Unicorn Roots

Healthcare & Legislation

Allopathic healthcare (Western medicine) and the complicated maze of legislation surrounding it can be extremely frustrating. For members of other minority communities, these frustrations only intensify. Disabled women, especially women of color, are often seen as unfit and dependent, leading to even more differential treatment and unequal access to resources. Because of this, they are also half as likely to be employed as men with disabilities, and limited accessibility early in life perpetuates the negative cycle (Slayter & Johnson, 2023).

Disabled women of color often start with decreased access to training and resources, entering into a job market that already discriminates against them. But this doesn’t just affect women. Disabled men frequently have their masculinity challenged in the workplace, while disabled transgender people tend to experience even higher levels of unemployment and underemployment than their cisgender counterparts. In 2015, 24% of transgender people in the US were unemployed, 45% were living in poverty, and 29% of disabled transgender people were seeking or receiving government benefits such as SNAP and WIC. Still, ableism is often overlooked as a contributor to inequality in research, even in studies that look at disability issues (Slayter & Johnson, 2023). And where employment challenges exist, housing and healthcare challenges follow.

The 2015 US Transgender Survey (USTS) documented more than 27,000 cases of disabled transgender respondents receiving limited access to affordable and inclusive healthcare. Some respondents reported withholding disability information or actively choosing not to disclose their LGBTQ+ identity due to past discrimination or fear of altered treatment, fears that are unfortunately well-founded. Disabled transgender people were also found to be twice as likely as their non-disabled counterparts to report mental health issues affecting their daily lives, six times more likely to have difficulty with concentration, memory, and/or decision-making, and four times as likely to have difficulty running errands alone (Slayter & Johnson, 2023).

LGBTQ+ people with intellectual or developmental disabilities (IDDs) face a particularly distinct form of discrimination: their LGBTQ+ identity is often misread as behavioral issues, even by well-meaning medical professionals. This is likely due to a lack of literature and education on the intersection of IDDs and LGBTQ+ identities, a gap that is likely due in part to difficulties involved in recruiting and supporting LGBTQ+ people with IDDs in research settings (Slayter & Johnson, 2023). However, the subtle discrimination and unconscious biases don’t end there.

On top of this, disabled parenting presents its own set of challenges. C-sections and labor inductions occur more frequently in those with disabilities, even when there’s no medical need. After birth, inaccessible buildings, enadequate equipment, insufficient policies, and limited quality interpreter services further create more barriers. Some disabled people are actively discouraged from having children based on unfounded assumptions that their disability will be inherited or that others will have to raise the child for them. Women with IDDs have even been forced or coerced into being sterilized without legal ramifications, a practice that is disproportionately common among disabled Black women (Slayter & Johnson, 2023).

Statistically, 41% of disabled Black women and 28% of disabled white women have used sterilization as a form of contraception. Disabled women have also frequently been excluded from both women’s rights and disability rights movements, overlooked because of the combined minority identities. Historically seen as weaker and more vulnerable, disabled women have been excluded from these movements. Though occasionally, disabled women have been included primarily for the optics (Slayter & Johnson, 2023).

Then there’s the legal side of things. Public schools are required to protect disabled students under federal laws like Section 504 of the Rehabilitation Act, while Title IX protects students and staff from discrimination based on sex. When these laws conflict in real-world cases involving students with multiple minority identities, the results can be especially challenging to navigate. Social movements like #MeToo have helped to improve Title IX enforcement. Still, without proper education on the applicability of these laws in real-world disability cases, some may not understand when something’s wrong, let alone what the true consequences are. Meanwhile, mental health diagnoses continue to increase while legislation remains largely unchanged, and disabled people continue to be significantly more likely to be sexually assaulted than their peers (Slayter & Johnson, 2023).

What’s important to understand is that when disabilities and other identities intersect, it’s almost impossible to address one without affecting the others. A queer, disabled, Black woman can’t simply choose which part of her identity will affect her day. And that’s the main point here: disabled people shouldn’t have to pick between living comfortably and avoiding harassment (Slayter & Johnson, 2023). 

In 2024, disabled LGBTQ+ adults in the US reported annual household incomes at least $3,000 below the average and significantly higher rates of workplace discrimination. They were also approximately two and a half times more likely to receive government unemployment benefits, and significantly more likely to receive SNAP, TANF, and EITC benefits, while being less likely to receive SSI benefits than their straight counterparts. Around 43% also reported postponing or avoiding medical care due to cost, and 31% did so because of discrimination (Doherty, Ives-Rublee, & Norris, 2025).

