Health care use among gay, lesbian and bisexual Canadians

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by Michael Tjepkema



This article examines whether consultations with health care providers, not having a regular doctor, unmet health care needs, and receipt of preventive screening tests vary by sexual identity for Canadians aged 18 to 59.

Data source

Results are based on the  Canadian Community Health Survey, combined 2003 and 2005 data.

Analytical techniques

Cross-tabulations were used to compare utilization rates of selected health care providers by sexual identity.  Multiple logistic regression models that controlled for predisposing, enabling and health need variables were employed to ascertain if sexual identity was independently associated with health care use, not having a regular doctor, unmet health care needs, and receipt of preventive screening tests.

Main results

Gay men, lesbians and bisexual people were more likely than heterosexuals to consult mental health service providers.  Lesbians had lower rates of consulting family doctors and were less likely to have had a Pap test, compared with heterosexual women.  Bisexuals reported more unmet health care needs than did their heterosexual counterparts.


Homosexuality, family physicians, health care services accessibility, health status, mammography, Pap smear test


While a variety of factors have been studied in relation to the decision to seek health care, relatively little research has examined health care use and access by sexual orientation. Much of the information about the role of sexual orientation in access to care comes from American studies, the balance of which suggests that gay men, lesbians and bisexuals experience unique obstacles. This research shows that lesbians are less likely than heterosexual women to have a regular source of care such as a family doctor, and more likely to report difficulties in access due to cost. Some gay men, lesbians and bisexuals have reported negative experiences with the health care system related to their sexuality, and, as a result, avoid or delay seeking care.     [Full text]


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Michael Tjepkema (416-952-4620; is with the Health Information and Research Division at Statistics Canada in the Toronto Regional Office, 25 St. Clair Avenue E., Toronto, Ontario, M4T 1M4.

What is known on this topic?

  • Gay, lesbian and bisexual Americans experience more barriers to health care than do heterosexual Americans.
  • Most American studies show that lesbians and bisexual women undergo preventive cancer screening tests less frequently than do heterosexual women.
  • Much of this research was based on non-probability surveys.

What does this study add?

  • Gays, lesbians and bisexual Canadians have different health-care-seeking behavior than do  other Canadians, independent of predisposing, enabling and health need factors.
  • Disparities in health care use were particularly evident among lesbians, who are less likely to have a regular doctor and who have lower utilization rates of GPs and Pap tests.
  • Bisexuals were more likely to report unmet health care needs, compared with heterosexual Canadians.
  • Evidence from this study is based on a large national probability survey.