Wegner Lindsay J, Sarno Elissa L, Whitton Sarah W
Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA.
LGBT Health. 2025 Apr;12(3):176-182. doi: 10.1089/lgbt.2023.0443. Epub 2024 Aug 16.
The present study investigated associations of sexual orientation and/or gender identity-based medical mistrust and racial/ethnic-based medical mistrust, respectively, with unmet medical care need among lesbian, gay, bisexual, transgender, queer, and/or sexually or gender diverse (LGBTQ+) people of color (POC) assigned female at birth (AFAB). We also tested the interaction of the two types of medical mistrust on unmet medical care need. Participants were 266 LGBTQ+ POC AFAB. Participants completed measures of medical mistrust based on race/ethnicity and LGBTQ+ identity. Unmet medical care need was assessed using the item: "During the past 12 months, was there ever a time where you felt that you needed health care but you didn't receive it?" Multivariate logistic regression models were run with either type of medical mistrust, as well as their interaction, as the predictor and unmet medical care need as the outcome variable. There were no significant main effects of either type of medical mistrust on unmet medical care need. However, there was an interaction between the two types of medical mistrust, such that associations between each type of medical mistrust and unmet medical care needs were stronger at higher levels of the other type of medical mistrust. Racial/ethnic medical mistrust was associated with a greater likelihood of unmet medical needs at high, but not low, levels of LGBTQ+ medical mistrust. Racial/ethnic medical mistrust and LGBTQ+ medical mistrust exacerbate each other's influence on unmet medical care need. These results underscore the need for inclusive clinical practices for LGBTQ+ POC.
本研究分别调查了基于性取向和/或性别认同的医疗不信任以及基于种族/族裔的医疗不信任与出生时被指定为女性的有色人种女同性恋、男同性恋、双性恋、跨性别、酷儿和/或性取向或性别多样化（LGBTQ+）人群未满足的医疗需求之间的关联。我们还测试了这两种医疗不信任对未满足的医疗需求的交互作用。参与者为266名出生时被指定为女性的LGBTQ+有色人种。参与者完成了基于种族/族裔和LGBTQ+身份的医疗不信任测量。使用以下项目评估未满足的医疗需求：“在过去12个月中，是否有过您觉得自己需要医疗保健但未得到的情况？”以任何一种医疗不信任类型及其交互作用作为预测因素，未满足的医疗需求作为结果变量，运行多变量逻辑回归模型。两种医疗不信任类型对未满足的医疗需求均无显著主效应。然而，两种医疗不信任类型之间存在交互作用，即每种医疗不信任类型与未满足的医疗需求之间的关联在另一种医疗不信任类型水平较高时更强。在LGBTQ+医疗不信任程度高而非低的情况下，种族/族裔医疗不信任与未满足医疗需求的可能性更大相关。种族/族裔医疗不信任和LGBTQ+医疗不信任会加剧彼此对未满足医疗需求的影响。这些结果强调了为LGBTQ+有色人种提供包容性临床实践的必要性。