Anti-LGBTQ+ legislation at both the state and federal level has also contributed to denied care in among disabled LGBTQ+ adults, including gender affirming and reproductive healthcare. Even when disabled LGBTQ+ adults did receive healthcare, they were more likely than non-disabled LGBTQ+ adults to have providers intentionally refuse to acknowledge their family or refuse to see them all together because of religious beliefs. Because of this, many feel uncomfortable discussing their sexuality, gender identity, or intersex variation with a therapist (Doherty, Ives-Rublee, & Norris, 2025).

But we don’t simply let this happen. Data collection and policy recommendations can be powerful tools for change in our communities. The 2024 LGBTQI+ Community Survey found that 48% of all LGBTQ+ respondents, and 70% of transgender respondents, identify as having a disability. Of these, 24% are related to mental health, 14% are emotional or behavioral, and 13% are a chronic illness. LGBTQ+ people with disabilities consistently showed worse outcomes across all categories discussed compared to those with a single minority identity. In fact, 51% of the disabled LGBTQ+ respondents had experienced some form of discrimination, nearly double that of non-disabled LGBTQ+ respondents and straight disabled respondents. These statistics don’t even account for race or religion, and every environment surveyed showed elevated discrimination rates for disabled LGBTQ+ adults (Doherty, Ives-Rublee, & Norris, 2025).

Clearly, policy change is urgently needed. This includes protecting Sexual Orientation and Gender Identity (SOGI) data that political organizations have been systematically removing, data essential for addressing health disparities in the LGBTQ+ community. It also means keeping medical decisions between patients and providers, protecting access to gender affirming care, restoring and improving SSI, restaffing and funding civil rights agencies, and protecting government agencies like the Department of Education (Doherty, Ives-Rublee, & Norris, 2025).

In 2020, “same-sex relations” were considered a criminal offence in 69 UN countries, with 11 imposing a death penalty. Luckily, since the 1980s, social acceptance of LGBTQ+ identities has increased in 56 of the 175 English-speaking countries reviewed for the Green et al. study. A country’s healthcare system also plays a significant role. Programs like Medicare and Medicaid offer some support in the US, but outcomes can vary considerably between countries with universal healthcare and those with privatized healthcare, like the US. Clearly, the LGBTQ+ and disability communities each have their own stigmas and discrimination, making those at the intersection a minority within a minority (Green et al., 2023).

Despite legislation being passed to prevent open discrimination, it’s clear that LGBTQ+ and disabled people are still facing it in many forms. Disabled people around the world are routinely ignored, stared at, attacked, misunderstood, and underestimated. Attitudes towards the LGBTQ+ community tend to be more positive in Nordic and Western European countries. Yet, even in these countries, LGBTQ+ people with disabilities are significantly more likely to have been harassed or assaulted than their non-disabled peers, and often feel less comfortable asking for help from law enforcement, particularly in the case of disabled transgender people. Media representation also supports this. While LGBTQ+ visibility in the media has greatly improved recently, LGBTQ+ people with disabilities are still largely absent from the screen (Green et al., 2023). 

Psychological impacts are also severe in the LGBTQ+ disabled community. Anxiety and stress rates are also higher among LGBTQ+ people with disabilities. In the Deaf community, LGBTQ+ identity has been linked to increased rates of depression, anxiety, lung disease, and arthritis. LGBTQ+ people with disabilities are also more likely to have experienced addiction and self-harm, and identifying as non-binary raises the risk of depression and anxiety by 80%. LGBTQ+ women with disabilities are also significantly more likely to be diagnosed with arthritis, asthma, COPD, lung disease, diabetes, PTSD, anxiety disorders, and substance use disorders. While this means that they are more likely to seek healthcare, they’re also less likely to have received an HIV test, a recent pap smear, or a mammogram. (Green et al., 2023).

Legal barriers compound all this. Some local US laws actively prohibit positive discussion of LGBTQ+ relationships, South Carolina, for example, only permits the discussion of same-sex relationships in schools when talking about sexually transmitted infections (STIs) (Green et al., 2023). But change is not impossible. It starts with conversations about these problems, educating others, openly advocating for LGBTQ+ and disability communities, and proud allyship.

References

Doherty, C., Ives-Rublee, M., & Norris, H. (2025). The State of Disabled LGBTQI+ People in 2024. Center for American Progress. https://www.americanprogress.org/article/the-state-of-disabled-lgbtqi-people-in-2024/

Green, A.K., Gomes, R.S.M., Heinze, N., Kempapidis, T. (2023). Queer and Disabled: Exploring the experiences of people who identify as LGBT and live with disabilities. MDPI.com. https://www.mdpi.com/2673-7272/4/1/4

Slayter, E., & Johnson, L. (2023). Social Work Practice and Disability Communities: An intersectional anti-oppressive approach — Chapter 7. Salem State University. ROTEL Project. https://pressbooks.salemstate.edu/disabilitysocialwork/chapter/chapter-7-gender-gender-identity-and-gender-expression/