LGBT People and Federal Health Policy: An Invisible Population?

Nick J. Mulé and Miriam Smith argue that the Canadian Federal government must recognize the distinct and diverse healthcare needs of LGBT populations.


Over the last thirty years, there have been major strides in the recognition of lesbian, gay, bisexual and transgender (LGBT) rights in Canada. While the situation is far from perfect, most Canadians probably think of themselves as quite tolerant and believe that most LGBT issues have been settled. Yet, when we look at health care policy, we find that is not the case.

LGBT people have issues in health care that are often overlooked in the current system. For example, transgender people have specific medical needs in transitioning and the LGBT population suffers disproportionality from certain cancers and mental health problems, often sparked or exacerbated by prejudice, stigmatization and discrimination. Doctors often don’t ask if patients are LGBT and simply assume that people are heterosexual.


Our research looked at the extent to which federal health policy recognized the specific health problems of the LGBT population. While provincial governments administer and deliver health care to Canadians, the federal government plays an important role in setting priorities and in influencing health perspectives. It is also directly responsible for public health, Aboriginal health, and drug regulation.

We found that Health Canada and the Public Health Agency of Canada pay very little attention to LGBT health and that, indeed, their documents and websites barely mention the words gay, lesbian, bisexual, transgender, sexual orientation or gender identity. This is surprising, given that both organizations have prioritized an approach to health policy that considers social factors that affect health such as poverty. Even when sex and gender are mentioned in federal health policy, such as the gender-based analysis initiative, these are not taken to include LGBT people. Our research shows that the federal government needs to clearly recognize the full diversity of the population, by specifically naming and including LGBT people in federal health policy in a meaningful way.

Hence, we recommend that policy makers in Health Canada and the Public Health Agency of Canada recognize the LGBT populations as distinct with unique health needs, much as other populations (Aboriginal, children, (dis)abled, homeless, seniors, women, etc.) are recognized. A considerable amount of research regarding the health and wellbeing of the LGBT communities has been conducted across Canada over the past 20 years. We urge the federal health departments to review and utilize this research in developing LGBT-focused health policy.

Funding, programs and services need to be made available for the broad range of health and wellbeing issues that affect the LGBT communities. The federal government should not take an illness-focused approach to LBGT issues, as is currently the case with most funding allotted for HIV/AIDS. Insofar as health and wellbeing issues are ever changing, more research dollars are needed for continued research in this area. Also, if funding and policy making are to be properly implemented, health care and social service professionals need to be properly trained to adequately address the unique issues of LGBT populations. Such training requires that colleges and universities have the necessary resources required to expand their respective curricula to include LGBT issues.

We believe the health and wellbeing of LGBT people is already heavily compromised by a heterosexist and cisgendered society. Thus, we encourage the federal government to take a more responsible position of ensuring that the LGBT communities and their health and wellbeing issues are treated knowledgeably, equitably, and with sensitivity.


Nick J. Mulé is an Associate Professor at York University. @nickjmule

Miriam Smith is a Professor at York University. @mcsmith82

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