Preventive Health Screenings for LGBTQ+ Patients: What You Need to Know

In This Article

Providing effective healthcare for LGBTQ+ patients means recognizing the many ways our backgrounds and experiences shape our health and access to care, including acknowledging the shortage of providers who take the time to understand LGBTQ+ patient needs and that they often have a history of negative healthcare encounters. These challenges in getting unbiased, effective care create tangible disparities that limit access to screenings and treatments, contributing to inequitable care.

When clinicians commit to learning, growing, and listening, they can transform the experience by being more welcoming and affirming to LGBTQ+ patients. One of the fundamental ways clinicians can improve access and patient outcomes is to speak to their patients about proactively testing for the common conditions that disproportionately affect the LGBTQ+ community. This engaged approach helps clinicians identify and address health issues early, ensuring patients receive timely and effective treatment.

Let’s take a few minutes to learn about some of the particular healthcare needs of LGBTQ+ patients and the essential screenings that can empower proactive health management, advocate for affirming care, and support your LGBTQ+ patients’ overall health and well-being.

Recognizing the Health Disparities Experienced by LGBTQ+ Patients

A 2021 survey by the Center for American Progress found that 50% of transgender respondents experienced provider bias, ranging from being misgendered to being outright refused care.
Economic challenges such as higher poverty rates among bisexual and transgender people limit access to insurance and, by default, preventative screenings.
Rural LGBTQ+ patients often struggle to find nearby providers trained in culturally competent care.
When you add in intersectional factors, like race, gender, ethnicity, or disability, disparities deepen, with Black and Indigenous LGBTQ+ people facing particularly heightened risks due to overlapping systemic inequities.

These challenges make regular, consistent health screenings not just beneficial but essential. For instance:

Transgender patients face elevated risks of cardiovascular disease and certain cancers, partly influenced by hormone therapies and partly by delayed or avoided care.
Gay and bisexual men currently account for the majority of new HIV diagnoses in the US.
LGBTQ+ teens are four times more likely to attempt suicide than their heterosexual peers, with higher rates of tobacco and alcohol use, increasing their risk of lung and liver diseases.

The Importance of Screenings: Early Detection Saves Lives and Improves Outcomes

Regular screenings help catch health issues before they become serious, lowering mortality and treatment costs while improving quality of life. Some key examples include:

Regular mammograms and Pap smears help clinicians diagnose breast and cervical cancers early, significantly improving patient outcomes.
Routine HIV testing paired with conversations about PrEP helps prevent infection and enables timely care.
With a higher prevalence of depression and anxiety due to social stigma and stress, mental health screenings are critical.
For transgender patients, gender-affirming care should include screenings tailored to each patient’s well-being, such as recommending prostate exams for trans women or cervical screenings for trans men. Oftentimes overlooked, but essential.

Cancer Screenings That Matter

Cervical Cancer

Pap smears and HPV testing are critical for anyone with a cervix to detect cervical cancer or precancerous changes early. These screenings have demonstrated a reduction in cervical cancer mortality, reducing deaths by up to 50% over 30 years.

The US Preventive Services Task Force recommends a Pap test for those aged 21–29 every three years. For ages 30–65, options include a Pap test every three years, an HPV test every five years, or co-testing (Pap and HPV) every five years. Those over 65 with adequate prior screening or who have had a hysterectomy with cervix removal may not need screening, unless high-risk factors like HIV or prior cervical precancer exist.

Breast Cancer

Unique risk factors for lesbian and bisexual women include higher rates of obesity, alcohol use, and nulliparity (never giving birth). Transgender women on long-term hormone therapy may also have elevated risks, while transgender men with chest surgery may have residual breast tissue that requires monitoring.

The American Cancer Society recommends annual mammograms starting at age 40 for average-risk individuals, with clinical breast exams every 1–3 years. Self-exams help foster body awareness and may help detect changes to breast tissue.

Educating patients is vital since stigma and previous experiences with provider bias may deter care. Community outreach and inclusive healthcare settings help bridge gaps in awareness and access.

Prostate Cancer

Prostate cancer affects gay, bisexual, and transgender women (with retained prostates) with a similar prevalence to the general population of about 1 in 8 men. Risk factors include age (over 50), being of African descent, and a family history of prostate cancer.

The American Cancer Society advises discussing prostate-specific antigen (PSA) testing with patients starting at age 50 (or 45 for high-risk groups). Discussing family history is crucial, as inherited mutations can increase risk. A lack of culturally competent care can delay screenings, emphasizing the need to develop inclusive spaces promoting open provider-patient dialogue.

Testicular Cancer

Gay and bisexual men, and transgender women who retain their prostate, face risk levels similar to the general population. Although rare, testicular cancer is highly treatable if caught early, making access to care critical. Starting discussions about PSA testing and self-examinations around age 50 (or earlier for high-risk groups) is important.

Having open, culturally competent conversations can help overcome barriers to screening. Creating awareness is critical, as embarrassment or lack of education, compounded by a history of discrimination, may delay or deter diagnosis and treatment.

