Last updated: 8/12/2022
Disability refers to conditions that impair the body or mind and make it more difficult or impossible to do certain activities or functions of daily living. The Centers for Disease Control & Prevention (CDC) states that a range of disabilities can impact a person’s vision, movement, thinking, remembering, learning, communicating, hearing, mental health and social relationships.
Societal norms pertaining to sexual orientation and gender identity, as well as norms around ability, often work to deny LGBTQ+ people and people with disabilities opportunities that others enjoy in their daily lives. Some studies have even proposed that the traumatic effect of discrimination and rejection on LGBTQ+ people’s mental and physical health can itself be considered a disability. Disabled LGBTQ+ people who live at the intersection of these two identities can face compounded discrimination and stigmatization, and it is important for those who serve, interact with, and love and care for those individuals to understand this complex dynamic.
Rates of disability among LGBTQ+ people
HRC Foundation analyzed the disability core questions in the 2020 Behavioral Risk Factor Surveillance System (BRFSS), a nationally representative survey of adults across the United States, and found that LGBTQ+ adults, and transgender adults in particular, were significantly more likely than non-LGBTQ+ adults to self-report having at least one disability. Overall, one in three (36%) LGBTQ+ adults self-reported having a disability, compared with one in four (24%) non-LGBTQ+ (cisgender and heterosexual) adults. In addition, more than a third (35%) of cisgender LGBQ+ adults, and more than half (52%) of transgender adults (including both LGBQ+ and straight transgender adults), self-reported a disability (Table 1).
|Table 1: Reported Disability Among U.S. Adults by Sexual Orientation & Gender Identity (2020)
|Type of Disability
LGBTQ+ adults most commonly reported having cognitive disability. About one-quarter (24%) of cisgender LGBQ+ adults, and a third (35%) of transgender adults reported this, compared to less than one in ten (9%) non-LGBTQ+ adults. Cognitive disabilities are most common among young people, so this may be due to the younger age of LGBTQ+ adults in the sample.
Much less is known about prevalence of disabilities among LGBTQ+ youth. In the HRC Foundation 2018 LGBTQ+ Youth Report, which surveyed over 12,000 LGBTQ+ youth age 13-17 from across the United States, one in seven (15%) LGBTQ+ youth said they had a disability. More recently, a 2020 Trevor Project survey found that 5% of LGBTQ+ reported having deafness or a hearing disability, whereas a 2021 Trevor Project survey found that 5% of LGBTQ+ youth were diagnosed with autism.
LGBTQ+ youth face significant challenges in school that can impede their ability to thrive. LGBTQ+ youth are significantly more likely than cisgender and straight youth to experience bullying at school and online, as well as to experience violence and physical and verbal harassment from their peers. Many LGBTQ+ youth report they are bullied specifically because of their sexual orientation and/or gender identity, leaving many to feel unsafe at school--and to even skip going to school due to safety concerns. Bullying does not always come from other youth--LGBTQ+ youth also experience higher rates of school-based discipline from teachers and administrators, which can increase their risk of dropping-out, expulsion, and even involvement in the juvenile justice system. At the same time, many LGBTQ+ youth lack resources that are inclusive of both their LGBTQ+ identity and disability, and rarely see themselves in their curriculum.
About 15% of public school students in the United States today receive special education services, of which one-third of those students have learning disabilities. However, not every student with disabilities is given the resources and opportunities to thrive and complete their education. According to the National Center for Education Statistics, high school dropout rates are higher for youth with disabilities. Bullying can be a significant source of dropping out of school. Unfortunately, many students with disabilities are worried about school safety and being injured or harassed by other peers, and being bullied for a disability is among one of the most common types of bullying in school. As with LGBTQ+ students, those living with disabilities are also more likely than their peers to experience school-based discipline, including suspensions which result in more days held out of school.
For LGBTQ+ youth with a disability, stigma associated with their intersecting identities places them at even more risk for bullying and harassment. More than one-third (36%) of disabled LGBTQ+ students say they have been bullied or harassed in school because of their disability, while three in ten (30%) say they have felt unsafe at school because of their disability.
Schools have the ability to create inclusive environments for LGBTQ+ students with disabilities to thrive and succeed. One such tool at the student level is the Individualized Education Program (IEP), for students enrolled in K-12 public schools (or an Instructional/Individual Service Plan for students enrolled in private school). Under this tool, families, teachers, school psychologists/youth specialists, and school administrators work together to create a tailored plan for a given student, including outlining a legally binding agreement over any specialized services and accommodations and curriculum modifications the student will receive. As IEP/ISP are unique to each student, there are strategies that can be employed to ensure that any such plans are inclusive of both their disability, and their LGBTQ+ identity. For example, as outlined in HRC Welcoming School’s resource guide on “Advocating for LGBTQ+ Students with Disabilities," one accommodation can be that transgender students’ chosen names and pronouns be used in school or ensuring that any member of their IEP team is someone who is trained on LGBTQ+ cultural competency.
In addition, schools can create more inclusive environments by implementing school wide policies to prevent disproportionate rates of discipline among those living with disabilities, providing professional development and training to staff and educators around LGBTQ+ and disability inclusion, creating curriculum that are inclusive of sexual orientation, gender identity, and disability (among other characteristics), and by supporting the creation of safe spaces for youth, including gay-straight alliances or gender and sexuality alliances (GSAs).
