Notice how cost and availability are pushing LGBTQ+ adults out of care: a new KFF survey finds many are skipping appointments, prescriptions or treatments , and a third say their health worsened. Here’s who’s most affected, why it matters, and practical steps patients and providers can take.

Essential Takeaways

  • Widespread avoidance: About six in ten LGBTQ+ adults reported missing needed healthcare in the past year, often because of cost or lack of appointments.
  • Trans and young adults hit hardest: Transgender people and those under 30 were most likely to forgo care; uninsured LGBTQ+ adults reported especially high rates.
  • Money and medicines: 22% of LGBTQ+ adults skipped prescriptions because of cost, compared with 12% of other adults, and nearly a third struggled with medical bills.
  • Insurance friction: Insured LGBTQ+ adults report higher denial or delay rates from insurers, with worse outcomes among Medicaid and marketplace enrollees.
  • Health impact: Around a third say their health worsened after skipping care , almost half among transgender respondents.

Why so many LGBTQ+ adults are skipping care , and it feels urgent

The headline figure is stark: six in ten LGBTQ+ adults missed needed healthcare in the last year, according to a major KFF survey. That’s not an abstract number; it translates into people skipping tests, delaying diagnoses and going without medications. You can almost imagine the quiet frustration , missed appointments, a prescription left at the pharmacy window. KFF’s report breaks down who’s most affected and points to cost, appointment availability and insurance problems as the main drivers.

Context matters: LGBTQ+ communities skew younger on average and face income and coverage gaps that make medical bills harder to swallow. So while identity plays a role, intersecting factors like age, employment and insurance status amplify the effect. The result is avoidable harm: a significant share say their health worsened after missing care.

Trans adults, young people and the uninsured , a trio at risk

Transgender adults emerged as the most likely to forgo care and to report worsening health. Young LGBTQ+ adults under 30 are also more likely than their non-LGBTQ+ peers to skip treatment, KFF found. And the uninsured are, unsurprisingly, the most vulnerable: more than three-quarters of uninsured LGBTQ+ respondents said they missed needed care.

This isn’t just about identity; it’s about structural barriers. Medicaid and marketplace plans show higher rates of denials or delays, and self-purchased insurance can leave gaps. For anyone choosing a plan, it’s worth checking how gender-affirming care, mental health services and routine prescriptions are covered before you sign up. Clinics and advocacy groups can help review benefits and spot out-of-pocket costs you might otherwise miss.

Cost, prescriptions and bills , the financial squeeze

Financial strain shows up in several ways: nearly a third of LGBTQ+ adults struggled to pay medical bills and 22% skipped prescriptions due to cost. That’s double the rate of non-LGBTQ+ adults for medication non-adherence. Skipping a pill or postponing a refill is an easy-sounding choice in the moment, but it compounds risk over time.

Practical tip: ask your provider or pharmacist about generics, therapeutic alternatives, patient assistance programmes and community clinics that supply meds at reduced cost. Many practices can write a short-term prescription that bridges the gap or connect you with local resources that reduce immediate costs.

Insurance denials and delays , gatekeeping that worsens outcomes

Insured LGBTQ+ adults reported higher rates of denials by insurance companies than other adults, and those denials often affected prescriptions, treatments or referrals. Denials were particularly common among people on Medicaid or self-purchased plans, KFF notes, which can slow urgent care or make ongoing treatment intermittent.

If you’ve had a denial, appeal , and don’t go it alone. Ask your provider to supply detailed documentation, keep records of phone calls and get support from patient advocates or legal clinics that handle insurance disputes. Organisations specialising in LGBTQ+ health can also advise on whether a denial violates anti-discrimination rules in your area.

What health systems, policymakers and communities can do next

There are concrete fixes that could make a difference. Expanding affordable coverage and stabilising access to gender-affirming and mental health services would target the groups most affected. Health systems can reduce no-shows by offering flexible hours, telehealth and clear pricing, while insurers should improve transparency around covered services and appeals.

Community-level action matters too. Clinics that visibly signal LGBTQ+ competence, train staff on inclusive practices and publicise sliding-scale options make it easier for people to seek help. And for those who’ve already felt harmed by missed care, local advocacy groups can be a practical ally in navigating appeals and locating timely services.

It's a small change that can make every appointment and prescription count.

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