Study explores how sexual minority status and mental health relate to experiences of primary care in England

by City St George's, University of London

edited by Gaby Clark, reviewed by Alexander Pol

Gaby Clark

Scientific Editor

Meet our editorial team
Behind our editorial process

Alexander Pol

Deputy Editor

Meet our editorial team
Behind our editorial process Editors' notes

This article has been reviewed according to Science X's editorial process and policies. Editors have highlighted the following attributes while ensuring the content's credibility:

fact-checked

peer-reviewed publication

trusted source

proofread

The GIST Add as preferred source

City St George's researchers have found that sexual minority individuals with long-term mental health conditions report poorer experiences in some areas of primary care, while also revealing patterns that suggest potential buffering effects that could help inform efforts to reduce health care inequalities

People from sexual minority groups with a reported long-term mental health condition experience particular inequalities in some aspects of primary care, including involvement in decisions about their care and health care professionals' interpersonal skills, according to new research from City St George's, University of London.

Published in eClinicalMedicine, the study examined how sexual orientation and reporting a long-term mental health condition relate to patients' experiences of GP services in England.

The researchers analyzed responses from 1.27 million GP patients who took part in the 2022–23 General Practice Patient Survey. The likelihood of reporting a positive experience in NHS primary care ranged from 62.5% to 94.3%, depending on the measure, indicating an overall moderate-to-high level of satisfaction with the services. Nonetheless, satisfaction varied by sexual orientation and mental health status. The researchers found that sexual minority people with a reported long-term mental health condition were significantly less likely than other patients to feel involved in decisions about their care and treatment and more likely to rate health care professionals' interpersonal skills negatively.

At the same time, the study showed an unexpected pattern for other aspects of primary care evaluation, including whether people felt that their mental health needs were recognized, their confidence and trust in health care professionals, and whether they felt their overall needs had been met. For these outcomes, people from sexual minority groups with a long-term mental health condition reported slightly better experiences than would have been expected based on the effects observed among sexual minority participants without long-term mental health conditions or individuals who reported a long-term mental health condition and were part of the heterosexual majority.

The researchers argue that these findings suggest that intersecting stigmatized characteristics are associated not only with the accumulation of disadvantages but also with potential protective or buffering effects. The study also found that sexual minority people with long-term mental health conditions were the most likely to seek information or support before attempting to book a GP appointment.

The researchers suggest this pattern might reflect dissatisfaction with previous health care experiences or could indicate greater mental health awareness and a more proactive approach to seeking help. They conclude that improving inclusivity, communication and patient-centered care in primary care settings could help address persistent inequalities experienced by sexual minority people and those with long-term mental health conditions.

Arthur Gomes-Mendes, a Ph.D. researcher in the Centre for Clinical, Social & Cognitive Neuroscience at City St George's and lead author of the study, said, "Our findings address a critical gap in the literature and suggest that sexual minority orientation and the presence of long-term mental health conditions intersect in complex ways in shaping health care experiences. While both characteristics relate to lower satisfaction, we observed both negative and protective intersectional effects across different care quality outcomes."

Dr. Anne-Kathrin Fett, co-director of the Centre for Clinical, Social & Cognitive Neuroscience at City St George's and co-author of the paper, said, "We expected that people who were members of a sexual minority group and also reported a long-term mental health condition would have more negative primary care experiences than sexual minority people, or heterosexual individuals with or without long-term mental health difficulties. While this was indeed the case with respect to some of the primary care experiences we looked at, we also saw patterns that suggested potential buffering effects. Understanding the mechanisms behind these will be important for reducing inequalities and tailoring primary care services to the needs of different patient groups."

Publication details

Arthur Gomes-Mendes et al, Primary care experiences at the intersection of sexual minority status and long-term mental health conditions in England: a cross-sectional analysis using the English General Practice Patient Survey, eClinicalMedicine (2026). DOI: 10.1016/j.eclinm.2026.104016

Journal information: EClinicalMedicine

Clinical categories

Psychology & Mental healthFamily medicinePsychiatry Provided by City St George's, University of London Who's behind this story?

Gaby Clark

MA in English, copy editor since 2021 with experience in higher education and health content. Dedicated to trustworthy science news. Full profile →

Alexander Pol

PhD nano-engineering from Delft University. Published researcher and journal reviewer. Brings scientific insight to content standards. Full profile →

Citation: Study explores how sexual minority status and mental health relate to experiences of primary care in England (2026, August 12) retrieved 12 August 2026 from https://medicalxpress.com/news/2026-08-explores-sexual-minority-status-mental.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.