The medical community has been slow to recognize the unique needs of LGBTQ+ individuals, who often face discrimination and prejudice from within the field. This bias is known as heteronormativity, which assumes that all people are either cisgender men or women, attracted to the opposite gender, and engage in monogamous, penile-vaginal intercourse. This narrow view has led to inequities in treatment outcomes, research priorities, and policy.
One area where this becomes evident is in endocrinology. Heteronormative biases have shaped clinical practice, leading to underdiagnosis and undertreatment of hormone imbalances affecting queer patients.
Transgender men may experience gynecomastia (enlargement of breast tissue) due to excess estrogen production, but providers may attribute it to obesity rather than their hormones. Similarly, transgender women may develop polycystic ovary syndrome (PCOS), a condition characterized by irregular periods and excessive hair growth, but physicians may assume they are taking hormones without prescription. These misconceptions lead to missed diagnoses and delayed treatments, exacerbating symptoms and increasing health risks.
Heteronormativity also impacts clinical trials. Studies focusing on sex differences in disease risk and progression have overwhelmingly included only cisgender men and women, leading to insufficient data for the LGBTQ+ population.
Many studies exclude sexual minorities altogether, limiting our understanding of how certain conditions manifest differently based on identity. The lack of information about sexual orientation can result in incorrect protocols being applied, worsening patient outcomes.
Policymakers often fail to consider the needs of the LGBTQ+ community when creating laws and regulations. Healthcare disparities exist because of this neglect; for instance, same-sex couples face barriers to family building through surrogacy or adoption, while intersex people struggle with genital mutilation and other forms of medical trauma. To ensure equitable care for all individuals, structural changes must be implemented, such as mandatory gender-neutral bathrooms, inclusive language training for staff, and diversity initiatives that prioritize queer representation across disciplines.
In healthcare, how do heteronormative biases affect treatment outcomes, research priorities, and policy, and what structural transformations are needed to ensure equitable care for queer populations?
Heteronormativity is an ideology that reinforces the cultural belief that sexuality is binary (i. e. , only male/female) and that gender roles are fixed. This perspective has been found to influence medical treatments, research priorities, and policies disproportionately toward those who fit this narrow definition of "normal" sexual orientation and gender identity.