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Outness, Stigma, and Primary Health Care Utilization among Rural LGBT Populations
J Whitehead1, John Shaver2, Rob Stephenson2
1Department of Pediatrics, School of Medicine, Northwestern University, Chicago, IL, United States of America.
Plos One
|January 6, 2016
Summary
Stigma negatively impacts healthcare access for rural LGBT individuals. Increasing disclosure and reducing stigma can improve primary care utilization for this underserved population.
Area of Science:
- Health Services Research
- Sociology of Health
- Rural Health Disparities
Background:
- Lesbian, gay, bisexual, and transgender (LGBT) populations face significant health disadvantages in the US.
- Stigma and fears related to disclosure are known barriers to healthcare for LGBT individuals, but research has largely focused on urban samples.
- Limited understanding exists regarding the specific impact of stigma on rural LGBT populations' access to care.
Purpose of the Study:
- To examine the relationship between stigma, disclosure, and primary care utilization among rural LGBT individuals.
- To investigate how anticipated, internalized, and enacted stigmas affect healthcare access.
- To understand the role of 'outness' in healthcare seeking behaviors.
Main Methods:
- Online survey recruitment of LGBT individuals residing in rural US areas.
- Data collection on demographics, healthcare access, health status, risk factors, and stigma experiences.
- Analysis of the association between stigma, disclosure levels, and primary care service utilization.
Main Results:
- Higher stigma scores correlated with lower health service utilization among transgender and non-binary individuals.
- Increased disclosure of sexual orientation was linked to greater health service utilization in cisgender men.
- Findings highlight differential impacts of stigma and disclosure based on gender identity and sexual orientation.
Conclusions:
- Stigma significantly influences primary healthcare access for rural LGBT individuals.
- Interventions aimed at reducing healthcare stigma or encouraging patient disclosure are needed.
- These interventions may improve primary and preventive healthcare service utilization for rural LGBT populations.
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