Discriminatory health care reported by seriously ill lgbtq+ persons and partners : Project respect

Article

BERKMAN, Cathy | STEIN, Gary L. | ROSA, William E. | ACQUAVIVA, Kimberly D. | GODFREY, David | WOODY, Imani | MAINGI, Shail | GONZÁLEZ-RIVERA, Christian | CANDRIAN, Carey | O'MAHONY, Sean | JAVIER, Noelle Marie

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.

http://dx.doi.org/10.1017/S1478951524001913

Voir la revue «Palliative & Supportive Care, 23»

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