Factors influencing clinical skills for lesbian, gay, bisexual, transgender, and queer individuals’ care among Italian primary, sexual and reproductive, and mental health practitioners

Purpose: This study examined factors associated with Italian healthcare practitioners' clinical skills when working with lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients across primary, sexual and reproductive, and mental health domains. Methods: A cross-sectional sample of 165 practitioners completed measures assessing clinical skills, heteronormative beliefs, and prejudice against sexual and gender diversity, along with sociodemographic and professional variables, between May 2024 and June 2025. Results: Participants (44 assigned male at birth, 121 assigned female at birth; mean age = 39.3 ± 11.4 years; 163 cisgender, 2 nonbinary; 49 identifying as LGBTQ) yielded significant differences across healthcare domains: primary care practitioners reported lower overall clinical skills, more negative attitudes and prejudice than mental health practitioners, as well as the lowest attendance at LGBTQ specific training among groups. Across the whole sample, greater clinical skills were associated with lower heteronormative beliefs and prejudice, attendance at LGBTQ training, and having at least one LGBTQ person among friends or relatives. Conclusions: These findings underscore the need for comprehensive educational interventions aimed at enhancing both knowledge and attitudinal components of LGBTQ clinical skills. Policy efforts should prioritize mandatory, experiential, and context-specific training programs and promote inclusive guidelines to reduce heteronormativity in Italian healthcare. Strengthening practitioners' LGBTQ clinical skills can foster more equitable, compassionate, and accessible health services across all domains of care.