Access to effective services is imperative to address the many health and mental health disparities that lesbian, gay, bisexual, and transgender (LGBT) people face. This population, however, remains underserved and often ill-served in health care environments. Furthermore, interactions between system- and individual-level dimensions of access create barriers to service engagement. Within much of the extant literature surrounding health care barriers among LGBT people, the rich narratives and varied experiences of LGBT community members from diverse backgrounds have often been excluded. The current interview-based study was conducted with a sample of 40 self-identified LGBT adults living in New York City. Participants were recruited through flyers distributed to LGBT-specific social and health service organizations. Twenty-nine participants who discussed health care access as a major health concern were included in the current study. Framework analysis revealed barriers stemming from characteristics of services and providers (system-level) and characteristics of care-seekers (individual-level) as major health concerns. The root causes of system-level barriers were all attributed to social-structural factors that worked to exclude and erase LGBT people from the institutions that shape the health and mental health systems. Individual-level barriers were attributed to both individual and social-structural factors, such as health literacy and stigma. Participants linked access barriers to forgone care and to other health and mental health concerns within their communities. We argue that addressing barriers at the individual and sociostructural levels will better serve LGBT communities. (PsycINFO Database Record

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Lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities of color experience intersecting systems of oppression that limit access to health care, safety, and other basic resources. Important research has documented these disparities, their antecedents, and consequences. However, little research has examined the strengths of multiply marginalized LGBTQ communities. Drawing from a health equity framework, this study is based on interviews with 38 LGBTQ-identified people of color in New York City. We used framework analysis to examine participants’ perspectives on the role of community in enhancing health and well-being. Community strengths identified by participants included (a) safety, acceptance, and support; (b) interconnectedness and resource sharing; and (c) advocacy, collective action, and community potential. Recommendations for policy, practice, and future research are suggested, including efforts toward community power building.

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