New York is home to more than one million LGBTQ+ adults. The modern LGBTQ+ rights movement was born here, communities have organized here for decades, and our community has built systems of care when none existed.
And yet, too many LGBTQ+ New Yorkers still struggle to access basics like healthcare.
This claim isn’t just based on lived experience, it also shows up clearly in the data. Thanks to the proposed Primary Care Investment Act moving through the state legislature, we have the power to change that.
Across New York State, LGBTQ+ adults face higher rates of unmet health needs than their non-LGBTQ+ peers. Cost prevents care for 13.5 percent of lesbian, gay, bisexual, and other (LGBO) adults and 17.3 percent of transgender adults, compared to 7.3 percent of non-LGBTQ+ New Yorkers. The facts are the facts: more LGBTQ+ people lack a regular health care provider.
These inequities are not isolated — they compound with other health disparities. LGBTQ+ adults are more than twice as likely to experience mental health challenges, with nearly one in three reporting persistent stress, depression, or emotional distress.
Primary care is where these issues should be addressed early, before they escalate into crises. It is where patients build trust, access preventive services, manage chronic conditions, and receive affirming care that reflects who they are.
But for many LGBTQ+ New Yorkers, accessing primary care is a struggle.
Nearly one-third of LGBTQ+ New Yorkers report that there are too few providers trained in LGBTQ+ health issues. For transgender and gender non-conforming people, that number rises to more than half. Too often, patients are forced to educate their own providers or avoid care altogether.
Among older LGBTQ+ New Yorkers, the consequences are even more severe. Many have lived through decades of discrimination in health care settings, experiences that continue to shape their willingness to seek care today. Fear of mistreatment leads some to delay care until it becomes urgent, or to avoid it entirely.
The result is a system that reacts to crises instead of preventing them.
We see it in the fact that 22 percent of LGBTQ+ New Yorkers have been unable to see a provider because of cost. We see it in disparities in chronic illness, mental health, and HIV, especially among older adults and transgender New Yorkers. We see it in the reality that access to culturally competent, community-based care is still too limited.
This is no coincidence; it’s the direct result of how we fund our health system.
Primary care is the foundation of prevention and long-term health, but it remains chronically underfunded. Despite being the front door to care, it receives a small share of overall health spending, leaving providers stretched thin and patients without access when they need it most.
The Primary Care Investment Act is currently moving through our state legislature, and it offers a path forward for our community across New York.
By requiring health plans to invest at least 12.5% of spending in primary care, the legislation would strengthen the very part of the system that LGBTQ+ communities rely on most: accessible, community-based, preventative care.
For LGBTQ+ New Yorkers, this is not just about improving efficiency. It is about equity.
It means expanding access to affirming providers with experience treating LGBTQ+ patients. It means reducing delays in care caused by cost and scarcity. It means addressing mental health needs earlier, managing chronic conditions more effectively, and ensuring that no one has to choose between their identity and their health.
New York has long led the nation in advancing LGBTQ+ rights. Now it must lead in ensuring access to comprehensive LGBTQ+ healthcare.
The Primary Care Investment Act is an essential step toward that goal. The time to pass it is now.
Patrick McGovern is CEO of Callen-Lorde Community Health Center, a global leader in LGBTQ+ healthcare.
