Abstract
An estimated 24.4 million (7.2%) U.S. adults identify as lesbian, gay, bisexual, or transgender (LGBT+) and 989,000 adult residents in Florida identify as LGBT+. The literature reports that LGBT+ individuals are at increased risk for worse mental and physical health compared to cisgender-heterosexual people.
A concept analysis of LGBT+ inclusive health care was completed prior to the start of the study. Walker and Avant’s approach for concept analysis development was used. Three antecedents were identified: 1) cultural competence of healthcare providers, 2) healthcare environments, and 3) client’s lived experiences. Three defining attributes were identified: 1) normalizing sexual orientation and gender identity, 2) sexual orientation and gender identity-affirming environment, and 3) client-health care provider relationship. Consequences include: 1) client experience, 2) health outcomes, and 3) health care-seeking behaviors of LGBT+ individuals.
A qualitative descriptive research design was used to describe the perceptions and expectations about health care from the perspective of LGBT+ adults in South Florida and describe the salient factors of LGBT+ inclusive health care. Data were collected through 19 individual interviews. The following themes emerged: 1) barriers to accessing health care, 2) health care experiences, and 3) ideal LGBT+ inclusive health care. Participants also verbalized the challenges of increasing anti-LGBT policies in the U.S. Participants feel attacked by the government and believe that LGBT+ discrimination will worsen and negatively impact the healthcare-seeking behaviors of LGBT+ individuals. Participants also feel unsafe in Florida and want to move to more LGBT+ friendly states.
Establishing policies that promote LGBT+ inclusivity, understanding sources of discrimination and stigma, improving LGBT+ representation in healthcare, and acknowledging LGBT+ clients’ sexual orientation and gender identity are methods that may help establish LGBT+ inclusive health care to support the LGBT+ community and reduce health disparities.