When talking about bringing the number of cervical cancer deaths to zero, it is crucial not to forget about LGBTQ people’s distinct experiences accessing health care. We know cervical cancer is completely preventable, and that regular pap smears are designed to catch any changes in the cervix that may lead to cancer later on. Just as with many other Latinas, however, preventing cervical cancer for LGBTQ Latin@s becomes a matter of access – to affordable exams, to providers who are culturally competent, and to providers who are trained to deal with LGBTQ patients. Unfortunately, for many LGBTQ Latin@s, affordable preventive care with properly trained clinicians is simply not accessible.
One of the most pressing issues for LGBTQ access to care is discrimination and bias. Homophobia at the doctor’s office is unfortunately common, and a great detractor to queer women seeking care. This then affects access to preventive care – women who have sex with women are at risk for cervical cancer, and research suggests that queer women who report positive attitudes about their providers are more likely to have had a recent pap. Transphobia is also a concern, and especially for highly gendered health services such as Pap smears, a huge barrier to access. In fact, in a recent survey about the experiences of transgender people with discrimination, nearly a quarter of trans Latin@s reported having been denied medical services due to their gender identity, and 36% reported delaying needed medicals services for fear of bias.
Discrimination at the doctor’s office is only part of the problem, however. While person-to-person discrimination is an issue, the systematic oppression and marginalization of LGBTQ communities plays a role in LGBTQ Latin@s’ ability to afford care, research and knowledge about LGBTQ health, and clinicians’ training on treating LGBTQ patients. Existing research suggests that LGBTQ communities are disproportionately poor, and the Latin@ respondents of the Transgender Discrimination Survey reported high rates of both unemployment and harassment at work due to gender identity. This means that health care is often out of reach for these communities, especially non-emergency and preventive care such as Pap smears. But even if LGBTQ people are able to afford care, most physicians are woefully unprepared to treat LGBTQ patients due to a lack of training on relevant issues.
We are seeing progress, however. Reproductive justice activism is incorporating the needs of LGBTQ communities, and the LGBTQ advocates are beginning to consider reproductive rights issues as ones that are relevant to their base. Every day we are seeing research on LGBTQ health grow. And last November, in a historic move, the American College of Obstetricians and Gynecologists released a statement urging their members to be prepared to treat transgender patients. It’s a long road ahead, but as long as we don’t forget our LGBTQ herman@s in the fight to bring down cervical cancer deaths to zero, we are moving forward.