STI Screenings: Compassionate, Nonjudgmental Care Saves Lives

Certain STIs disproportionately affect LGBTQ+ patients. For example, transgender patients face increased risks for STIS due to facing barriers to care. Regular screenings for chlamydia, gonorrhea, syphilis, herpes, hepatitis B and C, HPV, and HIV are a critical part of affirming sexual health care.

Chlamydia and Gonorrhea

Untreated, chlamydia and gonorrhea can cause pelvic inflammatory disease, infertility, or epididymitis, and they often have no symptoms but can cause serious complications if untreated. STI testing is recommended every 3–6 months for sexually active people or those with multiple partners. Antibiotics cure both conditions, but reinfection is common if the patient’s partners don’t also receive treatment.

Syphilis

Early detection of syphilis prevents serious long-term harm, such as neurological damage or death. Annual screenings are advised for men who have sex with men (MSM) and others at higher risk. Penicillin remains the primary treatment and is effective if administered early. Regular screening and partner notification are essential to slow rising rates.

Herpes

Over 500 million people globally have HSV-2. While HSV-2 is incurable, outbreaks are manageable with antivirals like acyclovir, and education about transmission helps reduce risk.

Hepatitis B and C

Screening and vaccination for hepatitis B (HBV), as well as universal screening for hepatitis C, protect against liver damage and transmission. The HBV vaccination is highly effective and is recommended for all unvaccinated adults. Treatment can cure Hepatitis C in most cases, but no vaccine exists. Regular testing prevents liver damage and transmission.

HPV

Human papillomavirus is a leading cause of cervical, anal, and throat cancers. Gay, bisexual, and pansexual men and transgender women face higher risk for anal cancer, while women (both within and outside the LGBTQ+ community) face significant cervical cancer risk. Vaccination is a powerful prevention tool, with the CDC recommending HPV vaccination for all patients up to age 26 to reduce cancer rates and promote health equity.

HIV

LGBTQ+ men represent a large proportion of new HIV diagnoses. Regular, stigma-free testing opens the door to early treatment and better outcomes. Pre-exposure prophylaxis (PrEP) offers a highly effective prevention method when taken as prescribed, reducing the risk of infection by nearly 99%. When combined with barrier use (condoms, dental dams) and maintaining an undetectable viral load, it creates a comprehensive strategy to curb transmission. Testing and access to prevention methods are critical for health equity.

Supporting Mental Health and Holistic Wellness in the LGBTQ+ Community

Mental health is foundational to overall well-being, influencing physical health, relationships, and quality of life. LGBTQ+ individuals face higher rates of anxiety, depression, and substance use disorder, often as a result of ongoing social stigma, discrimination, and rejection, making mental health screenings vital to conscious care.

The Trevor Project’s 2022 survey found 73% of LGBTQ+ youth reported anxiety symptoms.
The same survey noted that 58% of LGBTQ+ individuals experience depression, with transgender youth facing the highest rates.
Substances are a common coping mechanism for dealing with the constant stress of marginalization, with SUD prevalent in 28% of lesbian, gay, and bisexual adults and 20–30% of transgender people.

Regular mental health screenings, such as the PHQ-9 for depression, GAD-7 for anxiety, and AUDIT for substance use, provide opportunities for early intervention and, when paired with culturally competent and affirming care, help to build trust and encourage patients to seek help without fear of judgment.

Breaking Down Barriers to Care for the LGBTQ+ Community

Fear of discrimination, concerns about privacy, and a lack of culturally competent providers keep many LGBTQ+ individuals from seeking regular care, undermining health outcomes. This is especially true for those not fully “out,” individuals living in rural areas, or those facing economic hardship.

Cultural and societal pressures, like being rejected by family or religious stigma, further discourage access to care, with 59% of LGBTQ+ individuals feeling limited by societal bias. Healthcare teams can help reduce these barriers by consciously creating welcoming environments and reassuring patients of their right to privacy.

Finding affirming providers is easier when patients know where to look:

Online directories, such as GLMA’s Provider Directory or OutCare Health, list affirming clinicians.
Community health centers, like Fenway Health, offer tailored services.
Referrals from LGBTQ+ organizations and advocacy groups (e.g., The Trevor Project or local LGBTQ+ community groups) can help patients connect to trusted providers.
Social media posts from LGBTQ+ advocacy groups and patient reviews on sites like Healthgrades can highlight providers known for inclusive practices.
Insurance networks may provide filters for LGBTQIA-friendly providers.
Telehealth options offer discreet access to affirming care, especially for rural patients.

Advocacy and community support are powerful tools for dismantling systemic barriers. Grassroots efforts, like those by Trans Lifeline, work toward policy changes, like anti-discrimination laws, and community support groups foster resilience and offer safe spaces to share experiences and resources.

Why Preventive Health Screenings Matter

More than checkboxes, preventive screenings are acts of care that speak to the unique health risks facing LGBTQ+ patients. Early detection saves lives, reduces disparities, and affirms the dignity of every individual.

As healthcare providers, embracing inclusive practices and committing to affirming inclusive care can help your patients. Sharing this understanding with colleagues, engaging in community education, and promoting awareness at events like LGBTQ+ Pride can all contribute to building a future where no one is left behind.