Contraception, Abortion and More: Understanding Health Disparities for LBGTQ Patients in their Own Words [10G

Abstract

INTRODUCTION: Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) women experience numerous obstacles to accessing equitable reproductive healthcare. These barriers lead to known disparities in health outcomes between LGBTQ women and their straight counterparts. Despite these disparities, few published research studies specifically explore the health experiences of LGBTQ women in regards to contraception, abortion and obstetric care. This qualitative, grounded theory study seeks to address that gap. METHODS: Purposive sampling was used to recruit English speaking, LGBTQ individuals aged 18- to 45-year-old living in Kentucky. Participants (n = 10) were recruited and in-depth audio recorded interviews were performed. The transcriptions were then uploaded to Atlas.ti and analyzed using the Constant Comparative Method to identify relevant themes. RESULTS: Six themes were identified, including: identifying LGBTQ friendly practices, establishing trust and rapport, covert and overt provider bias, provider ignorance of LGBTQ health-specific issues, patient education and counseling, and additional barriers for transgender patients. These themes were sorted into a conceptual paradigm that represents three phases of the health care experience relating to care within the scope of Ob/Gyn: Pre-visit inquiry, direct provider interaction, and post-provider effects. CONCLUSION: Participants identified numerous barriers for LGBTQ patients seeking care within an Ob/Gyn practice. These barriers included a uniform difficulty with identifying receptive and adequately trained providers, perceived covert and overt bias, as well as difficulty establishing trust and rapport. Finally, while all LGBTQ women experienced some aspect of bias, the difficulties faced by transgender patients in accessing reproductive health care were notably more challenging.