It goes without saying that healthcare is supposed to be neutral. Scientific, inclusive, and available to all. But for many queer people, walking into a clinic or filling out a medical form is stepping into a system not built with them in mind. 

This isn’t about niche frustrations. It’s about systemic gaps that turn routine visits into emotional landmines. Ones that leave queer people misdiagnosed, under-treated, or simply ignored.

The result? Avoidance. Delays. Silent suffering. And in too many cases, long-term health consequences.

Beyond the Binary

Most medical systems are built around the assumption of a binary — male or female, heterosexual, cisgender. From intake forms to insurance categories, that binary is hard-coded into the architecture.

And if you don’t fit neatly into it? The system stumbles.

According to a 2023 report from the Center for American Progress, more than 1 in 3 LGBTQ+ Americans experienced discrimination in the past year when accessing healthcare. This included being refused care, misgendered, or belittled by providers.

Transmasc and nonbinary folk often avoid reproductive care altogether. Not because they don’t need it, but because healthcare providers don’t know how to talk to them without misgendering or making assumptions. Lesbian and bisexual women face people who assume they don’t need contraception, STI screenings, or fertility information.

And many queer people across the gender spectrum encounter doctors who conflate identity with behavior. They ask intrusive, irrelevant, or even judgmental questions.

This isn’t just awkward, it’s dangerous. Lack of affirming care can lead to missed screenings, misdiagnoses, and late-stage health problems. All preventable.

In their Racism, Discrimination, and Health survey from 2023, KFF found that 39% of queer adults would rather avoid getting care than deal with a negative experience.

The Risk of Invisible Side Effects

One of the less obvious dangers of non-inclusive healthcare is how often queer patients are excluded from conversations about risk. If your provider assumes your identity means you don’t need certain medications, you’re left out of decisions that shape your health.

This includes failing to warn you about the long-term effects of the ones they do prescribe.

For example, Depo-Provera, an injectable contraceptive, is sometimes prescribed to queer and trans patients off-label. Especially when period or fertility suppression is desired. The Depo-Provera lawsuit highlights many users who have reported long-term effects, including bone density loss and hormonal imbalances. But that’s not all.

According to TruLaw, findings from the British Medical Journal show that Depo-Provera users have a 555% higher risk of developing brain tumors. What’s more, where Pfizer gives clear health warnings in Europe, they fail to disclose the same in the U.S. 

It’s heartbreaking that these aren’t isolated issues. They’re signals of a broader failure: when the system doesn’t fully recognize queer people as patients, it doesn’t fully protect them either. 

The Unequal Geography of Access

The disparities in healthcare access become even sharper outside major cities. In rural areas, queer-affirming providers can be hours or even states away. Some patients are forced to travel long distances just to find basic care that won’t subject them to judgment or harm.

Availability is just one barrier to care. Another major one is cost. Queer people, particularly trans folks and people of color, are more likely to be uninsured or underinsured. The Food Research & Action Center lists stats on poverty in the LGBTQ+ community, with 15% of adults reporting that they don’t have enough to eat.

Living with this kind of poverty makes things like routine care, prescriptions, and specialized services seem like a lofty ideal. Just another pie-in-the-sky dream that non-LGBTQ+ people seem to achieve with ease.

Playing Catch-Up

A long history of pathologization and erasure means many queer people walk into doctors’ offices already on guard. Expecting the worst. Afraid of what might happen. That distrust is earned, and unfortunately, it’s all too often reaffirmed.

Even well-meaning providers can cause harm if they haven’t done the work to understand the lived experiences of queer patients. Without training in inclusive language, sexual health beyond heteronormativity, or gender-affirming care, providers miss critical nuances. They dismiss symptoms, offer incorrect information, or skip important screenings.

Rebuilding trust means not only including queer people in research and protocols, but actively listening. Investing in affirming education. Hiring more LGBTQ+ healthcare providers. Expanding patient protections.

It’s not enough to offer services if they’re services that don’t see queer people clearly. Or warn us of risks. Or treat us with respect, and include us in decisions that directly affect our health.

Because the healthcare system can’t claim to serve everyone if it hasn’t done the work to understand everyone. Non-inclusivity is a failure of infrastructure as much as empathy, and the more we challenge it, the closer we get to building care that’s worthy of us all.