Health inequalities of LGBT persons in Switzerland – Results from the first national LGBT health study

Abstract

Abstract Background Internationally, there is evidence that lesbian, gay, bisexual and transgender persons (LGBT persons) have poorer health outcomes than the heterosexual or cisgender population. In addition, LGBT populations face more frequent and unique healthcare access barriers. Barriers to healthcare among LGBT persons in Switzerland remained undocumented until recently, when the Swiss Federal Council mandated a report describing the health and healthcare access of LGBT persons, and related health inequalities. Methods Two data sets were included in analyses: (1) two waves of the representative Swiss Health Survey (SHS 2012, 2017) n = 29,793, ages 16 to 74, including 858 LGB persons, and (2) data from a non-representative national online survey (May to July 2021), including 1,542 LGB cisgender and 522 transgender persons, ages 15 to 81. Data were analyzed using descriptive and inferential statistics (e.g. binary logistic regression), controlling for potential confounding factors (e.g. year of study, age), using the Health Equity Promotion Model as a conceptual framework. Results The most significant areas of health inequalities across the groups of interest were mental health, experienced discrimination and violence, healthcare access barriers, substance use, and sexual health. For example, LGB persons experienced significantly higher rates of depression (16.0% vs. 7.4%; p<.001) and suicide attempts (11.0% vs. 3.3%; p<.001) compared to the heterosexual population. Additionally, LGB persons abstained from seeking medical care significantly more often than heterosexual persons (16.2% vs. 6.9%, respectively) due to a lack of trust in the healthcare system. Conclusions Besides targeted action in the identified (health) areas, a Health in All Policies Approach is needed to improve the lives and health of LGBT people in Switzerland by diminishing stigmatization and discrimination, and by implementing LGBT inclusive and specific protocols in healthcare and other settings.