Differences in Healthcare Access, Use, and Experiences Within a Community Sample of Racially Diverse Lesbian, Gay, Bisexual, Transgender, and Questioning Emerging Adults
Differences in Healthcare Access, Use, and Experiences Within a Community Sample of Racially Diverse Lesbian, Gay, Bisexual, Transgender, and Questioning Emerging Adults
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DOI：
10.1089/lgbt.2015.0124
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发表时间：
2016-12-01
期刊：
影响因子：
4.8
通讯作者：
Greene, George J.
中科院分区：
文献类型：
--
作者：
Macapagal, Kathryn;Bhatia, Ramona;Greene, George J.
目的：涉及女同性恋、男同性恋、双性恋、跨性别、酷儿和质疑（LGBTQ）个体的卫生服务研究侧重于顺性别、异性恋成年人和LGBTQ成年人在医疗保健获取、使用和体验方面的差异。然而，这些因素在LGBTQ群体中可能有所不同，并且尚未在新兴成年人（18-29岁）中得到很好的研究，这一群体在医疗保健方面存在独特的障碍。我们试图在LGBTQ新生成人样本中描述医疗保健挑战的特征。方法：从2012年到2013年，206名年龄在18-27岁的参与者（86%的种族/少数民族，10%的变性人）完成了一项纵向研究中评估医疗保健获取、使用和经历的问卷调查。描述性统计建立了医疗保健获取、使用和经验的模式，非参数检验检验了与社会人口变量、艾滋病毒状况、性取向认同和性别认同相关的差异。结果：总体而言，68%的参与者报告相对容易获得护理。白人和双性恋参与者报告的保险率分别高于种族/少数民族（P = 0.01）和同性恋参与者（P = 0.005）。虽然大多数参与者没有报告在医疗机构中有与LGBTQ身份相关的负面经历，但与顺性别参与者相比，跨性别参与者更有可能延迟护理（P < 0.001），并报告向其提供者披露的负面影响（P < 0.001）。被认为是酷儿或质疑自己性取向身份的参与者比被认为是lgb的参与者更频繁地报告负面的医疗保健经历（P = 0.001）。结论：尽管LGBTQ初生成人在护理方面遇到的障碍比之前对LGBTQ成人的研究中观察到的要少，但结果表明，与LGB和顺性人群相比，酷儿、质疑和跨性别个体可能面临更多的医疗挑战。
Purpose: Health services research involving lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) individuals has focused on differences in healthcare access, use, and experiences between cisgender, heterosexual adults and LGBTQ adults. Yet these factors may differ within the LGBTQ community and have not been wellstudied among emerging adults (18-29 years), a group with unique barriers to healthcare. We sought to characterize healthcare challenges within a sample of LGBTQ emerging adults.Methods: From 2012 to 2013, 206 participants aged 18-27 (86% racial/ethnic minority, 10% transgender) completed questionnaires assessing healthcare access, use, and experiences during a longitudinal study. Descriptive statistics established patterns of healthcare access, use, and experiences, and nonparametric tests examined differences related to sociodemographic variables, HIV status, sexual orientation identity, and gender identity.Results: Overall, 68% of participants reported relatively easy access to care. White and bisexual participants reported higher rates of insurance than racial/ethnic minority (P = 0.01) and gay or lesbian participants (P = 0.005), respectively. Although most participants did not report having negative experiences in healthcare settings related to their LGBTQ identity, transgender participants were more likely to delay care (P < 0.001) and report negative effects of disclosure to their provider (P < 0.001) compared with cisgender participants. Participants who identified as queer or were questioning their sexual orientation identity reported negative healthcare experiences more frequently than LGB-identified participants (P = 0.001).Conclusions: Although LGBTQ emerging adults experienced fewer barriers to care than observed in previous studies on LGBTQ adults, the results suggest that queer, questioning, and transgender individuals may face additional healthcare challenges compared with their LGB and cisgender counterparts.