Health Advice



Physicians are uneasy as Colorado collects providers' diversity data

Markian Hawryluk, Kaiser Health News on

Published in Health & Fitness

“There are a lot of really conservative parts of Colorado,” said Steven Haden, a mental health therapist and CEO of Envision:You, a Denver-based nonprofit focusing on LGBTQ+ behavioral health services. “In lots of communities outside of our metropolitan areas, it’s not safe to be out.”

State officials say the Colorado Option will be the first health plan in the nation built specifically to advance health equity, a term used to describe everyone having the same opportunity to be healthy. The framework includes better coverage for services that address health disparities. It requires anti-bias training for providers, their front-office staffers, and health plan customer service representatives. Plans must increase the number of community health centers — which treat more patients from underserved communities than other clinics — in their networks, as well as certified nurse-midwives, to help reduce maternal mortality.

Health plans’ directories will have to list the languages spoken by providers and their front-office staffers, say whether offices are accessible for those with physical disabilities, and note whether a provider has evening or weekend hours.

But officials are trying to figure out how they might use demographic data to guide patients to practitioners with similar identities while avoiding unintended consequences, particularly around sexual orientation or gender identity.

Dr. Mark Johnson, president of the Colorado Medical Society, said more doctors than ever feel comfortable disclosing their sexual orientation or gender identity, but incidents of disgruntled patients who lash out by referencing a physician’s personal characteristics do still occur.

“Even though we’re a purple state, there’s still a lot of bias here and there,” he said. “There could be some real problems that come out of this, so I am hoping they will be very, very sensitive to what they’re doing.”


LGBTQ+ patients often deal with stigma in health settings, which can result in negative experiences that range from feeling uncomfortable to being outright mistreated.

“There are lots of marginalized and disenfranchised people that when they don’t have a good experience, they disengage from care. They don’t go back to that provider,” Haden said. “So needs remain unmet.”

As a result, Haden said, LGBTQ+ people have rates of depression, anxiety, overdose, and suicide that are two to four times the rate of straight, cisgender people.

Many people in the LGBTQ+ community share information about which doctors and clinics are welcoming and competent and which to avoid. Finding medical professionals who are themselves LGBTQ+ is a way of increasing the likelihood that a patient will feel comfortable. But many experts stress that being trained in LGBTQ+ health care is more important for a provider than being part of that community.


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