Health Policy and Management
Read Faculty Profile
Freund, Deborah
Deborah Anne Freund
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Julie A. Elginer

EMPH Academic Program Director with expertise in healthcare marketing, finance, and reproductive health policy, teaching in the EMPH, MPH, MHA program

Health Policy and Management
Read Faculty Profile
Warren Scott Comulada
Warren Scott Comulada
Health Policy and Management
Read Faculty Profile
Dr. Yvonne Flores
Yvonne Flores
Health Policy and Management
Read Faculty Profile
Rosenstock
Linda Rosenstock
Environmental Health Sciences Health Policy and Management
Read Faculty Profile
Dr. Kristen Choi
Kristen Choi
Health Policy and Management
Read Faculty Profile
Dr. Alice Kuo
Alice Kuo
Health Policy and Management
Read Faculty Profile
Dr. Paul Fu, Jr.
Paul Fu, Jr.
Health Policy and Management
Read Faculty Profile
Dr. Lillian Gelberg
Lillian Gelberg
Health Policy and Management
Read Faculty Profile
Patricia Ganz
Patricia Ganz
Health Policy and Management
Read Faculty Profile
Dr. Risha Gidwani
Risha Gidwani
Health Policy and Management
Read Faculty Profile
Dr. Naomi Zewde
Naomi Zewde
Health Policy and Management
Read Faculty Profile
Michelle Keller
Michelle S. Keller

Dr. Michelle S. Keller is a health services researcher whose research focuses on the use and prescribing of high-risk medications.

Health Policy and Management
Read Faculty Profile
Jack Needleman
Jack Needleman
Health Policy and Management
Read Faculty Profile
Laura Erskine
Laura Erskine
Health Policy and Management
Read Faculty Profile
Leah Vriesman
Leah Vriesman
Health Policy and Management
Read Faculty Profile
Davidson - headshop
Pamela Davidson
Health Policy and Management
Read Faculty Profile
Vickie Mays
Vickie Mays
Health Policy and Management
Read Faculty Profile
Michael Ong
Michael Ong
Health Policy and Management
Read Faculty Profile
Gordon headshot
Thomas D. Gordon
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Barbara Berman
Health Policy and Management
Read Faculty Profile
Dr. Jonathan Fielding
Jonathan Fielding
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Arlene Fink
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Lori Pelliccioni
Health Policy and Management
Read Faculty Profile
Image of Dr. Susan Ettner
Susan Ettner
Health Policy and Management
Read Faculty Profile
Dr. Jennifer Wortham
Jennifer Wortham
Health Policy and Management
Read Faculty Profile
Comanor, Bill
William Comanor
Health Policy and Management
Read Faculty Profile
Dr. Thomas Rice
Thomas Rice
Health Policy and Management
Read Faculty Profile
Dr. William McCarthy
William J. McCarthy
Health Policy and Management
Read Faculty Profile
Moira Inkelas
Moira Inkelas
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Neal Halfon
Health Policy and Management
Read Faculty Profile
Gerald Kominski
Gerald Kominski
Health Policy and Management
Read Faculty Profile
Dr. John Lu
Z. John Lu
Health Policy and Management
Read Faculty Profile
Galper, Michael
Michael Galper
Health Policy and Management
Read Faculty Profile
Dr. Samuel Sessions
Samuel Sessions
Health Policy and Management
Read Faculty Profile
Dr. Beth Glenn
Beth Glenn
Health Policy and Management
Read Faculty Profile
Dr. Anthony Schiff
Anthony Hunter Schiff
Health Policy and Management
Read Faculty Profile
Sangeeta Ahluwalia
Sangeeta Ahluwalia
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Thomas Priselac
Health Policy and Management
Read Faculty Profile
Yusuke Tsugawa
Yusuke Tsugawa
Health Policy and Management
Read Faculty Profile
Mangione, C
Carol Mangione
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Jose J. Escarce
Health Policy and Management
Read Faculty Profile
Dr. Stephanie Taylor
Stephanie L. Taylor

Nationally recognized health services researcher and sociomedical scientist with 25+ years' experience in effectiveness and implementation research.

