Buckingham Pip, Bourne Adam, McNair Ruth, Hill Adam O, Lyons Anthony, Carman Marina, Amos Natalie
Australian Research Centre in Sex, Health and Society, La Trobe University, <city>Melbourne</city>, <state>Vic.</state>, Australia; and Department of General Practice, School of Public Health and Preventive Medicine, Monash University, <city>Melbourne</city>, <state>Vic.</state>, Australia.
Australian Research Centre in Sex, Health and Society, La Trobe University, <city>Melbourne</city>, <state>Vic.</state>, Australia; and Kirby Institute, UNSW, <city>Sydney</city>, <state>NSW</state>, Australia.
Aust J Prim Health. 2024 Feb;30(1):NULL. doi: 10.1071/PY23001.
Lesbian, bisexual+ and queer (LBQ+) cisgender women have considerable unmet mental health needs. The aims of this study were to examine LBQ+ cisgender women's prior engagement with general practitioners (GPs), and how this relationship shaped their mental health service use.
Data from 2707 cisgender LBQ+ women were drawn from a national survey of adults who are lesbian, gay, bisexual, trans, intersex, queer or questioning, asexual and other diverse sexuality and gender identities (LGBTIQA+) in Australia. Multivariable logistic regression analyses examined demographic predictors of continuity of care with GPs and GPs' awareness of LBQ+ women's sexual orientation. The relationship between these variables and recent mental health service use was then analysed, comparing LBQ+ women's engagement with services known to be LGBTIQA+ inclusive and those without an inclusive reputation.
LBQ+ cisgender women with a regular GP had greater odds of having accessed mental health services in the last 12months. Two-thirds had a regular GP, with the lowest odds among women aged 18-35years and highest odds among women with a disability. LBQ+ women who did not believe their regular GP knew of their sexuality had lower odds of having accessed LGBTIQA+ inclusive mental health services. These individuals were typically aged below 25years, bisexual+ or queer identified, had below undergraduate-level education, earned <$2000 AUD per week, or lived in an outer-suburban or regional area.
GPs may be missing opportunities to promote continuity of care through developing trusting relationships with specific sub-populations of LBQ+ women, which in turn appears to sustain inequitable access to mental health care. To offer appropriate care and referrals for this population, GPs should provide safe and inclusive environments to enable comfortable and supportive discussions about sexual orientation when this is relevant to a person's health care.
女同性恋、双性恋及以上性取向和酷儿（LBQ+）的顺性别女性有大量未得到满足的心理健康需求。本研究的目的是调查LBQ+顺性别女性此前与全科医生（GP）的接触情况，以及这种关系如何影响她们对心理健康服务的使用。
对澳大利亚2707名顺性别LBQ+女性的数据进行分析，这些数据来自一项针对女同性恋、男同性恋、双性恋、跨性别者、双性人、酷儿或疑问性取向者、无性恋者以及其他不同性取向和性别认同（LGBTIQA+）成年人的全国性调查。多变量逻辑回归分析研究了与全科医生持续护理的人口统计学预测因素以及全科医生对LBQ+女性性取向的认知情况。然后分析这些变量与近期心理健康服务使用之间的关系，比较LBQ+女性与已知包容LGBTIQA+群体的服务机构和没有包容声誉的服务机构的接触情况。
有固定全科医生的LBQ+顺性别女性在过去12个月内使用心理健康服务的几率更高。三分之二的人有固定的全科医生，18至35岁的女性几率最低，残疾女性几率最高。不相信其固定全科医生知晓其性取向的LBQ+女性使用包容LGBTIQA+群体的心理健康服务的几率较低。这些人通常年龄在25岁以下，自我认同为双性恋及以上性取向或酷儿，教育程度低于本科，每周收入低于2000澳元，或居住在郊区或偏远地区。
全科医生可能错失了通过与特定亚群体的LBQ+女性建立信任关系来促进持续护理的机会，而这反过来似乎维持了获得心理健康护理的不平等状况。为了为该群体提供适当的护理和转诊服务，全科医生应提供安全和包容的环境，以便在与个人医疗保健相关时能够舒适且支持性地讨论性取向问题。
