​Summary: This study examined differences in health insurance coverage and health care access by sexual orientation and gender identity among California adults.

Findings: Based on data from the California Health Interview Survey (CHIS), the results show that although lesbian, gay, and bisexual women and men had similar or better rates of insurance coverage compared to straight women and men, they were more likely to experience barriers in accessing health care, particularly delays in getting needed health care. In addition, gay men, lesbian women, and bisexual women were more likely than straight men and women to report experiencing unfair treatment when getting medical care. Transgender adults had higher rates of public insurance coverage than cisgender adults but were not more likely to lack health insurance. However, transgender adults were more likely to experience a number of barriers to care, including being less likely to have preventive care visits, more likely to have difficulty finding primary or specialty care providers, and more likely to experience delays in getting needed health care. These findings highlight the need to identify health care and structural interventions that will improve access to care for sexual and gender minorities.