Differences in Health Care Access, Utilization, and Experiences Among LGBTQ+ Subgroups in the Southern United States
Natalie R Holt1, Elizabeth D Eldridge-Smith, James A Griffin
1Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, Georgia (Drs Holt, Stepleman, Drescher, and Casanova); and Department of Medicine, National Jewish Health, Denver, Colorado (Dr Eldridge-Smith); Center for LGBTQ Health Equity, Chase Brexton Health Care, Baltimore, Maryland (Dr Griffin). Dr Holt is now at VA Tennessee Valley Healthcare System, Nashville, Tennessee.
Abstract:
Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) individuals experience health inequities and barriers to accessing appropriate, affirming care. Little is known about differing health care experiences within the LGBTQ+ population, particularly among individuals living in underserved areas. This study explored health care experiences and utilization among LGBTQ+ subgroups: lesbian and gay cisgender individuals (n = 258), bisexual+ cisgender individuals (n = 71), and transgender and gender-diverse individuals (n = 80). Participants were recruited from a geographic region in South Carolina and Georgia and completed an online survey regarding negative health care experiences, barriers to care, and utilization of different health care venues and services. Results revealed significant differences between LGBTQ+ subgroups, with transgender and gender-diverse participants reporting more discriminatory experiences and greater barriers to care. Bisexual+ cisgender individuals also experienced some disparities compared with lesbian and gay cisgender individuals. Most participants endorsed a need for more competent providers. Findings and recommendations are considered within the context of the Southeastern United States for addressing access and utilization disparities among LGBTQ+ communities.
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