Not all patients feel comfortable seeking healthcare, and not all patients feel the individuals working in these settings treat them with respect, new research finds.
The review, published in the International Journal of Environmental Research and Public Health, found sexual minority women (SMW) — in this case, those who identify as lesbian, bisexual, gay or queer — encounter barriers when accessing care. The primary cause of their concerns? Perceived ignorance and prejudice among healthcare professionals, according to the study authors.
What Did the Study Find?
Drawing on 26 different studies that focused on healthcare experiences of LGBTQ+ women in the U.K. between 2010 and 2018, researchers observed that SMW often delay or do not seek care at all. Many respondents had never registered with a provider, and the paper also cited two examples of women refusing to seek treatment despite actually having a medical problem. The study’s lead author Catherine Meads, MD, PhD, health professor at Anglia Ruskin University, notes that some SMW have access to good healthcare, but this isn’t the majority.
Ultimately, researchers concluded that healthcare professionals’ behavior toward such patients can “negatively impact access, service uptake and health outcomes … There is a strong need to enhance healthcare professionals’ understanding of how to provide culturally competent care for [LGBTQ+] people and to understand this group’s health needs.”
Several women included in the research shared specific experiences.
“If you were feeling bad about yourself, you’ve got low self-esteem or had the experience of homophobic abuse, and then you went somewhere and couldn’t find the information you wanted, it reinforces the difference,” said one respondent.
Another, who attended a medical appointment with her partner, expressed frustration with staff assuming she’s heterosexual: “[The receptionist] refused to put down my partner’s name and … kept saying ‘I’ll just put friend.’ I said, ‘No, I want you to put partner, and she looked at me, lips pursed, and said, ‘I’ll just put friend.'”
A third noted that some healthcare workers seem to lack knowledge about LGBTQ+ bodies, recalling, “I was scheduled for a small bit of surgery and was asked to [take] a pregnancy test. I pointed out that I was not only a gay woman but also post-op male-to-female trans. The reply was, ‘Well, best to be sure.'”
What Can Healthcare Providers Do?
Dr. Meads speculates that the driving factor behind the behavior from healthcare workers outlined in the study is “a mixture of institutional homophobia, apathy, ignorance, and a few instances of blatant individual homophobia.”
With that in mind, you should take time to assess your own implicit biases toward LGBTQ+ patients in order to prevent yourself from acting on them. The National LGBTQ Health Education Center has a guide for providers that explains how to uncover your own prejudices and walks through several scenarios. For example, one outlines how asking a female patient if she “has a boyfriend” could cause her to worry she’d be judged for sharing that she’s in multiple relationships with people of different genders.
You should also learn about the health-related and social issues affecting the LGBTQ+ community. It’s necessary for you to “do your job properly and without discrimination,” Dr. Meads tells Florence Health.
In addition, healthcare leaders in a position to implement educational standards about the LGBTQ+ community should consider doing so. “Anything appropriate being used to educate healthcare professionals would be better than the current situation,” Dr. Meads adds.
Last, don’t assume LGBTQ+ people, especially women, face the same health concerns as heterosexual people.
“This is far from the case,” Dr. Meads explains. “In the U.S., there’s some evidence that there’s a higher death rate from breast cancer in SMW, but no difference in rates of getting the condition, suggesting that SMW are dying needlessly because of difficulties with interacting with their health system.”
A Systematic Review of Sexual Minority Women’s Experiences of Health Care in the UK, International Journal of Environmental Research and Public Health.
Learning to Address Implicit Bias Towards LGBTQ Patients: Case Scenarios, National LGBTQ Health Education Center.
Last updated 9/25/2019