When it comes to healthcare, many people tend to resist seeing a doctor or setting up routine medical exams.
But for those who identify as a member of the LGBTQ+ community, fear of being truthful and/or not feeling comfortable enough to share personal information, especially in a medical setting, can add another layer of resistance and impede getting proper care.
Now there are real numbers to confirm what most people have suspected about the healthcare needs and concerns in the LGBTQ+ community on Long Island.
Stony Brook LGBTQ+ Community Health Needs Survey Results
To coincide with National Coming Out Day on October 11, Stony Brook Medicine (SBM) recently released the results of the 2021 Long Island LGBTQ+ Community Health Needs Survey it had conducted in the summer/fall of 2021 with the support of more than 30 community partners, including the Suffolk County Department of Health and the Suffolk County Human Rights Commission. Four years in the making, the results are sobering, if not eye opening, for the community in Suffolk and Nassau counties.
Of the 1,150 LGBTQ+ adults 18 years and older who took the anonymous, online survey: 43.6% rated themselves as being in fair to poor mental health, 33.5% had thoughts of self-harm and 23.9% had seriously considered suicide within the past three years.
More than a third of those who participated in the study indicated they were suffering from moderate to severe anxiety and/or depression.
The survey further revealed that demographic groups, such as transgender people, respondents who are gender nonconforming, low-income, young adult, Black and Asian reported experiencing an even higher prevalence of behavioral health concerns including intentional self-harm.
“The top three issues cited by the survey’s respondents were access to behavioral health resources, training healthcare providers about LGBTQ+ health needs and access to health insurance that addresses LGBTQ+ needs,” says Allison H. Eliscu, MD, medical director of the Adolescent LGBTQ+ Care Program at SBM, and principal investigator of the study. “Respondents also cited violence, bullying and harassment as critical issues facing the community.”
Survey results indicated that over one third of respondents admitted to excessive drinking (two drinks or more per day on average), nearly 15% to using illicit drugs. Also, 25% of respondents said they do not have a primary care physician, 37% of respondents said they have been treated disrespectfully by a healthcare provider on staff, with over 46% of respondents saying they preferred a telemedicine visit due to LGBTQ+ sensitivities.
The survey was open to LGBTQ+ adults including individuals questioning their identity, who resided in either Nassau or Suffolk counties or attended school on Long Island during the period of the survey (June–September 2021). What was clear in the findings is that respondents felt strongly about gender identity and how they choose to identify themselves, using over 30-plus unique gender identity terms in the study, versus expressing identity through sexual orientation.
“The things that were surprising to me were the differences within the LGBTQ+ community, that it’s not this monolithic community, that there’s all of these sub groups … especially with younger people — and the way people are identifying themselves is so different,” says Robert S. Chaloner, chief administrative officer of Stony Brook Southampton Hospital, which along with SBM, oversees the Edie Windsor Healthcare Center (EWHC) that provides LGBTQ+ healthcare services in addition to HIV/AIDs treatment and prevention services.
“When I was young, you were gay or straight. That was basically it — there weren’t all these other terms; even getting the terminology right around transgender people is something pretty new,” says Chaloner. “The people that don’t fit traditional definitions seem to be struggling a lot and that was striking to me. What’s also striking is when you overlap race and ethnicity on top of it, so if you are a Black or Brown person, that makes it even more challenging.”
What can be done to improve the healthcare environment and results in the LGBTQ+ community?
“Bringing awareness, knowledge and sensitivity to everybody in the healthcare field is crucial and that’s something we are working very hard on at Stony Brook Medicine,” says Eliscu. She points out the Stony Brook Medicine “LGBTQ+ website is a great community resource, including a tab for adolescents to ‘know your rights’ and one for senior citizens, as well as a tab called ‘Out and Proud,’ a voluntary place that shows how you identify.” She adds, “You find (out role models) at all levels of Stony Brook University on there.”
In response to the study, SBM is rolling out a multi-faced effort to respond to the key findings that includes clinical and support services — distributing a directory of SBM LGBTQ+ care providers, using data to support funding requests for expanded addiction treatment and prevention services and mental health services, expanded community outreach, training and research and additional services at the EWHC.
In addition to operating as the East End’s monkeypox vaccination site, the EWHC recently received a grant, along with community partner LI for Youth, to expand counseling services for LGBTQ+ young people. SBM also announced the Edie Windsor Center will increase mental health counseling services with an on-site licensed clinical social worker.
“I think what we need to do is create more environments like Edie Windsor where right from walking in the door and on through, people feel that they can be honest about their personal situation,” says Chaloner. “And that’s not just for the LGBTQ community — out here there’s been a lot of challenges for the Latino community feeling welcome that we need to create healthcare environments where people can say, ‘This is who I am, this is what I’m about, this is how I identify myself’ and feel safe saying that. If they can do that and we get real good information, we can provide better healthcare.”
To review the LGBTQ+ Health Needs Survey findings as well as access a list of LGBTQ+ resources, visit stonybrookmedicine.edu.
For SBM LGBTQ care, visit stonybrookmedicine.edu/LGBTQ.
For information about the Edie Windsor Healthcare Center, visit southampton.stonybrookmedicine.edu/services/LGBTQ-and-HIV-healthcare.