LGBTQ+ Healthcare Experiences in GR Survey Results 2022
Conducted by:
Grand Rapids LGBTQ+ Healthcare Consortium
Board of Directors Meeting March 15, 2023
Arly Winchester and Shahryar Oliai
Table of Contents
1.Overview
Goals Distribution
3.Results
Preferred facility type Obstacles & challenges
If you could change one thing... Avoiding care
Stigmatization
4.Conclusions
Lessons learned Further explorations
2. Demographics Age
Disability
Gender Identity HIV Status Income
Insurance Residence Race/Ethnicity Sexual & Romantic Orientation Location of Care
Goals of Survey
"The goal this year is to understand disparities in healthcare, areas of improvement, and trends of the community for LGBTQ+ patients. Understanding the intricacies of intersecting identities and barriers to care experienced by the community will allow us to better allocate resources and advocate with the community for affirming care for all."
Distribution
Received 101 English responses & 1 Spanish response Posted on Instagram and Facebook pages:
November 9th, 2022
December 1st, 2022
January 4th, 2023
January 20th, 2023
Consortium Website under Community News and Events
Flyers in local clinics, GVSU Health campus
Emailed to Consortium members and providers
Age
Under 18: 1
18-24: 21
Median age of respondents
25-34: 41
35-44: 25
45-54: 6
55-64: 6
65 & over: 2
Across age ranges*: Near 50-50 splits Disabled vs. Able-bodied
Cisgender vs. Transgender/Non-binary
Disability
Mentally disabled: 31
Chronically ill: 24
Physically disabled: 18
Consider self disabled (otherwise not listed): 17
Deaf or Hard of Hearing: 2
Blind or have serious difficulty seeing: 1
Not disabled: 47
Blank: 2
53/102 (52%)
21 respondents chose more than one option to describe their disability status.
Disability: Impact on Daily Tasks
Take care of yourself? (51) (Almost) Always: 11.8%
Sometimes: 47.1%
Rarely: 35.3%
No Impact: 5.9%
Obtain housing? (50)
(Almost) Always: 18%
Sometimes: 12%
Rarely: 20%
No Impact: 50%
Go out by yourself? (52) (Almost) Always: 21.2%
Sometimes: 42.3%
Rarely: 26.9%
No Impact: 9.6%
Maintain employment? (53)
(Almost) Always: 34%
Sometimes: 24.5%
Rarely: 28.3%
No Impact: 13.2%
Disability: Impact on Daily Tasks
Disability Impact Movement Overall
38% indicated sometimes impacts their movement
Disability Impact Care for Self Overall
42% indicated sometimes impacts their care for themselves
Disability Impact Employment Overall
31% indicated (almost) always impacts their employment
Disability Impact Housing Overall
54% indicated no impact on their housing
Disability: Impact
Gender ID & Sexual Orientation:
does your disability impact your ability to... [Go out by yourself?]
Agender
Queer
7/51 Agender people stated sometimes to almost always
19/51 Queer people reported sometimes to almost always
does your disability impact your ability to... [Maintain employment?]
Queer: Insufficient response data, but 16/52 stated from sometimes to almost always impact
Gender Identity
Top 5
Cisgender Woman: 37
Non-binary: 28
Genderqueer/Genderfluid: 20
Cisgender Man: 15
Gender Non-conforming: 12
23 respondents chose more than one label to describe their gender identity.
HIV Status
Negative, not taking PrEP/ PEP: 92*
Negative, taking PrEP: 5
Negative, taking PEP: 0
Positive, taking antiretroviral therapy meds (ART):2
Positive, w/o treatment: 1
Blank: 2
*Of the 92 respondents who said they are "Negative, not taking PrEP/PEP", 68 (73.9%) have not been tested in the last 12 months.
HIV Status
Have you ever talked with a provider or healthcare professional about getting tested for HIV?
Yes: 43
No: 53
I’m not sure: 3
Have you been tested for HIV in the last 12 months?
