(New York City) A study by New York’s Public Advocate into the ways the LGBT community receives healthcare has found major barriers and recommends urgent action.

The report, Improving Lesbian, Gay, Bisexual and Transgender Access to Healthcare at New York City Health and Hospitals Corporation Facilities, was released by Public Advocate Betsy Gotbaum.

It specifically details the barriers LGBT New Yorkers confront in obtaining health care from New York City Health and Hospitals Corporation (HHC).

The report found that both were in sensitive to LGBT medical needs, that there often was homophobia and hostility from providers, and as a result many LGBT people in the city are not accessing basic healthcare services. 

“All New Yorkers deserve equal access to public healthcare services, period. And every New Yorker should expect the quality of care to be the same no matter the sexual orientation or gender identity of the patient.,” Gotbaum said.

The report found an assessment of staff training conducted by HHC last year at the Public Advocate’s request shows great variation from facility to facility.

Of the seven HHC networks, three – North Brooklyn, Queens, South Manhattan – indicated that sensitivity to LGBT patients is not explicitly covered in their staff training. The Central Brooklyn network provides staff sensitivity training regarding different sexual practices but no training specific to LGBT individuals. The Generations and Northern Manhattan network only requires Behavioral Health staff to complete LGBT sensitivity training.

The Public Advocate worked with LGBT organizations to identify the most widely shared concerns and formulate recommendations.

Among those consulted were: Broadway Cares/Equity Fights AIDS; Bronx Community Pride Center; Callen-Lorde Community Health Center; Empire State Pride Agenda; Gay Men’s Health Crisis; National LGBT Cancer Network; The Lesbian, Gay, Bisexual & Transgender Community Center; Transgender Legal Defense & Education Fund, Inc.; and Services and Advocacy for GLBT Elders (SAGE).

“This report points out areas of concern that LGBT organizations and I have regarding healthcare for gay and transgender New Yorkers. I have shared these concerns with HHC, as well as recommendations for addressing them, and I expect HHC to take the necessary steps to help LGBT New Yorkers receive quality care,” said Gotbaum.

The report and Gotbaum’s action won plaudits from LGBT health groups.

“The current report is thorough, fair and accurately reflects our community voices and concerns. The National LGBT Cancer Network will do whatever is needed to help these recommendations be implemented,” said Liz Margolies, Founder and Executive Director of the National LGBT Cancer Network.

Ray Carannante, Gender Identity Project Coordinator and Associate Director of Center CARE said, “We know firsthand of the numerous barriers to care that LGBT communities face when seeking services at every level, from the waiting room to the emergency room.”

“Taking steps to ensure the ongoing education and skill development of providers within the Health and Hospitals Corporation will greatly impact the quality of life of all LGBT New Yorkers,” said Carannante.

The Office of the Public Advocate has recommended HHC require in-house LGBT sensitivity training for all HHC employees, that it designate an LGBT liaison in each HHC facility, establish, display, and enforce a zero-tolerance discrimination policy and establish a review process to monitor progress.

Gotbaum also recommended that the Department of Health and Mental Hygiene increase research on LGBT health issues to accurately assess the quality of healthcare services provided to LGBT individuals and to help medical providers address the needs of LGBT patients.

Health concerns common among gay and male bisexual patients include HIV/AIDS, depression, hepatitis, colon cancer, substance abuse, eating disorders, and HPV infection.

Health concerns common among lesbian and female bisexual individuals include breast and some gynecological cancers, obesity, heart disease, and osteoporosis.

For transgender individuals, the most pressing health concerns include HIV/AIDS and other STDs, substance abuse, depression and suicide. Transgender people also commonly face no insurance coverage for trans-health services or care that does not address transgender considerations like hormone therapy.