Project Respect: experiences of seriously ill LGBTQ+ patients and partners with their health care providers

• Published in: Health affairs scholar Vol. 1; no. 4; p. qxad049
• Main Authors: Stein, Gary L, Berkman, Cathy, Acquaviva, Kimberly, Woody, Imani, Godfrey, David, Javier, Noelle Marie, O'Mahony, Sean, González-Rivera, Christian, Maingi, Shail, Candrian, Carey, Rosa, William E
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.10.2023
• Subjects: LBGTQ; LGBTQ; serious illness care; discrimination; access to care; palliative care; LGBT
• ISSN: 2976-5390; 2976-5390
• DOI: 10.1093/haschl/qxad049

Discrimination against lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons in health care creates barriers to serious illness care, including patients avoiding or delaying necessary care, providers disrespecting wishes of surrogates, and adverse outcomes for patients and families. A cross-sectional mixed-methods study using an online survey was used to determine the extent to which LGBTQ+ patients and spouses, partners, and widows experienced disrespectful or inadequate care due to sexual orientation or gender identity. A total of 290 LGBTQ+ patients and partners reported high levels of disrespectful and inadequate care, including 35.2% stating their provider was insensitive to them because of their identity; 30% reporting their provider was unaware of LGBTQ+ health needs; 23.1% feeling judged; 20.7% experiencing rudeness; 20.3% stating providers did not use their correct pronouns; and 19.7% reporting their treatment decisions were disregarded. Black and Hispanic patients were 2-4 times more likely than non-Hispanic White patients to report discrimination. This study demonstrated high levels of disrespectful and inadequate care towards patients and partners due to being LGBTQ+, which was especially problematic for Black and Hispanic patients and those living in politically conservative regions. Recommendations include federal and state civil rights laws to prohibit LGBTQ+ discrimination and institutional practices to address discrimination, including cultural sensitivity training for staff.