Yes, through my healthcare provider: 17
Yes, at a testing event held by a health department and/or community center: 7
Yes, otherwise not listed: 3
No: 72
Income
Less than $10,000: 20
$10,000 to $19,999: 11
$20,000 to $29,999: 8
$30,000 to $39,999: 10
$40,000 to $49,999: 11
$50,000 to $59,999: 9
$60,000 to $69,999: 9
$70,000 to $79,999: 3
$80,000 to $89,999: 7
$90,000 to $99,999:1
$100,000 or more: 11
Median income
A single adult with no children in GR needs to
make $29,675 to meet all basic needs*.
*MIT Living Wage Calculator (2023)
Income
Income ~ Disability Impacts
Income ~ Disability Impact Movement
Highest impact group was <$10,000 (14/50) followed by $10K-$20K (8/51)
Income ~ Disability Impact Care for Self
Highest impact group was <$10,000 (14/51) followed by $10K-$20K (8/50)
Income ~ Disability Impact Employment
Highest impact group was <$10,000 (14/52) followed by $10K-$20K (9/52)
Income ~ Disability Impact Housing
Highest impact group was <$10,000 (14/49) followed by $10K-$20K (8/49)
Income ~ Disability
Most disabled respondents' income (35/52) was less than $40K
Insurance
Yes, through my/my partner’s employer: 44
Yes, through Medicaid: 28
Yes, through my parents: 18
Yes, I pay for it myself: 12
Yes, through Medicare: 7
No, I am uninsured: 2
Of the 26 respondents who have avoided receiving care due to lack of insurance or unable to afford copay, 24 (92%) have some form of insurance.
Place of Residence
Top 5 Zip Codes
49503: 15
49506: 13
49505: 10
49504: 9
49507: 8
Image Credit: SunCatcherStudio
Romantic Orientation
Top 5
Homoromantic/Gay/Lesbian: 34
Queer: 34
Biromantic: 22
Panromantic: 21
Aromantic/Aro Spec: 17
33 respondents chose more than one label to describe their romantic orientation.
Sexual Orientation
Top 5
Queer: 38
Homosexual/Gay/Lesbian: 37
Bisexual: 28
Asexual/Ace Spec: 20
Pansexual: 17
35 respondents chose more than one label to describe their sexual orientation.
Race/Ethnicity
Asian (Southeast Asian or Other): 2
Black, African American, African, or African Origin: 3
Hispanic, Latino/a/ex, or Spanish Origin: 3
Indigenous, Native American, or Alaska Native: 5
White or European Origin: 96 Other: 1
8 respondents chose more than one label to describe their race/ethnicity.
Location of Care
Top 6
Corewell Health: 62
Trinity Health: 18
U of M Health West: 18 Pine Rest: 11
Cherry Health: 9
Planned Parenthood: 9
41 respondents chose more than one location where they seek care.
System Ratings
Facility Preference
Traditional/mainstream: 18 Either (no preference): 37 LGBTQ+ Specific: 45
LGBTQ+ Specific
42.2% don’t have a disability 35.6% are cisgender
35.6% have Medicaid and/or Medicare
Traditional/mainstream 50% don’t have a disability 66.7% are cisgender
16.7% have Medicaid and/or Medicare
Either (no preference) 51.3% don’t have a disability 43.2% are cisgender
27% have Medicaid and/or Medicare
Avoidance of Care
Fear of discrimination from front desk staff: 12
Fear of discrimination from a healthcare provider: 30
Gender Dysphoria/Fear of misgendering, deadnaming, and general transphobia: 23
Lack of insurance/unable to afford copay: 26
Lack of transportation: 16
Unable to get time off work: 15
Of the 39 respondents who have avoided receiving care due to fear of discrimination from front desk staff/provider, general transphobia, 32 (82%) stated experiencing microaggression, discrimination, prejudice, or other stigmatization.