Health Policy and Management
Read Faculty Profile
Corrina Moucheraud
Corrina Moucheraud
Health Policy and Management
Read Faculty Profile
Emily Abel
Emily Abel
Health Policy and Management
Read Faculty Profile
Nadereh Pourat
Nadereh Pourat
Health Policy and Management
Read Faculty Profile
Dr. Aria Fallah
Aria Fallah
Health Policy and Management
Read Faculty Profile
Dr. Daniel Eisenberg
Daniel Eisenberg
Health Policy and Management
Read Faculty Profile
silhoette
Ty Robbins
Health Policy and Management
Read Faculty Profile
Dr. Elizabeth (Becky) Yano
Elizabeth (Becky) Yano
Health Policy and Management
Read Faculty Profile
Roshan Bastani Headshot
Roshan Bastani
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Ron Andersen

Dr. Ron Andersen is the Wasserman Professor Emeritus in the UCLA Departments of Health Policy and Management.

Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Robert Brook
Health Policy and Management
Read Faculty Profile
Dr. Joann Elmore
Joann G. Elmore
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Alan Tomines
Health Policy and Management
Read Faculty Profile
Avram Kaplan
Avram Kaplan
Health Policy and Management
Read Faculty Profile
Jeanne Miranda
Jeanne Miranda
Health Policy and Management
Read Faculty Profile
Ron D. Hays
Ron D. Hays

@UCLA since 1997

Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Mark Litwin
Health Policy and Management
Read Faculty Profile
Dr. Arturo Vargas Bustamante
Arturo Vargas Bustamante
Health Policy and Management
Read Faculty Profile
Balgrosky headshot
Jean Balgrosky
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
David Hayes-Bautista
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Emmeline Chuang
Health Policy and Management
Read Faculty Profile
Paul Chung
Paul Chung
Health Policy and Management
Read Faculty Profile
Diana Hilberman
Diana Hilberman
Health Policy and Management
Read Faculty Profile
Dr. Xi Zhu
Xi Zhu
Health Policy and Management
Read Faculty Profile
Burt Cowgill
Burt Cowgill
Health Policy and Management
Read Faculty Profile
Isomi Miake-Lye
Isomi Miake-Lye
Health Policy and Management
Read Faculty Profile
Aronberg, Sandra
Sandra Aronberg
Health Policy and Management
Read Faculty Profile
Faculty/staff profile placeholder image
Steven Teutsch
Health Policy and Management
Read Faculty Profile
Dr. Felicia Hodge
Felicia Hodge
Health Policy and Management
Read Faculty Profile
Dr. Kenneth Wells
Kenneth Wells
Health Policy and Management
Read Faculty Profile
Dr. Frederick Zimmerman
Frederick Zimmerman
Health Policy and Management
Read Faculty Profile
Jody Heymann
Jody Heymann
Epidemiology Health Policy and Management
Read Faculty Profile

Related Content

LGBTQ+ Youth Town Hall
June 1, 2022
"LGBTQ+ youth health and mental health"

KABC-TV interviewed Dr. Matthew Mimiaga, UCLA Fielding School of Public Health professor of epidemiology director of the UCLA Center for LGBTQ+ Advocacy, Research & Health (C-LARAH), about mental health issues related to LGBTQ+ youth.

Source: KABC-TV (ABC) Read Full Article
Doctor discussing with patient
June 30, 2022
Study spotlights gaps in access to health care among state’s LGBT community

Dr. Susan Babey, co-director of the UCLA Fielding School of Public Health's UCLA Center for Health Policy Research, itself led by Dr. Ninez Ponce, UCLA Fielding School of Public Health professor of health policy and management, addresses barriers to health care access by California's LGBT community.

Source: U Magazine Read Full Article