Experiences of LGBTIQ+ Population within Healthcare Contexts

Although research on the health of lesbian, gay, bisexual, transgender, intersex (LGBTI+) populations is expanding rapidly, including a focus on social and health policies, research on the experiences of LGBTI+ people within healthcare contexts needs to be deepened and expanded. Indeed, social acceptance of LGBTI+ people has been improving in the last decades, but they continue to face stigma and discrimination (Gallup, 2016; Grant et al., 2011; Scandurra et al., 2017). Stigmatizing experiences, combined with a lack of access to a culturally-affirming health care, result in a disadvantaged social status and health disparities for LGBTI+ population (Fredriksen-Goldsen et al., 2014; Reisner et al., 2014). To this end, many LGBTI+ people still avoid healthcare contexts for fear of discrimination from healthcare providers or because they feel the lack of healthcare professional knowledge and negative views of LGBTI+ individuals (Krehely, 2009). For instance, approximately 30% of LGBTI+ adults do not have access healthcare services or lack a regular healthcare provider (Winter, 2012). Furthermore, LGBTI+ people are more likely to avoid healthcare contexts compared to heterosexual counterparts, delaying proper treatments and, thus, resulting in negative health outcomes (Shields et al., 2012). Despite subjective experiences of LGBTI+ people within healthcare contexts, structural barriers (e.g., binary male/female medical record identification system, financial barriers, lack of equality signs and gender-neutral language, etc.) significantly contribute to the delay or avoidance of seeking healthcare (Roberts & Fantz, 2014). Indeed, the structural/institutional stigma is embedded within some health organizations due to the existence of laws and regulations that not guarantee full equality for LGBTI+ populations. On the other hand, many healthcare providers still have little knowledge about the specific health needs of this population (Roberts & Fantz, 2014), resulting in non-affirmative and competent provision of care. Thus, a more accurate understanding of the quality of care received and perceived by LGBTI+ population represents a fundamental social issue and a central focus for reducing health inequalities. It means that it is an urgent to provide affirmative and inclusive healthcare services for LGBTI+ people. The current thematic issue of the puntOorg International Journal intended to answer this need focusing on the experiences of LGBTI+ people within healthcare contexts. To this end, we were able to collect scientific contributions from multidisciplinary viewpoints. Specifically, the contribution by Annalisa Anzani (University of Milano Bicocca) reviews recent literature on microaggressions toward transgender and gender nonconforming (TGNC) individuals. The critical review offered by Annalisa Anzani is particularly focused on the emotional, cognitive, and behavioral reactions to microaggressions, as well as on the detrimental effects that microaggressions towards TGNC people have on their health and wellbeing. The work ends with some reflections on the affirmative psychological practice with TGNC individuals. The contribution by Emanuele Maria Merlo, Fabio Frosinone, and Salvatore Settineri (University of Messina) addresses again TGNC experiences within healthcare contexts, but from a different point of view. Indeed, the authors address their psychological-clinical experiences with transgender people who have access to the gender identity clinic of the University Hospital G. Martino in Messina, paying specific attention to the “clinical contact” from a theoretical perspective which embraces both the phenomenology and the life-course framework. The paper by Andrea Pennasilico and Anna Lisa Amodeo (University of Naples Federico II), instead, reviews critically recent literature on bisexual health. In particular, authors presents a critical review on 3 main areas: (1) stigma towards bisexual population; (2) health of bisexual people and its interface with stigma; and (3) experiences of bisexual people within healthcare contexts. The article by Joshua Minh Quach (New York University) explores qualitatively the lived-experiences of 20 men who have sex with men (MSM), divided in two age-cohorts (18-49 and 50+ ages). Specifically, the author provides an interesting comparison between these cohorts concerning their patient-provider relationships and assessing differences and similarities in healthcare experiences with regard to social trauma, medical trauma, and their proximity to the 1980s AIDS crisis. Finally, the contribution by Davide Bizjak (University of Naples Federico II), from an organizational perspective, addresses inclusive organizational practices for TGNC people, proposing a model centered on the relationship between transition stages and work status. This model may be applied to healthcare contexts, if interpreted as complex organizations. The editors hope this collection of scientific papers will expand the topic on the healthcare experiences of LGBTI+ individuals, drawing the attention of both scholars and policymakers. Indeed, this thematic issue highlights the need of promoting a culturally-affirming health care for LGBTI+ people, removing both individual and structural barriers which produce health disparities and drastically increase the psycho-social risk of developing negative health outcomes.