Barriers to Health Care Among Adults Identifying as Sexual Minorities: A US National Study

Am J Public Health. 2016 Jun;106(6):1116-22. doi: 10.2105/AJPH.2016.303049. Epub 2016 Mar 17.


Objectives: To assess the extent to which lesbian, gay, and bisexual (LGB) adults aged 18 to 64 years experience barriers to health care.

Methods: We used 2013 National Health Interview Survey data on 521 gay or lesbian (291 men, 230 women), 215 bisexual (66 men, 149 women), and 25 149 straight (11 525 men, 13 624 women) adults. Five barrier-to-care outcomes were assessed (delayed or did not receive care because of cost, did not receive specific services because of cost, delayed care for noncost reasons, trouble finding a provider, and no usual source of care).

Results: Relative to straight adults, gay or lesbian and bisexual adults had higher odds of delaying or not receiving care because of cost. Bisexual adults had higher odds of delaying care for noncost reasons, and gay men had higher odds than straight men of reporting trouble finding a provider. By contrast, gay or lesbian women had lower odds of delaying care for noncost reasons than straight women. Bisexual women had higher odds than gay or lesbian women of reporting 3 of the 5 barriers investigated.

Conclusions: Members of sexual minority groups, especially bisexual women, are more likely to encounter barriers to care than their straight counterparts.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Health Personnel*
  • Health Services Accessibility / economics*
  • Health Status
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Sexual Behavior
  • Sexual and Gender Minorities / statistics & numerical data*
  • Surveys and Questionnaires
  • United States