Experiences of Stigma
Yes, microaggression: 30
Yes, prejudice: 30
Yes, discrimination: 7
Yes, other stigmatization: 9 No, I have not: 46
Common themes
Off-handed comments about identities Provider/front desk staff discomfort discussing SOGI, especially in relation to contraception Frequent misgendering and deadnaming, even in facilities that claim to be affirming
Experiences of Stigma
Gender ID ~ Discrimination:
In the last year, have you experienced microaggression, prejudice, discrimination, or other stigmatization while receiving care?
Cisgender Man
Noncomforming
Nonbinary
Queer
Proportion of people expressing discrimination is higher for non-cisgender men
Nonconforming is 1.9X likely to face discrimination
Nonbinary is 2.25X likely to experience discrimination
Queer is 1.93X to face discrimination
Refraining from Sharing Info
Gender Identity (35)
Doctor/Nurse: 57.1%
Therapist/Psychologist: 40% Front Desk Staff: 82.9%
Other Healthcare Worker: 51.4%
Sexual Orientation (53)
Doctor/Nurse: 75.7% Therapist/Psychologist: 30.2%
Front Desk Staff: 60.4% Other Healthcare Worker: 39.6%
Romantic Orientation (42)
Doctor/Nurse: 71.4% Therapist/Psychologist: 35.7%
Front Desk Staff: 64.3% Other Healthcare Worker: 42.9%
Refraining from Sharing Info
Sexual Partner History (30)
Doctor/Nurse: 76.7%
Therapist/Psychologist: 30% Front Desk Staff: 66.7%
Other Healthcare Worker: 43.3%
HIV Status (9)
Doctor/Nurse: 77.8%
Therapist/Psychologist: 33.3% Front Desk Staff: 55.6%
Other Healthcare Worker: 33.3%
Obstacles & Challenges
Top 5 Themes
Affirming Providers: 22
Discrimination: 11
TGNB Care: 10
Burden of Education: 9 Access to Care: 7
Changes to be Made
Top 5 Themes
Affirming Providers: 13
Insurance: 10 Access to Care: 6
Inclusive Education: 6
Universal Healthcare: 5
Nearly 96% of respondents said that "any/all care (Medicaid for All/universal healthcare)" is an important benefit for insurance providers to cover.
Additional Feedback
Top 5 Themes
Avoidance of Faith-based orgs
Access to gender affirming care Discrimination
Deadnaming, misgendering, &
pronouns
Insurance & coding
Lessons Learned
Indicate all sources of distribution including contact and URL links Explore more venues for survey distribution
various organizations
consortium’s stakeholders and general membership
other websites, online discussion boards or forums, social media networks
Limit free text responses, asking three top choices
Refining the rating options on health facilities for better consistency
Cast a broader, wider net to include more BIPOC, and balance in the geographical areas
Translate the survey to other common languages (Arabic, Vietnamese etc.)
Explore providing the survey to those without internet/technology access
Data and results storage, access and security
Rephrase different questions to receive more accurate results
Greater insight based on income, age, and disability status of the survey respondents
Further Explorations
Ensure health facilities address patients with proper pronouns and terms
Harassment, Violence (Physical, Sexual and Verbal)
Disclosure of one’s sexuality and gender identification without their permission
Exclusion from events or activities
Substance abuse and misuse in the community Relationship status/Partner Status
Education level
Accessibility of (affirming) medium to high wage jobs
Life satisfaction
Safety level in their communities
Immediate, local, school, work or with their partners
Level of openness in their personal life about being LGBTQAI+
With family, friends, employers, neighbors and roommates Avoidance behaviors about their SOGI
Develop focus groups based on specific issues via zoom/in person Bridge communication between healthcare providers and patients
Please Share Your Questions Now or Via the Following E-mails:
Grand Rapids LGBTQ+ Healthcare Consortium grlgbtqhealthcareconsortium.org
Arly Winchester arlywinchesterlgbtqhcc@gmail.com
Shahryar Oliai oliai@saroyallc.com