Today, President Biden signed several executive orders aimed at improving access to health care. One order directs the Department of Health and Human Services to review the Title X gag rule, which restricts federal funding to health care providers who tell their patients how to safely and legally access abortion. Another executive order reopens federal marketplaces selling Affordable Care Act (ACA) health plans and lowers barriers to joining Medicaid. These actions will increase access to health care for millions of LGBT people.
Access to the types of care and services provided by reproductive health centers impacted by the Title X rule, such as Planned Parenthood, is critical for many LGBT people. According to a fact sheet released by the White House, “Across the country and around the world, people — particularly women, Black, Indigenous and other people of color, LGBTQ+ people, and those with low incomes — have been denied access to reproductive health care.”
Williams Institute research shows that over 48 million people of reproductive age assigned female sex at birth currently use contraceptives, including up to 3.9 million cisgender sexual minority women and transgender adults. In addition, reproductive health centers often provide access to HIV testing and PrEP, which gay and bisexual men and transgender people rely on to prevent HIV infection. Some, including some Planned Parenthood clinics, also provide gender-affirming hormone care for low-income transgender patients.
“Reproductive health centers provide a range of free or low-cost services, including prevention and treatment of HIV and STD testing,” said Kerith J. Conron, Research Director at the Williams Institute. “They are particularly important to LGBT communities that disproportionately experience poverty, including bisexual women, transgender people, and LGBT people of color, as well as LGBT youth who are economically dependent on caregivers.”
Reducing barriers to enrolling in ACA health plans and Medicaid will also improve access to care for LGBT people. Research indicates that the ACA and Medicaid expansion led to significant drops in uninsurance rates among LGBT people. An estimated 1,171,000 LGBT adults, including 152,000 transgender people, have Medicaid as their primary source of health insurance. Despite increases in coverage, LGBT people are still more likely to lack health insurance than non-LGBT people (15% compared to 12%).
Key findings from Williams Institute research include
- Research shows that unplanned pregnancies are more common among bisexual women than their heterosexual peers. More than one in ten (13%) high school girls and 6% of women ages 18-49 self-identify as bisexual.
- Among women ages 15-44, the odds of an unwanted pregnancy are nearly two times greater for bisexually identified women than their heterosexual peers.
- 4% of gay and bisexual men and 46% of transgender people at high risk of HIV infection are tested for HIV annually.
- 4% of gay and bisexual men and 3% of transgender people at high risk of HIV infection use PrEP. Barriers to PrEP uptake include lack of access to providers, poor patient-provider communication, and stigma.
- 22% of LGBT people live in poverty. About one in three cisgender bisexual women (29.4%), transgender adults (29.4%), LGBT Black (30.8%), LGBT Latino/a (37.3%), and LGBT American Indian or Alaska Native (32.4%) adults in the U.S. fall below the official poverty threshold.
- 15% of LGBT adults are uninsured, compared to 12% of non-LGBT adults.
- 1,171,000 LGBT adults, including 152,000 transgender people, have Medicaid as their primary source of health insurance.