Abstract
BackgroundLesbian, gay, bisexual, trans and intersex (LGBTI) people experience significant health inequalities. Located within a European Commission funded pilot project, this paper presents a review of the health inequalities faced by LGBTI people and the barriers health professionals encounter when providing care.MethodsA narrative synthesis of 57 papers including systematic reviews, narrative reviews, meta-analyses and primary research. Literature was searched in Cochrane, Campbell Collaboration, Web of Science, CINAHL, PsychINFO and Medline. The review was undertaken to promote understanding of the causes and range of inequalities, as well as how to reduce inequalities.ResultsLGBTI people are more likely to experience health inequalities due to heteronormativity or heterosexism, minority stress, experiences of victimization and discrimination, compounded by stigma. Inequalities pertaining to LGBTI health(care) vary depending on gender, age, income and disability as well as between LGBTI groupings. Gaps in the literature remain around how these factors intersect to influence health, with further large-scale research needed particularly regarding trans and intersex people.ConclusionHealth inequalities can be addressed via changes in policy, research and in practice through health services that accommodate the needs of LGBTI people. With improved training to address gaps in their knowledge of LGBTI health and healthcare, health professionals should work in collaboration with LGBTI people to address a range of barriers that prevent access to care. Through structural change combined with increased knowledge and understanding, services can potentially become more inclusive and equally accessible to all.
Highlights
International research increasingly demonstrates that lesbian, gay, bisexual, trans and intersex (LGBTI) people are frequently marginalized and experience significant health inequalities.[1,2,3,4,5,6] Reducing health inequalities is a fundamental goal of public health and is regarded by the European Union (EU) as being one of the most important public health challenges facing its Member States.[7,8,9] This emphasis is vital as inequalities impact on both the health outcomes of LGBTI people as well as their experiences of accessing healthcare.[10]
Evidence suggests that LGBTI people are more likely than the general population to report unfavourable experiences of healthcare including poor communication from health professionals and dissatisfaction with treatment and care received.[11,12,13]
Acknowledgement of the need to endorse and exercise the rights of LGBTI people are increasing within the EU where people are broadly protected against discrimination on grounds of sexual orientation, gender identity and sex characteristics
Summary
International research increasingly demonstrates that lesbian, gay, bisexual, trans and intersex (LGBTI) people are frequently marginalized and experience significant health inequalities.[1,2,3,4,5,6] Reducing health inequalities is a fundamental goal of public health and is regarded by the European Union (EU) as being one of the most important public health challenges facing its Member States.[7,8,9] This emphasis is vital as inequalities impact on both the health outcomes of LGBTI people as well as their experiences of accessing healthcare.[10]. Significant obstacles remain to full recognition of LGBTI people’s fundamental rights These rights include legal recognition of gender, non-discrimination in the workplace, freedom of expression and freedom of movement.[16] Despite such advances social exclusion, stigmatization and discrimination experienced by LGBTI people persist in many healthcare settings.[17,18] This is a social justice issue, but growing evidence links these experiences and related minority stress to health inequalities by showing that discriminatory behaviour can impact negatively on both mental health and physical health outcomes.[6,19]. With improved training to address gaps in their knowledge of LGBTI health and healthcare, health professionals should work in collaboration with LGBTI people to address a range of barriers that prevent access to care. Through structural change combined with increased knowledge and understanding, services can potentially become more inclusive and accessible to all
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