Sexual and gender minoritized persons in organ and tissue donation: a qualitative analysis

Sexual and gender minoritized persons (SGMs) experience inequities, harms, and gaps in care in organ and tissue donation and transplantation (OTDT) systems. The experiences of SGMs navigating OTDT have not been published from their own perspectives.

We conducted semistructured interviews, transcribed verbatim, and performed a formal qualitative best-fit framework synthesis and inductive thematic analysis with an SGM OTDT patient and caregiver advisory team (N = 12/13) to characterize their self-described experiences.

Emergent themes included: 1) stigma, discriminatory criteria, and inertia to change; 2) OTDT patient and community relations; 3) benefits, strength, and resilience of the SGM community; and 4) SGM priorities and opportunities for improvement. Each theme and its respective subthemes are presented with representative quotes.

Our novel findings detail the ways that SGMs experience OTDT health care, highlighting the harms of discriminatory donor risk assessment criteria and the need for equitable policy revision. Opportunities to enhance inclusive care include institutional acknowledgement of inequities and transparent communication, target training for health care providers, and intersectional SGM and OTDT caregiver support networks.