TY - JOUR
T1 - Discriminatory health care reported by seriously ill LGBTQ+ persons and partners
T2 - Project Respect
AU - Berkman, Cathy
AU - Stein, Gary L.
AU - Rosa, William E.
AU - Acquaviva, Kimberly D.
AU - Godfrey, David
AU - Woody, Imani
AU - Maingi, Shail
AU - González-Rivera, Christian
AU - Candrian, Carey
AU - O’Mahony, Sean
AU - Javier, Noelle Marie
N1 - Publisher Copyright:
© The Author(s), 2025.
PY - 2025/4/25
Y1 - 2025/4/25
N2 - Objectives. Recent increases in homophobic and transphobic harassment, hate crimes, anti-lesbian, gay, bisexual, transgender, gender nonconforming, and queer (LGBTQ+) legislation, and discrimination in healthcare toward LGBTQ+ persons require urgent attention. This study describes seriously ill LGBTQ+ patients’ and partners’ experiences of discriminatory care delivered by healthcare providers. Methods. Qualitative data from a mixed-methods study using an online survey were analyzed using a grounded theory approach. Seriously ill LGBTQ+ persons, their spouses/partners and widows were recruited from a wide range of organizations serving the LGBTQ+ community. Respondents were asked to describe instances where they felt they received poor care from a healthcare provider because they were LGBTQ+. Results. Six main themes emerged: (1) disrespectful care; (2) inadequate care; (3) abusive care; (4) discriminatory care toward persons who identify as transgender; (5) discriminatory behaviors toward partners; and (6) intersectional discrimination. The findings provide evidence that some LGBTQ+ patients receive poor care at a vulnerable time in their lives. Transgender patients experience unique forms of discrimination that disregard or belittle their identity. Significance of Results. Professional associations, accrediting bodies, and healthcare organizations should set standards for nondiscriminatory, respectful, competent, safe and affirming care for LGBTQ+ patients. Healthcare organizations should implement mechanisms for identifying problems and ensuring nondiscrimination in services and employment; safety for patients and staff; strategies for outreach and marketing to the LGBTQ+ community, and ongoing staff training to ensure high quality care for LGBTQ+ patients, partners, families, and friends. Policy actions are needed to combat discrimination and disparities in healthcare, including passage of the Equality Act by Congress.
AB - Objectives. Recent increases in homophobic and transphobic harassment, hate crimes, anti-lesbian, gay, bisexual, transgender, gender nonconforming, and queer (LGBTQ+) legislation, and discrimination in healthcare toward LGBTQ+ persons require urgent attention. This study describes seriously ill LGBTQ+ patients’ and partners’ experiences of discriminatory care delivered by healthcare providers. Methods. Qualitative data from a mixed-methods study using an online survey were analyzed using a grounded theory approach. Seriously ill LGBTQ+ persons, their spouses/partners and widows were recruited from a wide range of organizations serving the LGBTQ+ community. Respondents were asked to describe instances where they felt they received poor care from a healthcare provider because they were LGBTQ+. Results. Six main themes emerged: (1) disrespectful care; (2) inadequate care; (3) abusive care; (4) discriminatory care toward persons who identify as transgender; (5) discriminatory behaviors toward partners; and (6) intersectional discrimination. The findings provide evidence that some LGBTQ+ patients receive poor care at a vulnerable time in their lives. Transgender patients experience unique forms of discrimination that disregard or belittle their identity. Significance of Results. Professional associations, accrediting bodies, and healthcare organizations should set standards for nondiscriminatory, respectful, competent, safe and affirming care for LGBTQ+ patients. Healthcare organizations should implement mechanisms for identifying problems and ensuring nondiscrimination in services and employment; safety for patients and staff; strategies for outreach and marketing to the LGBTQ+ community, and ongoing staff training to ensure high quality care for LGBTQ+ patients, partners, families, and friends. Policy actions are needed to combat discrimination and disparities in healthcare, including passage of the Equality Act by Congress.
KW - discrimination
KW - LBGTQ+
KW - palliative care
KW - serious illness care
KW - transgender
UR - http://www.scopus.com/inward/record.url?scp=105003659936&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=105003659936&partnerID=8YFLogxK
U2 - 10.1017/S1478951524001913
DO - 10.1017/S1478951524001913
M3 - Article
C2 - 40275808
AN - SCOPUS:105003659936
SN - 1478-9515
VL - 23
JO - Palliative and Supportive Care
JF - Palliative and Supportive Care
M1 - e101
ER -