Barriers to Accessing LGBTQ+ Inclusive Healthcare in Underserved Communities


  • Sarah Emerick Indiana University School of Medicine; Hoosier Public Health Corps; Pride Center of Terre Haute
  • Niki Messmore Indiana University School of Medicine; Hoosier Public Health Corps



Background: LGBTQ+ individuals are more likely to face healthcare discrimination and thus delay medical care which contributes to increased mental health and psychosocial distress. Specific to transgender individuals, insurance denials and a paucity of providers that  provide trans-specific treatment make it increasingly difficult to access care that has been shown to lower psychological distress. Being situated in a medically underserved, rural area, accessing LGBTQ+ inclusive and competent care is a challenge that has been echoed by many who frequent the Pride Center of Terre Haute.

Methods: A literature search was conducted via PubMed and JSTOR. The 2015 US Transgender Survery and peer reviewed articles from 2011 - 2022 were utilized. Local healthcare providers were contacted via phone or email to discuss their willingness and ability to provide an inclusive environment to all LGBTQIA+ persons, as well as hormone therapy for transgender individuals.

Results: Transgender individuals are one of the most underserved patient populations within healthcare. In discussions of the disparity faced by those trying to access care, three issues discussed in the literature were as follows: insurance denials or inadequate financial coverage, lack of proper training of the provider, and distance to travel for gender-affirming care. Rural physicians are not as frequently  exposed to transgender individuals and therefore are less likely to be educated and trained in providing gender-affirming care as demonstrated through discussions with providers local to the Wabash Valley.

Conclusions & Future Implications: This work is part of an ongoing initiative to better understand the challenges faced by the LGBTQ+ community in a medically underserved area of southern Indiana. This study intends to further understand the challenges faced by the LGBTQ+ individuals in seeking care and also local healthcare providers' capability of administering competent trans-specific care.