Shoppers are waking up to a painful reality: LGBTQ+ adults are delaying essential care at far higher rates than others. A major new KFF survey finds cost and lack of appointments top the list, with transgender people and LGBQ+ women hit hardest , and the result is worse health and bigger medical bills.

Essential Takeaways

  • Higher delay rates: 58% of LGBTQ+ adults report skipping or postponing care in the past year, versus 38% of non‑LGBTQ+ people. They report a heavier emotional weight and practical strain.
  • Cost and access: The two leading reasons for delays are medical costs and inability to get appointments , even among those with insurance or higher incomes.
  • Insurance trouble: LGBTQ+ respondents report more insurance denials and delays (32% vs 21% non‑LGBTQ+), with the worst rates for those on Medicaid or buying their own plans.
  • Trans people disproportionately affected: Trans respondents face the highest rates of appointment trouble, medication non‑use due to cost, worsening health from postponed care, and insurance denials.
  • Real consequences: Nearly 3 in 10 LGBTQ+ people say their health worsened because they postponed care, and many struggle with medical bills.

A stark new snapshot , what the KFF survey shows

The Kaiser Family Foundation’s latest polling paints a sharp picture: LGBTQ+ adults are more likely to skip necessary care and more likely to be hurt by the decision. You can almost feel the anxiety in the numbers , people saying “I can’t afford it” or “I couldn’t get an appointment” and then watching conditions worsen. According to KFF, these problems persist even for people with insurance or higher incomes, which suggests the issue isn’t just poverty but structural barriers in the health system and insurer practices.

Why cost and availability matter , and why they persist

Cost is the headline issue, but it’s tangled up with appointment availability and denials. The survey connects the dots: when providers are hard to reach, people delay care; when insurers deny coverage, out‑of‑pocket costs spike. Reuters and Washington Post coverage of the survey underscores how these barriers aren’t hypothetical , they lead directly to skipped meds, delayed diagnoses, and financial strain. For LGBTQ+ people, who on average are younger and more often on Medicaid, these dynamics amplify existing disparities.

Trans people facing a crisis inside the crisis

Trans adults consistently report the worst experiences. KFF’s data show they’re most likely to be unable to find a provider with available appointments, to forgo prescriptions because of cost, and to face insurance denials. That mixture of clinical exclusion, specialist scarcity and payer obstacles helps explain why trans people reported the highest rates of worsening health after postponing care. In plain terms: when care is already hard to find, any added cost or denial becomes catastrophic.

Differences by gender identity within the LGBTQ+ community

The survey also highlights notable differences between subgroups. LGBQ+ cisgender women reported higher rates of delaying care than LGBQ+ cisgender men, with cost and lack of appointments named more often. This matters because it shows LGBTQ+ health is not monolithic , sexual orientation, gender identity, insurance type and income all shape a person’s experience. For clinicians and policymakers, that means solutions must be tailored, not one‑size‑fits‑all.

Practical steps people and policymakers can take now

If you’re an individual navigating this, start by documenting denials and asking for written explanations from insurers. Use patient navigators or local LGBTQ+ health centres where available, and explore sliding‑scale clinics for routine care. For policy, the data make a strong case for expanding provider networks, enforcing anti‑discrimination rules, and improving Medicaid reimbursement so more clinicians accept those patients. Legal advocacy groups and public‑health organisations say targeted policy fixes and community services can blunt the worst effects.

It's a small change in policy or practice , or a better appointment system , that can make every visit less fraught.

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