Abstract
Introduction
Sexual minority individuals (e.g., lesbian, gay, bisexual people) face sexual health inequalities related to their experiences with providers in sexual health care settings, yet few prior studies have focused on these experiences.
Methods
Thematic content analysis was used to analyze qualitative interviews with a diverse sample of 58 sexual minority individuals from three cohorts in the USA to explore sexual minority people’s perspectives of sexual health care. Subgroup differences in themes across gender, sexual identity, race/ethnicity, and cohort were also assessed.
Results
Our analysis revealed four key themes: erasure, enacted stigma, felt stigma, and affirmative care. Women and genderqueer participants reported erasure in the context of identity dismissal in family planning conversations, and men reported felt stigma in the context of hyperawareness of sexual minority identity. Some sexual minority people of color also reported intersectional felt stigma as a result of multiple marginalized identities. Additionally, fewer men reported erasure compared with women or genderqueer people and fewer gay and lesbian participants reported erasure than bisexual or queer people.
Conclusions
The sexual health care experiences of sexual minority people are characterized by erasure, stigma, and affirmative care, with important differences in erasure and stigma across subpopulations of sexual minority people.
Policy Implications
Implications of these findings include the need for more sexual minority health initiatives and training and the development of affirmative care practices for sexual minority populations, including those with multiple marginalized identities.
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Acknowledgments
The Generations Study is funded by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD grant 1R01HD078526) and through supplemental grants from the National Institutes of Health, Office of Behavioral and Social Sciences Research, and the Office of Research on Women’s Health. The Generations investigators are Ilan H. Meyer, Ph.D., (PI), David M. Frost, Ph.D., Phillip L. Hammack, Ph.D., Marguerita Lightfoot, Ph.D., Stephen T. Russell, Ph.D., and Bianca D.M. Wilson, Ph.D. (co-investigators, listed alphabetically). The authors thank the interviewers and field research workers and recognize the contribution of Heather Cole, Jessica Fish, Janae Hubbard, Evan Krueger, Quinlyn Morrow, Jack Simons, James Thing, and Erin Toolis. This research also was supported by grants, P2CHD042849 and T32HD007081, Population Research Center, awarded to the Population Research Center at The University of Texas at Austin by the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The authors acknowledge support for Russell from the Priscilla Pond Flawn Endowment at the University of Texas at Austin.
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Gessner, M., Bishop, M.D., Martos, A. et al. Sexual Minority People’s Perspectives of Sexual Health Care: Understanding Minority Stress in Sexual Health Settings. Sex Res Soc Policy 17, 607–618 (2020). https://doi.org/10.1007/s13178-019-00418-9
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DOI: https://doi.org/10.1007/s13178-019-00418-9