Abstract

Background: Despite increasing visibility in the United States and worldwide, sexual and gender minority (SGM) individuals continue to face significant health disparities, including increased substance use (Schuler et al., 2018), poor mental health (SAMHSA, 2023), and risky HIV behaviors (Solberg et al., 2023). These disparities often stem from negative experiences within the healthcare system, resulting in delayed care or lack of care for health problems (Ayhan et al., 2019). This study seeks to understand the experiences of SGM individuals in healthcare settings and was guided by insights from Uncertainty Management Theory (Brashers, 2001).

Methods: Participants were recruited online and from SGM-focused community centers in Michigan. Qualitative thematic analysis, informed by the Framework Method (Gale et al., 2013), was employed to analyze data from six in-depth, semi-structured focus groups from May 19 to September 5, 2024. Groups, lasting 1.5 to 2 hours, were conducted via Zoom and included diverse SGM community members, including lesbians and bisexual women, gay and bisexual men, transgender men, transgender women, non-binary and gender non-conforming individuals.

Results: Thirty-four people individuals, mostly White (57.7%), Black (23.3%), or Asian (5.8%). Around half were 21-29 years old (48.9%), 21.3% were 30-59, and 29.8% were 60 or older, and the remaining 18.4% were 30-59. Six major themes emerged: 1) verbal interactions (e.g., problematic statements or affirming statements), 2) provider/staff interactions and reactions (e.g., providers/staff exhibiting offensive or affirming behaviors), 3) environment and spaces (e.g., harmful or affirming practice spaces), 4) congruency of practices (e.g., inconsistent and consistent cultural practices), 5) client perspectives and actions related to care (e.g., client care burden), and 6) client aspirations for training and care for providers (e.g., hopes for training providers for competent care). Most themes had negative and positive aspects, but theme five solely focused on burdens while theme six focused solely on aspirations.

Conclusion: This study sheds light on the healthcare experiences of SGM individuals. Our findings highlight the need for inclusive healthcare environments. To address this, a training program to improve provider-patient interactions is being developed to improve the quality of care for SGM patients.

Notes

References:

Ayhan, C. H. B., Bilgin, H., Uluman, O. T., Sukut, O., Yilmaz, S., & Buzlu, S. (2019). A systematic review of the discrimination against sexual and gender minority in health Care Settings. International Journal of Social Determinants of Health and Health Services, 50(1), 44–61. https://doi.org/10.1177/0020731419885093

Brashers, D. E. (2001). Communication and Uncertainty Management. Journal of Communication, 51(3), 477–497. https://doi.org/10.1111/J.1460-2466.2001.TB02892.X

Gale, N. K., Heath, G., Cameron, E., Rashid, S., & Redwood, S. (2013). Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Medical Research Methodology, 13(1), 1–8. https://doi.org/10.1186/1471-2288-13-117

Substance Abuse and Mental Health Services Administration. (2023). Lesbian, gay, and bisexual behavioral health: Results from the 2021 and 2022 National Surveys on Drug Use and Health (SAMHSA Publication No. PEP23-07-01-001). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/LGB-Behavioral-Health-Report-2021-2022

Schuler, M. S., Rice, C. E., Evans-Polce, R. J., & Collins, R. L. (2018). Disparities in substance use behaviors and disorders among adult sexual minorities by age, gender, and sexual identity. Drug and Alcohol Dependence, 189, 139–146. https://doi.org/10.1016/J.DRUGALCDEP.2018.05.008

Solberg, M. A., Carr, K. D., & Peters, R. M. (2023). Adverse childhood experiences and health outcomes among sexual and gender minorities: A systematic review. Journal of Child & Adolescent Trauma, 1–13. https://doi.org/10.1007/s40653-023-00576-4

Description

SGM individuals face health disparities due to negative healthcare experiences. This study explored SGM experiences using qualitative thematic analysis. Six themes emerged: verbal and provider interactions, environmental factors, congruency of practices, client perspectives, and aspirations for provider training. Findings highlight the need for inclusive healthcare environments and a training program to improve care for SGM patients.

Author Details

Marvin Allan Schilt-Solberg, PhD, RN; Joseph Schwartz, PhD; Sarah Kiperman, PhD; Brayden Misiolek, BA; Rick Zimmerman, PhD

Sigma Membership

Rho

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Qualitative Research

Keywords:

Health Equity or Social Determinants of Health, Public and Community Health, Stress and Coping, Sexual and Gender Minority Patients

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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Understanding Sexual and Gender Minority Patients’ Experiences to Inform Provider Training

Seattle, Washington, USA

Background: Despite increasing visibility in the United States and worldwide, sexual and gender minority (SGM) individuals continue to face significant health disparities, including increased substance use (Schuler et al., 2018), poor mental health (SAMHSA, 2023), and risky HIV behaviors (Solberg et al., 2023). These disparities often stem from negative experiences within the healthcare system, resulting in delayed care or lack of care for health problems (Ayhan et al., 2019). This study seeks to understand the experiences of SGM individuals in healthcare settings and was guided by insights from Uncertainty Management Theory (Brashers, 2001).

Methods: Participants were recruited online and from SGM-focused community centers in Michigan. Qualitative thematic analysis, informed by the Framework Method (Gale et al., 2013), was employed to analyze data from six in-depth, semi-structured focus groups from May 19 to September 5, 2024. Groups, lasting 1.5 to 2 hours, were conducted via Zoom and included diverse SGM community members, including lesbians and bisexual women, gay and bisexual men, transgender men, transgender women, non-binary and gender non-conforming individuals.

Results: Thirty-four people individuals, mostly White (57.7%), Black (23.3%), or Asian (5.8%). Around half were 21-29 years old (48.9%), 21.3% were 30-59, and 29.8% were 60 or older, and the remaining 18.4% were 30-59. Six major themes emerged: 1) verbal interactions (e.g., problematic statements or affirming statements), 2) provider/staff interactions and reactions (e.g., providers/staff exhibiting offensive or affirming behaviors), 3) environment and spaces (e.g., harmful or affirming practice spaces), 4) congruency of practices (e.g., inconsistent and consistent cultural practices), 5) client perspectives and actions related to care (e.g., client care burden), and 6) client aspirations for training and care for providers (e.g., hopes for training providers for competent care). Most themes had negative and positive aspects, but theme five solely focused on burdens while theme six focused solely on aspirations.

Conclusion: This study sheds light on the healthcare experiences of SGM individuals. Our findings highlight the need for inclusive healthcare environments. To address this, a training program to improve provider-patient interactions is being developed to improve the quality of care for SGM patients.