Abstract
Aim
The purpose of this study was to examine the lived experiences of lesbian, gay, bisexual, transgender, queer, and other (LGBTQ+) people with disabilities when interacting with healthcare professionals related to their gender identity, sexuality, and disability.
Subject and methods
Historically marginalized groups face many inequities in health care. However, little is known about the intersectional experiences of LGBTQ+ people with disabilities when receiving health care given their likelihood to encounter multiple marginalizations. Data were collected via the 2019 National Survey on Health and Disability (NSHD) and included a sample of 197 LGBTQ+ respondents with disabilities living in the USA. Quantitative data and demographics were analyzed using descriptive methods. Qualitative data were analyzed using deductive and inductive methods.
Results
Of the LGBTQ+ respondents with disabilities, 72.2% avoided discussing their gender or sexual identity with their healthcare providers, with 9.8% never disclosing their identity. Qualitative analyses revealed themes centered around experiences of negative interactions with healthcare providers, including fear, distrust, and avoidance of care (40.1%), dismissal or denial of treatment (30.5%), and assault or aggressive activity (4.1%), although some reported no problems or need to discuss their LGBTQ+ or disability identities (14.7%).
Conclusion
LGBTQ+ people with disabilities reported high rates of negative experiences disclosing gender or sexual identity and/or disability with healthcare providers. Further research is needed to determine whether negative interactions with medical providers may be caused by a lack of medical understanding, false assumptions about the de-sexualization of disabled people, or ignorance about LGBTQ+ identities.
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Data availability
Inquiries about the survey and dataset can be made by contacting the NSHD Administrator at the University of Kansas Noelle Kurth, at pixie@ku.edu.
Code availability
Inquiries about the code used can be made by contacting the corresponding author, Abby Mulcahy, at abigail.mulcahy@va.gov.
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Funding
The National Survey on Health and Disability (NSHD) is funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR project #s: 90DP0075-01-00 and 90IFRE0050-01-01). This work was supported, in part, by a fellowship (Mulcahy) from the Veterans Administration Office of Academic Affairs.
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Conceptualization, K. B, A.M., D.J.M., J.P.H., and N.K.; methodology, A. M, K.S.G, D.J.M.; formal analysis, A.M., K.S.G., and N.K.; data curation, A.M. and N.K.; writing—original draft preparation, K.B.; writing—review and editing, A.M., C.G.S., A.M.W., and J.P.H. All authors have read and agreed to the published version of the manuscript.
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All participants gave their informed consent to participate in this study. The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board of the University of [redacted] (Study#00147878).
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Informed consent was obtained from all participants involved in the original NSHD study. All consent procedures and documents were approved by the University of Kansas IRB (Study#00004253).
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The National Survey on Health and Disability (NSHD) is administered by the University of Kansas Institute for Health & Disability Policy Studies and funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR, project #s 90IFRE0050 and 90DP0075). The contents of this manuscript do not necessarily represent the policy of NIDILRR, ACL, or HHS and you should not assume endorsement by the federal government.
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Mulcahy, A., Batza, K., Goddard, K. et al. Experiences of patients with disabilities and sexual or gender minority status during healthcare interactions. J Public Health (Berl.) (2023). https://doi.org/10.1007/s10389-023-02145-3
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DOI: https://doi.org/10.1007/s10389-023-02145-3