When care isn’t freely given, we build it ourselves.
Commentary by Dr. Jan Oosting
Wednesday, April 2, 2025 | LGBTQ Nation
A great deal has been written about disparities in our healthcare system and how they impact the LGBTQ+ community. According to the Second Annual State of LGBTQ Health National Survey by the National Coalition for LGBTQ Health, members of our community are more likely to experience higher rates of HIV and other sexually transmitted infections, autoimmune conditions such as chronic fatigue and arthritis, and mental health challenges like depression and anxiety.
Trans and gender-expansive individuals face even greater risk, with more than 40% of transgender teens reporting that they have considered suicide in the past year. The recent wave of bans on gender-affirming care only adds to these challenges, making access to life-saving healthcare even more difficult.
In the face of these obstacles, there must also be a focus on our community’s strengths. It’s easy to feel discouraged in times like these. But we are a resilient community. We have faced immense challenges and, time and time again, we have found ways to push forward. Our struggles have forged a powerful sense of community, a deep well of knowledge, and a continuing legacy of resistance.
The coming years may not be easy, but I believe that by working to bridge the disparities while recognizing and embracing our strengths, we can continue to build a future where we all thrive.
My hope is that everyone reading this — LGBTQ+ individuals, allies, and healthcare providers alike – will take the following strengths to heart. Let them be both shield and light, guiding us through difficult times and reminding us of the power we hold.
Prevention Mindset
One of the LGBTQ+ community’s greatest strengths is a deeply ingrained prevention mindset when it comes to our collective health. From the early days of the HIV/AIDS crisis to the ongoing fight for access to gender-affirming care and mental health support, we have learned the critical importance of proactive, community-driven healthcare. Whether through harm reduction strategies, advocacy for inclusive policies, or the creation of our own support networks, we consistently prioritize prevention, education, and early intervention.
This mindset not only protects individual well-being but also strengthens the entire community, ensuring that no one is left behind in the pursuit of health and dignity. For example, nearly a year after vaccines first became available for COVID-19, 92% of LGBTQ+ adults had received at least one dose, according to the Human Rights Campaign (HRC) Foundation. This is huge compared to about 50% of the general adult population in the U.S. who had received at least one shot during a similar time frame.
The rise of mpox in recent years is another example of the community’s ability to effectively and efficiently respond to a potential health crisis.
The National Coalition for LGBTQ Health quickly formed its Mpox Resource Center to provide information and news about prevention, transmission, testing, and treatment. It created a microgrant initiative to support the mpox-awareness efforts of smaller LGBTQ organizations. Our community united to carry out drives for men who have sex with men for preventative health services like testing and vaccinations for mpox. Pride celebrations in cities across the country now offer mpox and other vaccinations to attendees.
Health advocacy & activism
Health advocacy and activism have long been among our community’s greatest strengths. From grassroots organizing to national policy change, we have continuously fought for equitable, affirming healthcare. Our advocacy during the HIV/AIDS epidemic stands as a powerful testament to our resilience and determination, forcing both medical institutions and governments to acknowledge and address the crisis. Over time, numerous organizations have emerged, each working to advance LGBTQ+ health equity in areas ranging from mental health and transgender healthcare to reproductive rights and harm reduction. This ongoing commitment ensures that our voices are heard, our needs are met, and future generations inherit a healthcare system that is more just and inclusive.
Here are just a few community organizations created by our people for our people:
- GLMA: Health Professionals Advancing LGBTQ+ Equality (previously known as the Gay & Lesbian Medical Association) — an association of LGBTQ+ healthcare professionals working for health equity for community members and equality for LGBTQ+ healthcare professionals at work and in school
- The Lesbian Health Fund — a research fund started by GLMA to support LGBTQ+ women and girls’ health and well-being
- The National Coalition for LGBTQ Health — an initiative using federal and local advocacy, education, and research to advance LGBTQ+ health and well-being issues
- The Trevor Project — an organization that advocates for laws to prevent suicide and support the mental health of LGBTQ+ youth
- OutCare Health — a non-profit promoting LGBTQ+ health equity through a list of ally providers, mentorship for LGBTQ+ members of the healthcare profession, community outreach initiatives, and consulting services for healthcare plans and systems
Robust support networks
Both proactively and in response to discrimination and stigma, LGBTQ+ communities have developed robust support networks. We are adept at resource sharing and at mutual aid. The Aging With Pride study found that “older [LGBTQ+] adults have cultivated resourceful and positive social connectedness over their lifetime,” and that those support networks “are extensive and diverse, more connected to nonrelative family members than immediate family.” It also showed that we have “built chosen families amid the challenging context of social exclusion.” Many studies have shown the positive impact of this family-building on physical and mental health and general well-being throughout our lives.
Resilience & adaptability
People who have faced trauma, adversity, discrimination, and other forms of emotional distress are often the ones who develop the greatest resilience and adaptability. For many LGBTQ+ individuals, these challenges are our lived realities, as we’ve had to navigate a world that isn’t always safe or accepting.
These are skills that are at the heart of resilience. Resilience isn’t just about enduring hardship; it’s a key factor in long-term health. Research consistently shows that greater resilience leads to better physical and mental health outcomes. The evidence is clear: Our ability to persist, heal, and support one another isn’t just a survival mechanism – it’s a powerful force that shapes our overall well-being.
Creativity
Creativity informs all of our health strengths, especially around advocacy, forming support networks, and resilience. When communities and healthcare providers shunned people with AIDS and HIV, we had to come up with new ways of coping. We held fundraisers, vigils, protests, and the “largest community art project in history.” Before hospice became a refuge, we even figured out that cannabis could ease AIDS patients’ suffering.
Those early efforts grew into the Human Rights Campaign, the organizations listed above, and countless community centers, support groups, LGBTQ+ healthcare facilities, and more. From the fight against AIDS and Mpox to the ongoing battle for gender-affirming care and equitable healthcare access, our community’s creativity continues to drive us forward. No matter the obstacles, we find new ways to support one another. Because when care isn’t freely given, we build it ourselves.
Grab a candle
It is essential to recognize and reaffirm our strengths in times of adversity. We have faced immense challenges before, and we have endured. We will endure again.
Our lived experiences have cultivated a deep well of coping strategies, emotional and mental fortitude, and an instinct for self-advocacy — qualities that empower us to navigate obstacles and fight for our health and dignity. These strengths are not just survival mechanisms; they are beacons of hope. In difficult times, we must remember to ignite them and keep their flames lit for others, allowing our collective light to shine through this darkness and guide us forward.
Dr. Jan Oosting, PhD, RN-BC, is an associate professor of nursing at City University of New York (CUNY) School of Professional Studies
