The Elusivity of Health Care Equality: Founded at the onset of the AIDS crisis, one organization is still defying an antagonistic system amid new legislative attacks.

• Author: Johnson, Sharon
• Position: Gay and Lesbian Medical Association

In April, the Missouri attorney general issued a new state directive that severely restricts gender-affirming treatment for both adults and minors by citing a consumer protection law normally used to prosecute fraudulent business practices.

This is just one of several unusual approaches Republicans have recently devised to deny care to people in the LGBTQ+ community. As of this writing in early May, 125 health care measures have been introduced in state legislatures in the 2023 legislative session, according to the American Civil Liberties Union (ACLU), many of them targeting access to medically necessary health care, like Medicaid, for transgender people and gender-affirming care. Sixteen measures have passed.

More than one in eight LGBTQ+ people now live in states where doctors and nurses can legally refuse to treat them, according to research by the Movement Advancement Project, an LGBTQ+ think tank. Many studies and surveys have found that LGBTQ+ people are often turned away or refused treatments, including those related to gender-affirming care. LGBTQ+ patients report that doctors and other health care providers have used harsh and abusive language or subjected them to unwanted physical contact. As a result, LGBTQ+ people may forgo health care and develop life-threatening conditions that end in disability or death.

Fortunately, the community has a powerful ally in overcoming discrimination. GLMA: Health Professionals Advancing LGBTQ+ Equality was founded in San Francisco as the American Association of Physicians for Human Rights and is now based in Washington, D.C. It has been at the forefront of the movement to provide quality health care for the LGBTQ+ community since the onset of the HIV and AIDS epidemic in 1981.

The percentage of U.S. adults who self-identify as LGBTQ+ is at an all-time high at 7.1 percent, according to Gallup, and GLMA Executive Director Alex Sheldon says this brings new challenges, such as protecting the well-being of young LGBTQ+ people, which is one of GLMA's top concerns. According to Gallup, roughly 21 percent of adult Americans in Generation Z--those born between 1997 and 2003-identify as LGBTQ+.

The increasing number of older LGBTQ+ adults also presents difficulties, because they often lack funds, as well as family and friends who can help them navigate the health care system, Sheldon says. A shortage of facilities and practitioners with expertise in gerontology and trained in diversity, equity, and...