LGBTQ+ people can face significant challenges around accessing health care in numerous ways, which can result in them addressing their health needs and concerns. A study by the Center for American Progress found that 8% of LGBQ+ adults, and 29% of transgender adults, were denied treatment from a doctor or health care provider because of their actual or perceived sexual or gender identity. As a result, nearly one in five (18%) of LGBTQ+ adults who reported discrimination in that same study had avoided health care in the future. For transgender people, accessing health care can be additionally challenging. According to the 2015 U. S. Transgender Survey, one-third (33%) of transgender people who had been to the doctor in the last year had some negative experience with a provider as it related to their transgender identity.
Disabled people also face discrimination in healthcare. A study in the Disability and Health Journal found that disabled people who faced perceived discrimination sought health care at lower rates (79%) than those who did not perceive discrimination (86%). Disabled people may also have less access to routine health care, which can lead to multiple unmet health needs. One analysis of data on people with physical disabilities saw that physically disabled people are 75% more likely to have unmet medical needs, 57% more likely to have unmet dental needs, and 85% more likely to have unmet prescription medication needs.
LGBTQ+ people living with disabilities face compounding difficulties when seeking out care, especially transgender people. One study, found that transgender adults living with disabilities were significantly more likely to have experienced discrimination when seeking out social services than their non-disabled transgender peers. A more recent study found that transgender adults with a disability were between two and five times as likely as cisgender adults with a disability to experience numerous forms of unmet need for healthcare , including being unable to see a doctor in general, a specialist as needed, and a dentist.
While LGBTQ+ health care and access to care have improved over the past decades, there is still much more work left to do. It is imperative that institutions and healthcare professionals commit to building greater competency in the needs of disabled LGBTQ+ people by educating themselves, training their staff and continually marketing their places of care as LGBTQ+ affirming and disability accessible.
A study by Williams Institute estimates that 22% of LGBTQ+ adults live in poverty compared to 16% of non-LGBTQ+ adults. Underlying this disparity are the many ways that homophobia and transphobia are woven into our economic institutions and workplaces. For example, HRC Foundation’s 2018 LGBTQ+ Paid Leave Survey found that fewer than half of LGBTQ+ respondents reported that their employer’s policies cover new parents of all genders equally, and only 49% said that employer policies are equally inclusive of the many ways families can welcome a child, including childbirth, adoption or foster care. Previous research from the HRC Foundation found that LGBTQ+ workers do not earn equal pay for equal work, with LGBTQ+ adults earning about 90% of what the average American worker earns—and LGBTQ+ women earning approximately 79% of what the average American man earns. LGBTQ+ adults are also more likely to be unemployed ,and uninsured, than their cisgender and straight peers.
Many of the structural barriers faced by LGBTQ+ workers parallel those experienced by people living with disabilities. According to data from the 2019 American Community Survey, roughly 25% of adults with disabilities live in poverty, compared to the 2019 national poverty rate (roughly 11%). At the same time, unemployment is a significant issue among disabled people. According to 2021 data from the Bureau of Labor Statistics, only 19% of disabled people were employed compared to 64% of people without a disability. Second, disabled people also have less access to paid leave benefits. A study from the U.S. Department of Labor found that roughly 27% of people with disabilities had access to paid family and medical leave, compared to 37% of workers without a disability.
For LGBTQ+ adults living with a disability, risk of both poverty and unemployment is further compounded. One study from The Williams Institute found that LGBTQ+ men with disabilities are roughly 86% more likely to live in poverty than LGBTQ+ men without disabilities. Likewise, LGBTQ+ women were about 78% more likely to live in poverty than LGBTQ+ women without disabilities. At the same time LGBTQ+ people and people with disabilities are more likely to work in industries that have, on average, lower wages or less access to benefits. In 2017, a Movement Advancement Project study found that only 36% of adults with a disability were employed compared to 77% of those without a disability. It also found that unemployment among LGBTQ+ people was much higher for those with a disability: close to 9% of LGBTQ+ people with a disability were receiving unemployment benefits compared to roughly 5% of LGBTQ+ people without a disability.
Employers have a critical role in ensuring that their disabled LGBTQ+ workers can access paid leave policies and other benefits. By spelling out leave policies in an employee handbook alongside other benefits and guidelines, all employees, including disabled LGBTQ+ workers will have a greater understanding of what benefits are available to them. Employers also have the critical role to make sure that human resources staff are prepared to answer questions regarding leave, including those unique to disabled LGBTQ+ people.
A Call to Action
LGBTQ+ people are more likely to be disabled than non-LGBTQ+ people. The duality of their identities as LGBTQ+ and disabled increases the amount of discrimination and bias they face in their daily lives, at school, at the doctors, or at work. The barriers disabled LGBTQ+ people face start early in life. Disabled LGBTQ+ youth are bullied in school at elevated rates, which can lead to adverse outcomes such as dropping out of school. In healthcare settings, disabled LGBTQ+ people face higher risk of discrimination than both their cisgender and heterosexual peers with disabilities, and their LGBTQ+ peers without disabilities, which can cause them to avoid care and lead to unmet health needs and greater health risks. Disabled LGBTQ+ people are also more likely to face adverse economic outcomes, such as poverty, due to earning less for equal work, facing higher unemployment or lacking access to inclusive workplace benefits. Taken together, these troubling trends serve as a call to action for educators, service providers, healthcare professionals and employers to create more inclusive environments for disabled LGBTQ+ people throughout life and all spaces of daily living.
Resources for LGBTQ+ People Living with Disabilities
Resources for Schools and Educators
Resources for Health Care Professionals and Institutions
Resources for Employers