Japanese Association of Healthcare Communication
Vol.4, No.1 2026

An LGBTQ perspective on the healthcare context in the United States

Yoshikazu Watanabe

Over the past 70 years in the United States (US), civil rights for LGBTQ (lesbian, gay, bisexual, transgender, and queer/questioning) have gradually gained recognition, culminating in the federal legalization of same-sex marriage. However, prejudice against LGBTQ individuals is still present in a variety of social settings. In addition to concerns about their illness, LGBTQ patients experience anxiety associated with their sexuality when receiving healthcare services. In this report, I share my experience as an LGBTQ person living in Los Angeles navigating the US healthcare system.

Structural Perspectives and Practical Challenges in Advancing SOGI -Related Efforts: Initiatives at Juntendo University

Yuko Takeda 1)

1) Juntendo University Graduate School of Medicine

Social factors that shape health disparities are defined as the social determinants of health . In Japan, respect for diversity has improved, and the term LGBTQ+ (lesbian, gay, bisexual, transgender, queer or questioning, intersex, asexual, and more ) is now widely recognized. However, this increased visibility has not been matched by adequate structural reform. Same-sex marriage remains unrecognized under the law, and comprehensive anti-discrimination legislation is still absent. Moreover, less visible forms of social exclusion persist, and insufficient education continues to produce gaps in knowledge and understanding, thereby perpetuating prejudice and inappropriate responses.
These conditions have serious consequences. LGBTQ+ youth face markedly elevated mental health risks, with rates of suicidal ideation and suicide attempts estimated to be three to four times higher than those of their peers. In addition, stigma and discrimination contribute to health care avoidance among LGBTQ+ individuals, resulting in delayed diagnosis and treatment.
In this paper, we describe initiatives addressing sexual orientation and gender identity (SOGI) at Juntendo Hospital and delineate concrete actions that health care professionals must take. We further argue that the social and structural determinants underpinning health disparities─including stigma, discrimination, and systemic exclusion─must be explicitly recognized and addressed. Approaches such as trauma-informed care and anti-oppressive practice are not optional but essential. Crucially, the advancement of these efforts depends on their sustained co-creation with LGBTQ+ communities.