Gynaecological Challenges Faced by LGBTQ+ People: Addressing the Gap in Inclusive Care

Healthcare should be a safe and affirming space for all individuals, yet for many in the LGBTQ+ community, gynecological care can be a source of anxiety, discomfort, and even avoidance. While sexual and gender minorities face unique health challenges across the medical spectrum, gynaecology remains a particularly difficult area due to longstanding gendered norms, lack of provider training, and systemic barriers. Addressing these challenges is essential to delivering equitable and inclusive care.

 

  • Mistrust and Medical Discrimination

A significant barrier is the mistrust many LGBTQ+ people have toward healthcare systems, often grounded in personal experiences of discrimination or being misunderstood. For transgender, non-binary, and gender-diverse individuals, gynecological visits can be especially distressing when assumptions are made about their identity based on anatomy. Studies have shown that LGBTQ+ patients are more likely to delay or avoid preventive gynecological care, such as cervical screening or STI testing, due to fear of misgendering, judgement, or lack of knowledge on the part of the provider.

 

  • Gender Dysphoria and Pelvic Exams

For transgender men and non-binary people assigned female at birth (AFAB), pelvic exams and discussions about reproductive organs can provoke significant gender dysphoria. The language often used in gynaecology—terms like “women's health,” “female reproductive organs,” or “ladies' clinic”—can be alienating. These patients may feel invisible or invalidated when their gender identity is overlooked. Some avoid appointments altogether, missing out on potentially life-saving screening like Pap smears or HPV testing.

 

  • Lack of Provider Knowledge

Despite growing awareness, many healthcare providers still lack training on LGBTQ+ health, particularly in gynaecology. There may be uncertainty around which services are necessary for transgender men or intersex individuals, how to address contraception and fertility preservation in queer relationships, or how to provide trauma-informed care. In some cases, providers unintentionally offer incomplete or inappropriate care because of binary assumptions about sex, gender, and sexual behavior. For example, a lesbian woman might be told she doesn't need STI testing or Pap smears because she doesn't have sex with men—an inaccurate and potentially harmful assumption. Similarly, transmasculine patients may be denied care because staff are unfamiliar with their needs or unsure how to proceed.

 

  • Fertility and Family Planning Gaps

Fertility discussions are often heteronormative, focusing on cisgender women in heterosexual relationships. LGBTQ+ people may face additional emotional and financial hurdles when trying to conceive. Transgender individuals on hormone therapy may have fertility concerns that are poorly addressed, and discussions around egg or sperm preservation are not always offered proactively before gender-affirming treatments. Additionally, same-sex couples and single LGBTQ+ individuals may encounter limited access to assisted reproductive technologies (ART) and fertility services, both due to policy barriers and provider biases.

 

  • Pride 2025: Activism and Social Change

This year's Pride Month theme—“Activism and Social Change”—is a powerful reminder that healthcare reform is a key part of LGBTQ+ advocacy. Activism in the gynaecological space means pushing for inclusive education in medical schools, demanding systemic accountability, and elevating patient voices. It means healthcare providers stepping up as allies, challenging outdated systems, and creating environments where queer and trans individuals feel safe to access essential care without fear. Pride is not just celebration—it's a call to action to transform care into something truly equitable.

 

  • Creating Inclusive Care

To improve outcomes and rebuild trust, healthcare systems must prioritize inclusive and affirming gynecological care. This starts with:

• Inclusive language: Avoiding assumptions and using gender-neutral terms like “patients” instead of “women.”

 • Training clinicians: Ensuring providers understand the diverse needs of LGBTQ+ individuals and know how to offer sensitive, trauma-informed care.

 • Reforming forms and systems: Intake forms should allow for diverse gender identities, pronouns, and sexual orientations.

 • Collaborative care: Gynaecologists should work closely with endocrinologists, mental health professionals, and fertility specialists to support patients holistically.

 

  • Final Thoughts

LGBTQ+ individuals have the same right to respectful, comprehensive, and compassionate gynecological care as anyone else. Addressing the unique barriers they face isn't about political correctness—it's about clinical excellence and equity. This Pride Month, as we champion activism and social change, let's make space for reform in healthcare. By embracing inclusive practices and challenging outdated norms, providers can ensure all patients—regardless of identity—feel seen, heard, and cared for.