Improving pathways to primary health care among LGBTQ populations and health care providers: key findings from Nova Scotia, Canada

Abstract

BackgroundThis study explores the perceived barriers to primary health care as identified among a sample of Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) identified individuals and health care providers in Nova Scotia, Canada. These findings, based on a province-wide anonymous online survey, suggest that additional efforts are needed to improve pathways to primary health among LGBTQ populations and in deepening our understanding of how to advance the unique primary health needs of these populations.MethodsData were collected from the LGBTQ community through an online, closed-ended anonymous survey. Inclusion criteria for participation were self-identifying as LGBTQ, offering primary health care to LGBTQ patients, being able to understand English, being 16 years of age or older, and having lived in Nova Scotia for at least one year. A total of 283 LGBTQ respondents completed the online survey which included sociodemographic questions, perceptions of respondents’ health status, and their primary health care experiences. In addition, a total of 109 health care providers completed the survey based on their experiences providing care in Nova Scotia, and in particular, their experiences and perceptions regarding LGBTQ access to primary health care and physician-patient interactions.ResultsOur results indicate that, in several key areas, the primary health care needs of LGBTQ populations in Nova Scotia are not being met and this may in turn contribute to their poor health outcomes across the life course.ConclusionA framework of intersectionality and health equity was used to interpret and analyze the survey data. The key findings indicate the need to continue improving pathways to primary health care among LGBTQ populations, specifically in relation to additional training and related supports for health care providers who work with these populations.

A Framework for Enhancing Access to Equitable Home Care for 2SLGBTQ+ Communities

“…We now have a much deeper understanding of some of the issues of 2SLGBTQ+ access and equity within health and social care services in Global North societies, with the growing body of research on access to care pointing to the detrimental impact of inequities on the health and well-being of 2SLGBTQ+ individuals and communities. A diversity of topics has been addressed within this scholarship and includes attention to challenges experienced across the life course such as those related to aging [ 15 , 16 , 17 ]; gender identity [ 18 , 19 , 20 ]; racialization [ 21 , 22 , 23 ]; Two-Spirit identity [ 24 , 25 ] health conditions [ 26 , 27 ]; rurality [ 28 , 29 , 30 ]; and health services policy and delivery [ 31 , 32 ].…”

“…Brotman et al [ 43 ] describe how receiving care in the home is unique for 2SLGBTQ+ people, highlighting that older adults who experienced particularly acute forms of violence and oppression in their younger adult lives often experience home as one of the few spaces in which they can live out their identities and relationships in safety and security. Given what is known about 2SLGBTQ+ communities and barriers to accessing equitable health services, and the significance of “home” for members of these communities, the lack of existing research on home care is an important social justice concern in need of further attention [ 28 , 44 ].…”

Primary Care for Transgender Individuals: A Review of the Literature Reflecting a Canadian Perspective

“…After removal of duplicates and articles which did not meet the search criteria, 13 primary research studies were included. Primary research studies included 10 quantitative studies (Bauer et al, 2012(Bauer et al, , 2014Bauer, Zong, et al, 2015;Gahagan & Subirana-Malaret, 2018;Heinz & MacFarlane, 2013;Rotondi et al, 2013;Scheim et al, 2017) and three qualitative studies (Bauer et al, 2009;Ross et al, 2016;Vermeir et al, 2018). Research purposes of the primary studies were grouped together to explore common themes, which included exploring transgender health care needs (Bauer et al, 2012;Ross et al, 2016;Vermeir et al, 2018), and the access to and barriers to health care (Bauer et al, 2009(Bauer et al, , 2014Bauer, Zong, et al, 2015;Heinz & MacFarlane, 2013;Rotondi et al, 2013;Scheim et al, 2017;Vermeir et al, 2018).…”

Formação dos profissionais de saúde para o atendimento de LGBTQI+

“…The authors identify that, in continuing education programs for physicians, there is no approach aimed at the care of LGBTQs and alert to the biologicist standard of care for these identities, Interface (Botucatu) https://doi.org/10.1590/Interface.200684 disregarding their emotional aspects. There is a stigma posing that this population seeks health services to treat aspects related to sexually transmitted diseases or to gender transition processes and sexual resignification 26 .…”