How do LGBTQ+ people with multiple sclerosis experience the healthcare system – and where do they encounter hurdles that often remain invisible? In this special episode, I talk to Dr. William Conte, a neuroimmunologist and member of the LGBTQ+ community himself, about a lack of representation, medical trust, mental health and the importance of affirmative, inclusive care.
Dr. Conte brings not only professional expertise but also personal perspective – and is passionate about ensuring that queer people with MS are finally seen, heard and receive better medical care. A conversation about courage, change and why “keeping an open mind” is sometimes the most important first step.
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More InformationTable of Contents
Introduction & Personal Perspective
Can you share a bit about your journey as a neurologist specializing in MS and your experience as a member of the LGBTQ+ community?
My journey into neurology began during my undergraduate years. I started neuroscience research by chance and quickly developed a passion for it. That led me to medical school, then a residency in neurology, and ultimately to a subspecialization in neuroimmunology. During my residency, I was drawn to MS because of the patients and the rapid advancements in therapies at the time. Being a gay man myself, I recognized a lack of representation and research in LGBTQ+ MS patients and felt compelled to become an advocate for this community.
What inspired you to advocate for LGBTQ+ MS patients and focus on health disparities in this group?
I saw a clear gap in the literature and the healthcare experience for LGBTQ+ MS patients. My personal experiences and the absence of inclusive care in research and support systems made me want to speak up. There are very few studies focused on LGBTQ+ people with MS, and I knew it was time to change that.
Do you think the LGBTQ+ MS community faces unique challenges that are often overlooked in healthcare?
Absolutely. LGBTQ+ individuals represent an „invisible“ minority, unlike racial or ethnic groups. MS patients from the LGBTQ+ community often withdraw from both their queer community and MS-related support systems, leading to social isolation. This dual exclusion worsens outcomes and amplifies minority stress—chronic stress caused by discrimination and social stigma, which impacts mental and physical health.
Health Disparities & Barriers to Care
How does the lack of LGBTQ+ representation in MS research impact treatment options and outcomes?
Most phase III trials for MS treatments don’t include SOGI (sexual orientation and gender identity) data. Without that data, it’s impossible to analyze outcomes by identity group. Pharmaceutical companies are beginning to prioritize diversity, but they’re still missing this critical piece. As a result, we can’t evaluate treatment effectiveness or safety specifically for LGBTQ+ patients.
How does medical mistrust affect LGBTQ+ MS patients, and what steps can be taken to build better doctor-patient relationships?
Trust is crucial in managing a lifelong condition like MS. LGBTQ+ patients often anticipate discrimination, even if it’s not overt. That anticipation alone affects their willingness to disclose important health information. Providers must actively create affirming environments and show cultural competence. Small gestures—like using correct pronouns and updating electronic records—go a long way.
Does the mental health burden impact MS symptoms or progression in the LGBTQ+ community?
We lack concrete outcome data, but minority stress clearly contributes to worse mental health in LGBTQ+ individuals. Stress, depression, and anxiety likely impact MS progression, though this remains under-researched. Social support and affirming care environments can buffer some of these negative effects.
The Role of Inclusive & Culturally Competent Care
How can healthcare providers create a more inclusive and welcoming environment for LGBTQ+ MS patients?
Start by acknowledging that LGBTQ+ identity matters in healthcare. Ask for and use patients’ pronouns and names respectfully. Mistakes happen—own them, apologize, and move forward. Also, educate yourself. Attend sessions at conferences, read, and be curious without being intrusive. Even design elements like inclusive pamphlets and signage can send powerful signals of belonging.
What should LGBTQ+ MS patients look for when choosing a neurologist or healthcare provider to ensure they receive affirming care?
First, prioritize getting in with an MS specialist. Then, assess whether the provider is culturally competent. Microaggressions—like misuse of names or dismissive behavior—are red flags. Most patients can sense if a doctor is genuinely affirming. Word of mouth and online research also help.
Community, Advocacy & Research
Are there specific LGBTQ+ MS support groups or organizations that you recommend?
In-person groups are the most effective, but they’re often limited to urban areas. Online groups, like those offered by the National MS Society or MSAA in the U.S., are a great starting point. Community and peer support are vital for mental health and resilience.
Do you see improvements in how the healthcare system addresses LGBTQ+ health disparities in MS?
Unfortunately, not yet. Some healthcare professionals are becoming more inclusive, but recent policies—especially in the U.S.—are increasing minority stress, particularly for trans individuals. Even the threat of discriminatory policy affects well-being. On the bright side, awareness among providers is growing, and platforms for advocacy are expanding.
Quickfire Q&A Session
Complete the sentence: "For me, multiple sclerosis is...."
Fun—at least from a research and clinical perspective. It offers complexity, individuality, and constant evolution. For patients, it’s obviously a tough journey, but for clinicians, it’s intellectually engaging.
What development would you like to see in the field of multiple sclerosis in the next 5 years?
A successful remyelination therapy. We need treatments that repair damage, not just prevent new lesions. Also, a definitive diagnostic test for MS would be transformative.
Farewell
What advice would you give to LGBTQ+ individuals who are newly diagnosed with MS?
Take the diagnosis seriously from the start. Don’t wait for symptoms to worsen. Seek out a qualified MS specialist and start on high-efficacy treatment quickly. Early intervention has long-term benefits.
What is your message to healthcare professionals who want to improve care for LGBTQ+ MS patients?
Be curious. You don’t need to have all the answers or hang rainbow flags everywhere. Just take the time to learn. Whether it’s attending a session on LGBTQ+ health or simply asking thoughtful, respectful questions, it shows patients that they’re in the right place.
Where can listeners find you or learn more about your work?
I’m very Googleable! You can find me through my clinic’s website or on LinkedIn. I regularly publish and speak on these topics, and I’m always happy to connect.
See you soon and try to make the best out of your life,
Nele
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