Characterizing Barriers to Engaging in Digestive Health care for Sexual and Gender Minority People in the United...

In a national US-based group, we sought to describe barriers identified by sexual and gender minority (SGM) patients and primary care providers (PCPs) that challenge the provision of SGM-affirming digestive health care by qualitative methodology.

Forty patient participants and 24 PCPs were recruited from a random sample of 18 states within the 9 principal US Census Divisions and 2 states near the home institution. Patient participants selected completed a virtual semi-structured qualitative interview regarding their experiences with digestive health care and their views on barriers to engaging in digestive health care. PCPs were interviewed on treating SGM patients with gastrointestinal (GI) disorders and interactions with GI consultants. Interviews were conducted until thematic saturation was achieved. The study was conducted from November 2023 to August 2024.

Thematic saturation was achieved at 36 patient participants and 21 PCPs. Major themes included SGM discrimination in digestive health care, SGM issues in engaging in digestive health care, GI symptoms and other aspects of health-specific conditions, and ways to improve digestive health care for the SGM community. Participants noted a link between psychological distress in the SGM population and GI symptoms and offered actionable suggestions to improve SGM-focused digestive health care.

Systematic deficiencies were identified in the provision of SGM-affirming digestive care, related to bias within health care systems and a lack of understanding of unique SGM-related needs throughout the United States. Further research studying improved shared clinician and SGM GI patient engagement is needed to address these sources of health inequity.