June is Pride Month, and whether you’re in Raleigh or anywhere in North Carolina, I want to use this post to make the case for why LGBTQ+ health deserves specific clinical attention. I hear the question sometimes, even if people don’t always say it out loud: why does this need to be a separate conversation? A person is a person. Shouldn’t everyone get the same care?
The answer is that good medicine has never been one-size-fits-all. We screen for different cancers based on the organs a person has, not a checkbox on a form. We assess cardiovascular risk differently based on a patient’s history, lifestyle, and genetics. We ask about family history because it matters. We account for the specific stressors, exposures, and biological factors that affect the specific person in front of us, because that’s what accurate care requires. “Everyone gets the same care” sounds fair, but in practice it means ignoring factors that are directly relevant to a patient’s health. LGBTQ+ patients have specific, well-documented health considerations that a competent provider needs to understand and address. That’s not a political statement. It’s a clinical one.
Here’s what the research actually shows, and what it means for how we practice at Staywell Health.
The Clinical Differences Are Real
LGBTQ+ people face measurably higher rates of certain health conditions compared to the general population. Understanding why requires looking at the same thing we look at for any population-level health difference: the specific stressors, behaviors, biological factors, and barriers to care that affect that group.
One of the most significant factors is what researchers call minority stress. This is the chronic, cumulative stress that comes from navigating a world that treats your identity as abnormal, problematic, or invisible. It’s not dramatic stress in most cases. It’s the low-grade, constant kind: the vigilance of calculating whether a space is safe before you disclose something about yourself, the years of messaging that something about you is wrong, the experience of discrimination in workplaces, families, and healthcare settings. As we covered in last month’s post on the mind-body connection, chronic stress has direct physiological consequences. Elevated cortisol, increased inflammation, disrupted sleep, suppressed immune function, higher cardiovascular risk. The same mechanisms that make any chronic stressor bad for your health apply here, and the research shows they do.
The data is consistent across studies. LGBTQ+ people have higher rates of depression, anxiety, and PTSD than the general population. Suicide rates are significantly elevated, particularly among transgender and nonbinary people and LGBTQ+ youth. Bisexual people show some of the poorest mental health outcomes of any subgroup, a finding that often surprises people but makes sense when you understand that bisexual individuals frequently experience erasure and marginalization from both straight and gay communities. Lesbian and bisexual women have higher rates of certain cancers, in part because they access preventive screening at lower rates. Gay and bisexual men have specific considerations around HIV and STI risk that require knowledgeable, non-judgmental care to address effectively.
None of this is an inherent consequence of being LGBTQ+. It is the documented result of specific stressors and barriers. And it is largely addressable when people have access to providers who understand it and don’t require their patients to educate them.
Why LGBTQ+ People Avoid the Doctor, and Why That Matters Clinically
From a purely practical standpoint, a patient who doesn’t trust their provider gives incomplete information. A patient who avoids the doctor delays diagnosis. A patient who doesn’t disclose their full health picture gets incomplete care. These aren’t social problems. They are clinical problems with clinical consequences.
LGBTQ+ patients, and trans patients in particular, delay or avoid care at significantly higher rates than the general population. The reasons are straightforward. A provider who uses the wrong name or pronouns signals that they haven’t done basic preparation. A provider who doesn’t know how to care for a trans patient and doesn’t acknowledge it signals that the visit will require the patient to do the educating. A provider who asks invasive or irrelevant questions signals discomfort or judgment. Intake forms that don’t reflect your reality signal that the practice wasn’t designed with you in mind. None of these are dramatic events. They are small, consistent signals that add up to a patient deciding it’s not worth the effort, or that the care they’ll receive won’t be accurate anyway.
The downstream effects are the kind of thing that shows up in population health data. Lower rates of preventive screening. Later-stage diagnoses. Conditions managed at home longer than they should be. These are the concrete, measurable costs of a patient not having a provider they can work with honestly.
Research consistently shows that LGBTQ+ patients who have an affirming provider have better health outcomes, better medication adherence, more complete disclosure of health information, and higher rates of preventive care. Finding the right provider is not a luxury. It’s a health intervention.
Trans and Nonbinary Healthcare Needs
Trans and nonbinary patients have specific healthcare needs that require a provider who is knowledgeable, current, and genuinely committed to providing competent care. This includes gender-affirming hormone therapy, which I provide at Staywell Health, as well as the monitoring and management that comes with it. It includes understanding how hormone therapy affects labs, cardiovascular risk, bone density, and other health markers. It includes screening recommendations that are based on the organs a person has, not assumptions based on their gender identity or legal documents. It includes using correct names and pronouns without making it a big deal, because it shouldn’t be a big deal.
It also includes understanding that gender dysphoria, the distress that comes from a mismatch between a person’s gender identity and their body or how they’re perceived, is a real and significant source of psychological suffering that affects physical health. Gender-affirming care, including social, medical, and when appropriate surgical affirmation, has strong evidence behind it for improving mental health outcomes and reducing suicidality. This is not controversial in the research. It is well established.
Trans and nonbinary people deserve providers who know this, who stay current as guidelines evolve, and who treat gender-affirming care as the legitimate medical care that it is, not as a political position or a favor.
What Affirming Care Actually Looks Like
Affirming care is not just being “nice” to LGBTQ+ patients. It’s competence. It’s knowledge. It’s creating an environment where people don’t have to spend energy managing their provider’s discomfort or educating them about their own identity. Here’s what it looks like in practice at Staywell Health.
It means asking for and using your name and pronouns correctly and consistently, including in your chart. It means intake forms that reflect the full range of gender identities and relationship structures. It means asking relevant questions about your health without making assumptions based on how you look or what your ID says. It means being as knowledgeable about the specific health needs of LGBTQ+ patients as I am about any other area of primary care, and staying current as guidelines and best practices evolve. It means not flinching, not qualifying, not adding caveats when you tell me about your life or your body. It means being a place where you can be fully honest about your health without calculating whether it’s safe to do so.
It also means being honest when something is outside my scope and making warm referrals to trusted colleagues who can help. Affirming care isn’t about having all the answers. It’s about being a provider you can actually work with.
A Note on the Current Climate
I can’t write a Pride Month post in 2026 without acknowledging that the political climate around LGBTQ+ health, and trans healthcare in particular, has become increasingly hostile in many parts of the country, including in North Carolina. Legislative attacks on gender-affirming care, restrictions on healthcare for trans youth, and the broader rollback of protections for LGBTQ+ people have created real fear and real harm in our community.
I want to be clear about where Staywell Health stands: we provide affirming, competent, evidence-based care for LGBTQ+ patients. Full stop. That is not contingent on the political environment. It is not going to change. If you are an LGBTQ+ person in Raleigh who is looking for a provider you can trust, I want you to know that this practice exists for you.
Staywell Health provides gender-affirming hormone therapy, LGBTQ+-informed primary care, STI screening and treatment, PrEP for HIV prevention, and whole-person care that sees you as a complete human being. If you’ve been putting off finding a provider because you weren’t sure it would be safe, I hope this helps. We’re here.
Book a free 15-minute meet and greet to see if Staywell is the right fit for you: schedule here.
Daniel Corbin, DNP, APRN, FNP-C
Board-certified Family Nurse Practitioner and founder of Staywell Health, a direct primary care practice in Raleigh, NC specializing in whole-person care, LGBTQ+ health, and lifestyle medicine.