Factors Associated with Medical Mistrust Among Sexual and Gender Minority Young Adults

Medical mistrust (MM), distrusting medical professionals and systems due to experiences of marginalization, is related to health disparities. Little is known about MM among young cisgender sexual minority women and transgender and non-binary (TNB) young adults. We examined correlates and compared rates of MM among these groups.

Data came from a longitudinal cohort study, collected between 2019 and 2020. Participants completed measures of demographics (age, race/ethnicity, and gender identity), MM, victimization, internalized stigma, social support, resilience, STI testing, gender-affirming hormone use, and self-rated physical health. Bivariate correlational analyses tested the strength of associations between predictor variables and MM. Variables significantly correlated with MM were included in multiple regression models. Moderating effects of gender identity were also tested.

Analyses included 410 participants (M = 22.4, SD = 3.5, 18-33 years, 27% White, 33% TNB). MM was significantly correlated with victimization, resilience, family support, STI testing and self-rated health. In regression analyses, Black and TNB identities, higher victimization, lower family support, and poor self-rated health were significantly associated with higher MM (R ² = .147, F(9, 400) = 8.85, p < 0.001). Additionally, MM decreased as family support increased for cisgender, but not TNB participants (R ² = .152, F(17, 392) = 5.32, p < 0.000). Comparing model fit statistics, the main effects model best described our data.

More distal instead of proximal minority stressors and family support over other types of social support were associated with reduced MM.

Reducing general experiences of victimization, increasing family support, and considering intersectional structural stigma can help address MM among these groups.