Perceiving greater discrimination in health care, the LGBTQIA+ community delays seeking medical appointments
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People in the LGBTQ+ community face extra barriers in their daily lives due to their sexual orientation or gender identity. One of the areas where these individuals sometimes suffer discrimination is in health care. In fact, a survey by the State Federation of Lesbians, Gays, Trans, Bisexual, and Intersex People found that more than 20% of the trans people surveyed had felt discriminated against when visiting primary care providers.
In this context, researchers Andrea Miranda and Judith Velasco, along with their colleague Francisco Javier Sanmartín, with the Department of Psychology at the University of Córdoba (UCO), sought to conduct research on young LGBTQ+ individuals' perception of discrimination by exploring several questions: Do these individuals feel more discriminated against than cisgender individuals? Does this affect their trust in health care providers and cause them to attend appointments less often?
"We conducted a study combining both quantitative and qualitative approaches," explained researcher Sanmartín. "The quantitative data, gathered through closed-ended questionnaires, showed us that gay, bisexual, lesbian and trans individuals reported higher rates of perceived discrimination than cisgender individuals, although the latter also felt discriminated against," continued researcher Velasco. Specifically, 217 people between the ages of 18 and 40 took part in the study.
The paper is published in the journal Archives of Sexual Behavior.
It was in-depth qualitative interviews with 23 of these individuals that brought the issue to light: While cisgender people felt discriminated against because their explanations were overlooked or because of the clash between medical authority and their personal experiences, members of the LGBTQIA+ community perceived higher levels of discrimination, which they linked directly to their sexual orientation or gender identity.
The main discriminatory experiences suffered by these individuals included the use of "deadnames" for trans people (the ones they had before transitioning), the incorrect use of pronouns despite an explicit request to use the appropriate ones, and the application of biases related to promiscuity, paternalism or moral judgments toward gay, lesbian and bisexual people.
"Perceived discrimination was associated with greater psychological distress and lower trust in health care professionals," Velasco noted. Thus, this perceived discrimination led these individuals from the community to seek medical consultations less often and also to resort to strategies such as concealing their sexual orientation or gender identity.
This concealment can lead to misdiagnoses or less effective treatments, but people also associated the visibility of these issues during consultations with prejudices, biases and the linking of pathologies to their identity or orientation without exploring other issues. Thus, the study demonstrates that delays in seeking medical care among LGBTQ+ individuals can lead to worse prognoses for their illnesses, whether physical or psychological.
For the research team, this study highlights a lack of training, as "medical staff do not act with ill intent; rather, there is a lack of training and of updated protocols that promote sensitivity toward these individuals and ensure that they receive individualized care," concluded Sanmartín. According to the team, this training should begin in the university setting, with content that cuts across all subjects, with a view to improving health care later at the doctor's office.
Publication details
Andrea Miranda-Tena et al., Perceived Healthcare Discrimination and Its Impact on Mistrust and Delayed Care Among Sexual and Gender Minority Young Adults in Spain, Archives of Sexual Behavior (2026). DOI: 10.1007/s10508-026-03516-z
Journal information: Archives of Sexual Behavior
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Psychology & Mental healthFamily medicineCommon illnesses & Prevention Provided by University of Córdoba Who's behind this story?
Gaby Clark
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