The Quiet Crisis Affecting LGBTQ+ Physicians and Their Patients
We're closing MCMS Pride Month coverage for June 2026 with the research that sits underneath everything else we've shared this month.
Two studies published in the past year document what's happening to LGBTQ+ people in medicine right now, on both sides of the exam room. The picture isn't good, and it has practical implications for how Montgomery County physicians practice.
On the physician side
A Boston University study published in JAMA Network Open earlier this year is one of the first to examine the link between LGBTQ+ identity and physician well-being at scale. The data came from the Healthcare Professional Well-being Academic Consortium, which surveys tens of thousands of physicians across dozens of academic medical centers. Researchers asked participating institutions to add sexual orientation and gender identity questions. Not all agreed, but those that did generated several thousand LGBTQ+ respondents.
The finding: LGBTQ+ physicians and trainees reported significantly higher burnout and lower professional fulfillment than their straight, cisgender peers. They were also less likely to receive support for it.
Lead researcher Carl Streed, Jr. at Boston University's medical school didn't soften the forecast. He said things weren't going well before the current federal climate and expects them to get worse. He flagged moral injury specifically: the stress of being professionally trained and ethically obligated to provide care that you're simultaneously being told to withhold.
Burnout in physicians is already linked to higher medical error rates, reduced hours, and people leaving medicine altogether. An LGBTQ+ physician who leaves takes with them the specific ability to care for patients who may have no other affirming provider nearby. In Montgomery County, the 2024 Office of Legislative Oversight report found only three practices in the county offer any gender-affirming services. Losing physicians from that already thin bench is not a theoretical concern.
What you can do: Streed said straight and cisgender colleagues have a real role here. Pay attention to how your LGBTQ+ colleagues are doing. Say something when something seems off. Make sure partners are included in social settings. At the practice level, check whether your non-discrimination policies have functioning reporting mechanisms, not just language on paper. MCMS's Physician Peer Partners program is available to any member dealing with burnout.
On the patient side
A research letter in the December 2025 issue of JAMA Network Open used National Health Interview Survey data from 132,000+ participants to compare healthcare access by sexual orientation. LGBTQ+ respondents were three times more likely to skip necessary medical care because of cost. The researchers called this "sobering, given the increased burden of mental illness in the LGBTQ+ community."
Breaking that down: LGBTQ+ patients were 73% more likely to skip mental health care, 64% more likely to skip medical care, 63% more likely to go without prescriptions, 59% more likely to take smaller doses to stretch their supply, and 53% more likely to delay refills. These gaps held even after controlling for insurance coverage.
Cost is part of it. But separate research found that 35% of LGBTQ+ patients said their provider was insensitive to their identity, 30% said their provider didn't know enough about LGBTQ+ health, and 23% felt judged. Patients who expect that experience don't make the appointment. That delay has downstream consequences on chronic disease management, mental health outcomes, and preventive care.
What you can do: Ask about cost barriers during the visit and have referral options ready. The Maryland Family Planning Program runs 60+ clinics statewide with free and low-cost services and no insurance requirement. For mental health, the MoCo Pride Center in Bethesda and the Rainbow Youth Alliance (for patients under 18) are the main county-based options. Check whether your EHR's SOGI fields are turned on. The AMA has practice guidance on how to introduce those questions in a way that doesn't feel clinical or awkward.
From MCMS
MCMS's full LGBTQ+ Healthcare Resource Guide is available on the website with local referral options, Maryland Medicaid coverage details, and CME resources.