College Students’ Guide to LGBTQ+ Healthcare

The importance of LGBTQ+ inclusive healthcare cannot be overstated, especially for college students who are away from home and may be taking care of their own healthcare needs for the first time. This may also be the first time they are not around family who may disapprove of their identity, making it an ideal time for them to receive accurate information and care.

In recent history, LGBTQ+ communities have encountered significant challenges when attempting to access healthcare services. In her book “The Care We Dream of: Liberatory and Transformative Approaches to LGBTQ+ Health,” Zena Sharman poses the question of what it would be like if LGBTQ+ individuals actually enjoyed going to the doctor. The significant challenges that LGBTQ+ communities have faced when trying to receive quality and inclusive care creates the need to ask this question.

LGBTQ+ college students may have better opportunities to receive the healthcare they need in a safe and inclusive environment by accessing services their school provides. Colleges need to create a welcoming environment that includes knowledgeable and compassionate healthcare providers who can address this population’s unique health needs.

For members of the LGBTQ+ community, accessing healthcare can be particularly hard due to various barriers. Here are three pressing obstacles that LGBTQ+ students often face when trying to access healthcare:

The lack of adequate insurance coverage can significantly affect LGBTQ+ students’ ability to access essential healthcare services. Uninsured or underinsured students may face more challenges, especially if they cannot rely on parents or guardians for support, as their coverage may be restricted or lost.

In addition, college students may have coverage under their college or university’s insurance plans. But they might not know how to use their insurance or understand what their policy covers, particularly if they’re making healthcare choices for the first time.

Healthcare for LGBTQ+ students can be incredibly cost-prohibitive and could result in their avoiding care altogether. Gender-affirming procedures may not be covered by one’s insurance policy, or an insurance company may deem it “medically unnecessary.” This can lead to more out-of-pocket spending. Even students on their parent or guardian’s insurance policy may need to pay for medical expenses due to financial barriers or because their parents or guardians refuse to support their medical needs.

Unfortunately, there are no promises that LGBTQ+ students will find healthcare providers that acknowledge and respect their experiences or won’t discriminate against them. This is especially true in many red states where anti-LGBTQ+ laws are being passed or rural areas that may have fewer options for certain health services. Fear of being mistreated or pathologized can deter LGBTQ+ students from seeking care, which impacts their overall well-being and could compound with other health concerns over time.

For many LGBTQ+ students, finding social support is crucial in maintaining their mental health and well-being. This is especially important because of the rising prevalence of harassment, discrimination, and violence against LGBTQ+ communities.

Support can come in many forms, such as counseling, peer networks, and online communities. These resources can aim to provide an LGBTQ+ safe space where students can connect with others who understand their experiences, find validation, and access information to navigate challenges.

LGBTQ+ communities have a rich history of overcoming adversity. However, discrimination and bias against LGBTQ+ people still exist today. And this discrimination has long-term effects on LGBTQ+ folks’ mental health and their comfort in seeking mental healthcare.

According to a recent BestColleges survey, LGBTQ+ college students are more likely to experience mental health challenges, including depression, anxiety, and suicidal ideation, than their straight and cisgender peers. The survey also found that a little under half of LGBTQ+ students have felt isolated and are not able to connect with others.

LGBTQ+ students can find support through on and off-campus resources such as LGBTQ+ student groups, counseling services, peer networks, and national organizations. Adding mental healthcare to your college experience is important, and tuition often covers on-campus options. Here are some options to consider:

Gender-affirming care consists of healthcare deeply knowledgeable about trans and nonbinary people’s needs. This can include biomedical transition-related care but can also include correctly addressing a patient by their pronouns and chosen name in any medical setting. Here are some suggestions for seeking gender-affirming healthcare:

Trans and nonbinary people experience gatekeeping in healthcare settings, so it’s important to do your research before selecting a provider. This may mean setting up a consultation with a potential provider to ask questions if there is unclear information on that provider’s website.

