Sexual Identity Differences in Health Care Access and Satisfaction: Findings from Nationally Representative Data.

Abstract

Identification of barriers to adequate health care for sexual minority populations remains elusive as they are complex and variable across sexual orientation subgroups (e.g., gay, lesbian, bisexual). To address these complexities, we use a U.S. nationally representative sample of health care consumers to assess sexual identity differences in health care access and satisfaction. We conducted a secondary data analysis of 12 waves (2012-2018) of the biannual Consumer Survey of Health Care Access (n=30,548) to assess sexual identity differences in 6 health care access and 3 health care satisfaction indicators. Despite parity in health insurance coverage, sexual minorities - with some variation across sexual minority subgroups and sex - reported more chronic health conditions alongside restricted health care access and unmet health care needs. Gay/lesbian females had the lowest prevalence of health care utilization and higher prevalence rates of delaying needed health care and medical tests relative to heterosexual females. Gay/lesbian females and bisexual males were less likely than their heterosexual counterparts to be able to pay for needed health care services. Sexual minorities also reported less satisfactory experiences with medical providers. Examining barriers to health care among sexual minorities is critical to eliminating health disparities that disproportionately burden this population.