Nurses might thoughtlessly make presumptions about sexual orientation and say things such as "Is your wife with you?" to adult male patients. In states without marriage equality laws or where someone's employment is in danger due to their sexual orientation, being forthcoming about answering these questions can be awkward or difficult.
Without knowing a patient's sexual orientation, healthcare providers are unable to optimally address their unique health needs. According to HealthyPeople.gov, people in the LGBT community have high rates of psychiatric disorders, substance abuse, obesity, and tobacco use, to name a few.
Other barriers include end-of-life issues, healthcare decision making-rights, and lack of joint healthcare benefits. And transgender people can have unique and complex healthcare needs depend on where they are in the transition process.
Zuzelo says it's valid for people in the LGBT community to worry about being honest about their sexuality.
"You can lose your job. There are good reasons for people to be concerned," she says. "It's outrageous that people cannot go into their healthcare system… and be able to discuss and share [information about] their sexual orientation and not have to worry about that. It's healthcare."