"We Call Ourselves The Pride Truck": A Phenomenological Approach to Contextualizing LGBTQ+ EMS Professional Life

Despite increasing evidence suggesting a more inclusive health care environment promotes clinician well-being and patient health equity, little is known about the lived experience of lesbian, gay, bisexual, transgender, or queer (LGBTQ+) prehospital emergency medical services (EMS) clinicians. The objective of this study was to explore the relationship between LGBTQ+ identity and the prehospital clinician role.

This qualitative study used an interpretive phenomenological approach to capture the lived experiences of LGBTQ+ prehospital clinicians. Participants were recruited via social media and word-of-mouth. Inclusion criteria were: current role as a prehospital clinician; self-identity as LGBTQ+; residence in the United States (U.S.); and age ≥18 years. We developed a semi-structured interview guide and completed interviews between February and May 2021. Using a reflexive process, inductive coding and thematic analysis were performed.

Eleven prehospital clinicians participated in the study. Of participants, 45% (n = 5) were cisgender males, 27% (n = 3) were cisgender females, and 27% (n = 3) were transgender. A plurality of participants identified as homosexual (45%; n = 5), with the remaining participants identifying as bisexual/pansexual (36%; n = 4) and queer (18%; n = 2). The majority of participants were certified as Emergency Medicine Technician-Basic (55%; n = 6) and resided in the Southern region of the U.S. (55%; n = 6). Three themes emerged from the data. The strategic closet proposes a case-use approach to self-disclosure in which clinicians weigh the benefits and risks of coming out on the job. Clinician-first identity defines the desire of LGBTQ+ prehospital clinicians to be recognized for their skills as prehospital clinicians before any other identity within their professional space. The power of intersectionality informs the necessity to bridge minority identity with first responder identity in the prehospital profession to improve health equity and workspace safety.

Our study examines the lived experiences of LGBTQ+ prehospital clinicians in the workplace. To better serve prehospital patients and clinicians, the tolerance of minority identities, recognition of the informative nature of clinician personal experience, and incorporation of policies and education recognizing cultural and personal differences must be prioritized.