The study is part of the research project A Safer Future, which focuses on health and well-being among migrants who identify as LGBTQ+. It provides valuable insights into how healthcare needs to become more accessible and tailored to their needs.
The study is titled "Sexual and gender minority migrants’ experiences of health service access and utilization: a qualitative meta-synthesis." It has compiled research from various countries, exploring how migrants experience contact with health services. A total of 21 studies were analyzed, including 486 study participants from 72 different countries.
Barriers to Accessing Healthcare
The results show that LGBTQ+ migrants often encounter multiple obstacles when seeking healthcare. Various environmental and situational barriers affected their ability to access care. Financial constraints, lack of insurance, long waiting times, and language difficulties had a negative impact on the possibility of accessing health services. The ability to seek healthcare was also influenced by internal processes within them. This included fear of being reported to authorities and, as a result, risking deportation. Fear of discrimination in interactions with health professionals and concerns about confidentiality being breached also led to ambivalence about seeking care.
Migrants who identify as LGBTQ+ experience exclusion from necessary healthcare due to structural barriers but also because of personal fears and past negative experiences. Ensuring accessible and inclusive healthcare is essential, but this requires a deep understanding of these complex challenges. Our study shows that barriers to healthcare exist in many different countries. Research is needed to better understand how these barriers can be reduced, says Tommy Carlsson, Associate Professor and Project Leader.
Layered Discrimination in Healthcare Encounters
The results highlight the varying experiences within healthcare encounters. While several studies acknowledged the importance and appreciation of affirming support, there were also negative experiences from interacting healthcare. In such cases, interactions with health services became burdensome for this population. Discrimination based on racism, homophobia, and transphobia severely impacted health and well-being. Beyond overt discrimination and judgmental attitudes, the studies also described experiences of more subtle forms of mistreatment, such as microaggressions.
Healthcare visits can become stressful experiences when medical staff display non-affirming attitudes and a lack of understanding. Unfortunately, we saw that discrimination occurred in various settings. What is clear is that policymakers, researchers, and clinical practitioners must take these findings seriously, says Maria Gottvall, Associate Professor and one of the researchers behind the study.
The Importance of Affirming Care
The findings emphasize the need for affirming care, where everyone seeking healthcare feels safe sharing their identity, concerns, and needs. Participants highly appreciated when health services were accessible and affirming. Health services improved mental health conditions such as post-traumatic stress, anxiety, and sleep difficulties. Compassionate and knowledgeable healthcare professionals played a crucial role in building trust and enhancing the experience. Feeling seen and welcomed was central to the participants.
A warm and open approach can really make a significant difference when seeking care. The very essence of healthcare is to accommodate the unique needs and situation of each patient. What we see in the results of this study is that, while much is good, there is still room for improvement when it comes to health services. Everything hinges on patients feeling safe and having trust in healthcare as an institution as well as in individual health professionals, says Tommy Carlsson.
This study is part of the A Safer Future. The project focuses on health and well-being among people who identify as LGBTQ+, which is an abbreviation for lesbian, gay, bisexual, transgender, and other queer identities or gender expressions.
The publication is authored by Maria Gottvall, Osszián Péter-Szabó, Rummage Isaac, Christoffer Aaav, Erik Norgren, and Tommy Carlsson. It has been published in the Journal of Clinical Nursing.
