{"id":3778,"date":"2026-01-21T14:29:32","date_gmt":"2026-01-21T19:29:32","guid":{"rendered":"https:\/\/www.bumc.bu.edu\/gim\/?p=3778"},"modified":"2026-02-02T14:36:36","modified_gmt":"2026-02-02T19:36:36","slug":"commentary-on-sexual-orientation-and-cost-related-health-care-deferral","status":"publish","type":"post","link":"https:\/\/www.bumc.bu.edu\/gim\/2026\/01\/21\/commentary-on-sexual-orientation-and-cost-related-health-care-deferral\/","title":{"rendered":"Commentary on Sexual Orientation and Cost-Related Health Care Deferral"},"content":{"rendered":"

\u201cSGM people are caught in a catch-22 for health care: defer care to avoid immediate costs and likely medical debt but have worse health that requires more costly care in the future.\u201d<\/strong><\/p>\n

Emily Lupez, Assistant Professor of Medicine, and Carl G. Streed Jr, Associate Professor of Medicine and Research Director for the GenderCare Center, were invited to write a commentary<\/a> on the research article \u201cSexual Orientation and Cost-Related Health Care Deferral\u201d by Balshi et al. Drs. Lupez and Streed call attention to the research\u2019s finding that sexual and gender minority (SGM) adults ability \u201cto access health insurance has not resulted in being able to financially access health care.\u201d<\/p>\n

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Emily Lupez, MD, MSc, MPH<\/figcaption><\/figure>\n

They note that \u201cthese results are made more alarming as they remained significant even when accounting for differences in sociodemographic factors, such as income and insurance, as well as self-reported health care status, a proxy for health care needs.\u201d They point out how deferring care due to costs despite insurance coverage reflects an imbalance in costs and ability to pay for SGM populations specifically. Drs. Lupez and Streed note that these increased costs of care could be the result of \u201cvarious well-documented disparities in physical and mental health conditions\u201d and \u201cunique health care needs of SGM people that are frequently excluded from insurance coverage.\u201d<\/p>\n

Drs. Lupez and Streed contextualize these findings further by noting that \u201cthe economic fortunes of SGM people are not equivalent to their straight, cisgender peers,\u201d and \u201cwhen seeking health care becomes critical, SGM people are faced with the difficult choice of facing serious health consequences from continuing to defer care or accumulating medical debt.\u201d They add, \u201cThese individual decisions by SGM people are not made in a vacuum but reflect the environments in which they seek care.\u201d<\/p>\n

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Carl G. Streed Jr., MD, MPH<\/figcaption><\/figure>\n

Drs. Lupez and Streed note that \u201caddressing the economic disparities and burdens in health care for SGM people will require a broader undertaking that must (1) improve access to routine and preventive care, (2) eliminate exclusionary policies affecting care frequently used by SGM people, and (3) expand the health care workforce, particularly in mental health, to meet the needs of the population.\u201d<\/p>\n

They conclude, \u201cAt a time when we could be saving public and private dollars by paying for an ounce of prevention, we will soon get the bill for a pound of cure.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

\u201cSGM people are caught in a catch-22 for health care: defer care to avoid immediate costs and likely medical debt but have worse health that requires more costly care in the future.\u201d Emily Lupez, Assistant Professor of Medicine, and Carl G. Streed Jr, Associate Professor of Medicine and Research Director for the GenderCare Center, were […]<\/p>\n","protected":false},"author":23454,"featured_media":3790,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1384],"tags":[],"_links":{"self":[{"href":"https:\/\/www.bumc.bu.edu\/gim\/wp-json\/wp\/v2\/posts\/3778"}],"collection":[{"href":"https:\/\/www.bumc.bu.edu\/gim\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.bumc.bu.edu\/gim\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/gim\/wp-json\/wp\/v2\/users\/23454"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/gim\/wp-json\/wp\/v2\/comments?post=3778"}],"version-history":[{"count":3,"href":"https:\/\/www.bumc.bu.edu\/gim\/wp-json\/wp\/v2\/posts\/3778\/revisions"}],"predecessor-version":[{"id":3788,"href":"https:\/\/www.bumc.bu.edu\/gim\/wp-json\/wp\/v2\/posts\/3778\/revisions\/3788"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/gim\/wp-json\/wp\/v2\/media\/3790"}],"wp:attachment":[{"href":"https:\/\/www.bumc.bu.edu\/gim\/wp-json\/wp\/v2\/media?parent=3778"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/gim\/wp-json\/wp\/v2\/categories?post=3778"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/gim\/wp-json\/wp\/v2\/tags?post=3778"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}