Lean onto others in the community who have navigated this process already. If you’re not well connected with other trans folks on your campus, see if there’s a local group on social media where others have posted their questions or firsthand experiences.

Insurance can be confusing and frustrating and prolong getting the care you need. Review your policy, and if it’s unclear, contact your insurance provider to clarify how your coverage impacts the cost of your care. In addition, many companies often provide an online directory that lets patients check whether their plan covers a particular doctor or healthcare center.

There are different pathways to accessing transition-related or gender-affirming care. One option is informed consent, which is a more straightforward process. This process involves a conversation between the patient and the healthcare provider about the potential risks and benefits of gender-affirming care before the patient consents to the treatment. In this case, the patient’s consent is all that is required to start the care.

A mental health referral can involve a more prolonged process of trying to obtain a letter from a provider confirming a patient should undergo gender-affirming care.

This is your body, so make sure you’re clear on the care you seek and your boundaries with your provider. Ask questions, request examples of results, and discuss the processes step by step until you’ve achieved clarity on how they will deliver your care.

LGBTQ+ students deserve sexual health services and information acknowledging their needs and experiences. Many sexual health and sex education resources center around cisgender and straight audiences. This means that LGBTQ+ folks often have to sift through material that doesn’t address their questions, desires, or pleasure regarding sexual and reproductive health.

Each campus is different, but many campuses offer sexual health resources such as free and confidential STI testing, as well as free contraceptives and lubricants. Many provide educational spaces such as workshops, wellness courses, or online modules that help students learn more about safer sex practices. Whether by asking questions or seeking extra support, consider the following tips for finding and talking to an LGBTQ+-friendly provider.

LGBTQ+ folks benefit from healthcare providers that are well equipped to support clients in understanding their relationship with their (a)sexuality. Finding a provider who can help with your sexual health goals can ensure greater comfort and comprehension of your (a)sexual experiences.

Establish a plan or prepare talking points for conversions with your provider. Consider practicing this conversation with a trusted friend or writing out key items you want to address before the appointment. Arrange a check-in with a supportive person to discuss and debrief before or after your appointment.

Be clear and upfront about what you’re comfortable discussing with your provider. A competent provider will be receptive to your boundaries. Model the language you want used to describe your sexuality and body.

Try not to leave your appointment confused about the information you’ve received or the treatment plan you’re receiving. Let your provider know how you prefer to receive information and updates. Feel free to ask for a step-by-step breakdown of any treatments or support they provide.

You are the expert on your own experiences and your body. When educating your provider, decide what you’re willing to accept and be prepared to confront mistakes. Look into patient/medical advocate services if you’re concerned about being heard by your provider or medical facility.

Campuses should ensure any healthcare materials are expansive and relevant to LGBTQ+ college students. Review existing resources used to prevent, bring awareness to, or respond to healthcare issues affecting college students and make sure they are expansive in their language, messaging, and imagery.

For example, materials about HIV/AIDS should address the continued reality of transmission and avoid stigmatization. STI testing and materials should acknowledge a wide variety of sexual experiences. And contraceptives, lubricants, and other safer sex items should be marketed based on use, not assumptions about who uses them.

Campus staff and administrators are responsible for curating a campus experience that is resonant and affirming for LGBTQ+ college students. However, according to the Proud & Thriving Project, school staff have admitted to having insufficient training to feel competent in addressing LGBTQ+ students’ needs.

From the classroom to the dorm and everything in between, campus staff should regularly evaluate spaces, policies, and practices to maximize the experience of LGBTQ+ college students. Prioritizing inclusive curriculums and maintaining a high standard that rejects discrimination benefits LGBTQ+ college students. It also models an ethic of care and inclusion for all students.

Campuses can bolster their own services and better support students by knowing healthcare offerings off campus. Keep a record of LGBTQ+ affirming healthcare directories, especially local lists where students can easily be referred if there’s no available option on campus.