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CMS Office of Minority Health Working to Achieve Health Equity





Advancing health equity during Pride Month

The Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH) celebrates Pride Month [ https://www.cms.gov/priorities/health-equity/minority-health/resource-center/resource-center/health-observances ] each June by highlighting the unique health care challenges and barriers faced by members of the Lesbian, Gay, Bisexual, Transgender, Queer and Questioning, Intersex, Asexual, and Two Spirit (LGBTQI+) community and sharing resources to help promote equity.  

Many LGBTQI+ individuals may have shared experiences when it comes to facing stigmas surrounding their sexual orientation or gender identity, but individual health outcomes often vary by race, ethnicity, income, and other characteristics. For example, transgender women experience a higher risk of HIV, with rates highest among Black transgender women (44%) and Hispanic transgender women (26%). Gay, bisexual, and other men who have sex with men are also disproportionately affected by HIV, making up 67% of all new diagnoses in the US.

Social determinants of health (SDOH) also contribute to poorer health outcomes among the LGBTQI+ community, including exposure to stressors like stigma, discrimination, violence, and anti-LGBTQI+ policies. For example, the poverty rate is higher among LGBTQI+ individuals (21.6%), specifically among transgender people and bisexual women (29.4%). SDOH factors can also contribute to mental health disparities, including depression, anxiety disorders, and health risk behaviors.

In addition to disparities in health outcomes, LGBTQI+ individuals continue to face barriers to accessing care, including an increased likelihood of being uninsured, delaying care, and being more concerned about medical bills than non-LGBTQI+ individuals. Many LGBTQI+ individuals are reluctant to disclose their sexual orientation to health care providers because they fear rude and discriminatory reactions or are concerned that their personal information could become public.

State and national surveys often lack questions on sexual orientation and gender identity (SOGI), creating a lack of information and gap in addressing disparities. To minimize this gap, CMS has updated the Health Insurance Marketplace application with new SOGI questions that will allow patients to reflect and affirm their identities. These questions will be used to help analyze health disparities in access to coverage. Additionally, we have recently updated the Caring for LGBTQI+ Patients Medicare Learning Network Training [ https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3390633-OMH-LGBTQ/OMHLGBTQ/sogi/LGBTQI/index.html ]. [ https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3390633-OMH-LGBTQ/OMHLGBTQ/sogi/LGBTQI/index.html ]

During Pride Month, CMS OMH is highlighting how you can help address these barriers and disparities impacting the LGBTQI+ community. Share these resources during Pride Month and beyond to help individuals receive better health care coverage.

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Resources

* Recognizing Health Disparities in the LGBTQI+ Community [ https://www.cms.gov/files/document/recognizing-health-disparities-lgbtqi-community.pdf ]
* Caring for LGBTQI+ Patients Medicare Learning Network Training [ https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3390633-OMH-LGBTQ/OMHLGBTQ/sogi/LGBTQI/index.html ]
* HIV/AIDS Disparities in Medicare Fee-For-Service Beneficiaries [ https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/OMH_Dwnld-DataSnapshot-HIV.pdf ]
* LGBTQI+ Partners webpage [ https://www.cms.gov/Outreach-and-Education/Outreach/Partnerships/LGBT ]
* Manage Your Chronic Condition webpage [ https://www.cms.gov/priorities/health-equity/c2c/manage-your-chronic-condition ]
* Coverage to Care (C2C) Enrollment Toolkit [ https://www.cms.gov/files/document/c2c-enrollment-toolkit-2021.pdf ]
* C2C Adult Preventive Services Flyer [ https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/Preventive-Services-Adult.pdf ]
* C2C Roadmap to Behavioral Health [ https://www.cms.gov/about-cms/agency-information/omh/downloads/roadmap-to-behavioral-health-508-updated-2018.pdf ]
* Health Insurance Coverage and Access to Care for LGBTQ+ Individuals: Recent Trends and Key Challenges [ https://aspe.hhs.gov/sites/default/files/2021-07/lgbt-health-ib.pdf ]
* Telehealth for LGBTQ+ Patients [ https://telehealth.hhs.gov/providers/health-equity-in-telehealth/telehealth-for-lgbtq-patients/ ]
* Center of Excellence on LGBTQ+ Behavioral Health Equity [ https://www.samhsa.gov/lgbtq-plus-behavioral-health-equity ]
* Protecting the Rights of Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex (LGBTQI+) People [ https://www.hhs.gov/ocr/lgbtqi/index.html ]
* Lesbian, Gay, Bisexual, and Transgender Health Workgroup [ https://health.gov/healthypeople/about/workgroups/lesbian-gay-bisexual-and-transgender-health-workgroup ]
* Healthy People 2030 [ https://health.gov/healthypeople/objectives-and-data/browse-objectives/lgbt/increase-number-national-surveys-collect-data-lesbian-gay-and-bisexual-populations-lgbt-01 ]











*CMS Office of Minority Health*  |  Working to Achieve Health Equity

"Paid for by the US Department of Health and Human Services"








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