Lesbian, Gay, Bisexual, Transgender, Queer/Questioning (LGBTQ) Perceptions and Health Care Experiences

Abstract

Background: The goal study of this was to explore attitudes, health knowledge, and experiences with healthcare setting and providers among gay, lesbian, bisexual, transgender, queer/questioning (GLBTQ) individuals and to identify areas for improvement. Methods: Members of Equality Florida™ residing in the five counties of the Tampa Bay region were recruited through email invitation to complete a 60-item questionnaire assessing demographics, attitudes, and experiences with healthcare providers (HCPs). Additional open-ended questions focused on experiences with HCPs and suggestions for ways to improve HCPs’ cultural competency. Results: 632 respondents completed the survey of which 41% were gay men and 29% were lesbian. The majority of participants was White, non-Hispanic (93%), married/partnered (78%), and had health insurance (88%). The majority (67%) reported they always or often disclosed their sexual orientation/identity to an HCP and few had negative reactions in the healthcare setting (<10%). Healthcare settings with equality signs and gender-neutral language were perceived as safer. Participants’ responses suggested need for policy changes and improved cultural competence among HCPs. Conclusion: Results show high rates of sexual orientation disclosure, greater acceptance from providers of GLBTQ status, and the need for examination of hospital policies and improved cultural competency.

Perceived Discrimination, Coping Mechanisms, and Effects on Health in Bisexual and Other Non-Monosexual Adults

“…Not only did some participants in the current study perceive their physical health to be directly impacted by discrimination, they also perceived a connection between mental health and physical health, as supported by prior research (Mereish & Poteat, 2015). Bisexual health disparities may be associated with bisexual discrimination from medical providers and reduced access to bisexual health resources, but most research has examined discrimination and healthcare against LGBTQ individuals more broadly (Ebin, 2012; Quinn et al, 2015). Findings from the current study indicated that participants experienced discrimination in healthcare via diminished access as well as biased and discriminatory treatment from healthcare providers.…”

Sexual orientation disclosure in health care: a systematic review

“…21,[23][24][25][27][28][29][31][32][33][34][35][36][37][38][39] One participant felt the need to disclose to enable their healthcare professional to provide 'more focused advice' 24 and another thought their 'gayness to be highly relevant to [their] health needs'. 21 36 Communication factors, such as using inclusive language 30,34,36,[39][40][41] and open, welcoming body language, 23,34,36,[41][42][43] were seen as facilitators to disclosure whereas the opposites -closed-off or unfriendly body language 41 and heteronormative language, 26,34 such as using a male pronoun to identify a female patient's partner, and vice versa -were viewed as barriers. There were mixed opinions on the merits of using direct questions to explore a patient's SO.…”

“…Some described their delight at finding a registration form that included their SO as an option, 35 whereas many felt their SO was not accommodated by the options presented. 26,36 Most described these types of written disclosure as a facilitator to disclosure, 22,35,39,41,42,46 but only if they were adapted to be more inclusive and depict a broad spectrum of SOs. 22 The final barrier at the moment of disclosure was the patient's response to heteronormative assumptions.…”

Establishing Effective Health Care Partnerships with Sexual and Gender Minority Patients: Recommendations for Obstetrician Gynecologists

“…[1][2][3][4][5][6][7] Even when sexual and gender minority patients do not experience outright mistreatment or disrespect, they describe interacting with health care teams who are under-educated and unprepared to provide culturally relevant care or address many of the health care issues and challenges they face. 1,2,[7][8][9][10][11][12] And when sexual and gender minority patients anticipate or experience culturally incompetent or disrespectful care, they are less likely to disclose these parts of their identities to health care team members, which can result in inadequate communication, lack of preventive services, inaccurate diagnosis, inappropriate treatment, and poor health outcomes. 11,13 Examples of sexual and gender minority patients' negative health care experiences include, but are not limited to, registration systems and forms that do not allow patients to specify same-sex partners, a transgender identity, or a preferred name that is different than the legal name; assumptions that parents of pediatric patients are opposite-sex and hold heterosexual identities; electronic health records that do not prompt providers that transgender patients may require preventive screenings not associated with their gender identity (e.g., male patients may require cervical or breast cancer screening); providers assuming that patients who identify as lesbian do not require screening for sexually transmitted infections or cervical cancer; patient education materials and images in clinics that depict only heterosexual families and gender conforming individuals; restroom designations that require identification with either the male or female binary gender; staff and providers deliberately or mistakenly misgendering patients when interacting with them (e.g., referring to a female-identified patient as "he" or using her male-gendered legal name instead of her preferred name); and micro-aggressions such as emotionally and interpersonally distant or "cold" body language, lack of eye contact, and assumptions of particular sexual practices and activities, illegal substance use, sex work, or engagement in gender-stereotyped recreational activities and interests (e.g., assuming same-sex partners recreate stereotypically binary male and female gender roles often associated with heterosexual relationships among cisgender individuals, or those whose sense of personal identity and gender corresponds with their sex at birth).…”