Disability doesn’t discriminate. It can affect anyone at any age of any gender, sexual orientation, or ethnicity. Many people will experience a disabling condition at some stage in their lives; it’s an simple reality of being human.
However, compared to the general population, people with disabilities are disproportionately overrepresented in marginalized communities, which poses unique challenges to those who find themselves at the intersection of identities. People in these communities are also more likely to experience “minority stress,” a chronic state of nervous system activation due to a mismatch between the individual and their experience of society, which can negatively impact their health.
According to data analyzed by the Human Rights Campaign, LGBTQ+ people in the United States report higher rates of disability and long-term services and support needs than non-LGBTQ+ people. The estimates indicate that 3 to 5 million, or as many as one in three, LGBTQ+ adults live with a disability as opposed to one in four of their cisgender and heterosexual counterparts.
While people with disabilities experience varying degrees of limitations in daily lives, some researchers argue that they become disabled not because of their physical, psychological, or cognitive impairments but rather because of marginalization and society failing to create an inclusive, accommodating environment. Disabled LGBTQ+ folks, therefore, are often subject to double marginalization and encounter prejudice both because of being queer and being disabled.
History of disability in the LGBTQ+ community
Homosexuality remained in the globally accepted Diagnostic and Statistical Manual under the harmful label of “mental disorder” until 1987. It was removed as a result of activism and campaigning by numerous civil rights organizations across the country, urging the American Psychiatric Association to reconsider their unfair treatment of sexual minorities.
In 1990, the landmark Americans with Disabilities Act for the first time offered rights and protections to all people with disabilities, but it didn’t extend to people with HIV until 1998.
The World Health Organization removed “gender identity disorder” from the disease classification only in 2019, and in 2022 gender dysphoria was officially recognized as a protected disability in the United States, allowing trans people to seek relief under the ADA.
In the last few decades, medical opinion on sexual and gender minority patients slowly shifted from pathological to a more accepting and educated one, but LGBTQ+ people still run into obstacles in receiving medical care due to limited access to healthcare services, persisting misconceptions about the community, and a lack of relevant training among providers.
Social and systemic barriers
The 2022 study done by KFF showed that almost one in two LGBTQ+ people earns less than $27,180 annually as a single-person household, which suggests that fewer people in the community can afford private health insurance and more have to rely on Medicaid to cover their medical costs.
A different study, published in the American Journal of Public Health, mentioned transportation as one of the barriers for LGBTQ+ people with disabilities. Well-trained and competent healthcare providers may not be easily accessible, especially to patients in rural areas. This forces them to commute long distances to receive care and to postpone treatments, resulting in late diagnosis or even health complications.
Fear of discrimination and mistreatment because of intersecting identities is another reason LGBTQ+ people may delay seeking care, as they are twice more likely than non-LGBTQ+ people to have a negative experience during their medical visits.
A common example of discrimination in a medical setting is “trans broken arm syndrome,” when doctors ascribe unrelated symptoms to a patient’s gender identity and offer solutions they would never offer to a cisgender patient. Gays, lesbians, and other people with a same-sex partner are also more likely to have their complaints invalidated and attributed to their sexual orientation or stereotypes about the LGBTQ+ community.
Urgent need for change
Since Trump’s inauguration, his administration, with Robert F. Kennedy, Jr., as the Secretary of Health and Human Resources, has been introducing relentless cuts to medical services and dismantling the system upon which millions of Americans depend for their well-being. The Office of Minority Health, an agency established in 1987 with the goal of eliminating health disparities, has seen significant layoffs as a result of Trump’s war against diversity and inclusion.
The reality that queer people with disabilities are faced with is harsh, and the need for change has never been clearer. When the most vulnerable people in American society suffer under Trump’s despotic regime, communities have a responsibility to take matters into their own hands.
Systemic change may take time and a nationwide effort to achieve, but there are many things that can be done on a local level to fight the injustice queer folks with disabilities struggle with everyday. Communities should strive to ensure accessibility in gathering areas, push policymakers to recognize the importance of inclusion, and normalize conversations about disability in the LGBTQ+ spaces by spreading awareness and challenging ableism. Every small step counts and will bring the society closer to a kinder future, where everyone’s differences are embraced and accommodated, and not punished.
