New report shows disparities in health for LGBTQ North Carolinians, Black, transgender

The Campaign for Southern Equality and Western North Carolina Community Health Services have released a new report about LGBTQ health in North Carolina.

That report is a supplement to The Report of the 2019 Southern LGBTQ Health Survey. More than 900 LGBTQ people in North Carolina and more than 5,600 people across the South took part in the 2019 Southern LGBTQ Health Survey – the largest sample ever of LGBTQ Southerners talking specifically about their health and healthcare. The report released today provides new insights into the health disparities that LGBTQ people in North Carolina experience. 

The release also comes as elected officials and advocates across North Carolina are working to pass LGBTQ-inclusive nondiscrimination protections at the local level. On Monday night, the City Council of Charlotte, the largest city in North Carolina, cast a unanimous bipartisan vote in favor of the ordinance. Ten local governments in total have passed similar ordinances in 2021.

North Carolina is home to more than 382,000 LGBTQ adults and key findings of this North Carolina supplement – which you can read here or click here for the PDF – include:

1. Transgender North Carolinians experience significant barriers to accessing quality health care. Trans respondents in NC reported high rates of dealing with mistreatment due to their LGBTQ identity to access care (41% said they always, often, or sometimes deal with mistreatment) and 48% said they have to educate their medical providers about their LGBTQ identity (48%).
2. Black LGBTQ North Carolinians also experience disproportionate barriers to care, when compared with non-Black LGBTQ respondents. For example, while 27.8% of all North Carolina respondents worry about losing their health care coverage, 43.3% of Black (43.3%) and 54.5% of Black trans respondents in North Carolina said they worry about losing coverage. Black respondents in the state (41.1%) also reported that being LGBTQ always or often changes how a medical professional interacts with them at a higher rate than non-Black respondents (35.4%). 
3. Black and transgender respondents were far more likely to report experiencing poor mental health outcomes. While 44.7% of all North Carolina respondents rated their mental health as fair or poor, 67.6% of Black respondents in NC, 64.5% of trans respondents in NC, and 83.3% of Black transgender respondents reported the same. One hundred percent of Black trans respondents in NC reported experiencing depression, 83.3% anxiety, 58.3% suicidal ideation, and 41.7% self-harming behaviors. 
4. A moderate proportion of respondents living in North Carolina did not know their HIV status (7.9%). Less than one-third of NC respondents who did not know their status said they can easily access HIV testing (24.7%) or that they know where to access treatment in their community (30.1%).

Survey findings also showed that growing numbers of LGBTQ people in NC are able to access affirming care, a promising trend.

Dr. Abigail Bowen, Research & Policy Manager at the Campaign for Southern Equality, said:

“These statistics about the LGBTQ community in North Carolina are a call to action and provide a diagnostic about the many ways that we can improve the health and healthcare experiences of LGBTQ people in North Carolina, especially LGBTQ people who are Black or transgender. These data underline an urgent and clear need for health care providers, advocates, and policy makers to work toward a shared vision of a North Carolina where LGBTQ people can access quality care and are also equal under the law.” 

Kim Wagenaar, Chief Executive Officer of Western NC Community Health Services, said:

“It is up to us as medical providers and healthcare institutions to step up and do better for all of our patients – and that includes recognizing the unique needs and challenges that marginalized populations, including those in the LGBTQ community, experience. This report is a step toward understanding and a signal to everyone in the NC medical community that it’s time to recommit our efforts to lowering barriers to care for LGBTQ people.”

The project is part of the Southern LGBTQ Health Initiative, a collaboration of CSE and WNCCHS to improve access to LGBTQ-friendly primary care, HIV care and support services across the South. In addition to community-based research, this initiative involves training primary care providers in affirming health care practices and providing direct funding to grassroots groups leading innovations in access to LGBTQ health care.

Access the North Carolina state supplement for the Southern LGBTQ Health Survey – as well as the full report and executive summary in English and Spanish at www.southernequality.org/Survey#NC.