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残疾患者以及性少数群体或性别少数群体在医疗互动过程中的经历。

Experiences of patients with disabilities and sexual or gender minority status during healthcare interactions.

作者信息

Mulcahy Abby, Batza Katie, Goddard Kelsey, McMaughan Darcy Jones Dj, Kurth Noelle K, Streed Carl G, Wallisch Anna Marie, Hall Jean P

机构信息

Center to Improve Veteran Involvement in Care, VA Portland Healthcare System, 3710 SW US Veterans Hospital Rd, Portland, OR 97239, USA.

School of Public Health, Oregon Health & Science University/Portland State University, 1810 SW 5th Ave, Portland, OR 97201, USA.

出版信息

Z Gesundh Wiss. 2023 Dec;2023. doi: 10.1007/s10389-023-02145-3.

Abstract

AIM

The purpose of this study was to examine the lived experiences of lesbian, gay, bisexual, transgender, queer, and other (LGBTQ+) people with disabilities when interacting with healthcare professionals related to their gender identity, sexuality, and disability.

SUBJECT AND METHODS

Historically marginalized groups face many inequities in health care. However, little is known about the intersectional experiences of LGBTQ+ people with disabilities when receiving health care given their likelihood to encounter multiple marginalizations. Data were collected via the 2019 National Survey on Health and Disability (NSHD) and included a sample of 197 LGBTQ+ respondents with disabilities living in the U.S. Quantitative data and demographics were analyzed using descriptive methods. Qualitative data were analyzed using deductive and inductive methods.

RESULTS

72.2% of LGBTQ+ respondents with disabilities avoided discussing their gender or sexual identity with their healthcare providers, with 9.8% never disclosing their identity. Qualitative analyses revealed themes centered around experiences of negative interactions with healthcare providers, including fear, distrust, and avoidance of care (40.1%), dismissal or denial of treatment (30.5%), and assault or aggressive activity (4.1%), although some reported no problems or need to discuss their LGBTQ+ or disability identities (14.7%).

CONCLUSION

LGBTQ+ people with disabilities reported high rates of negative experiences disclosing gender or sexual identity and/or disability with healthcare providers. Further research is needed to determine whether negative interactions with medical providers may be caused by a lack of medical understanding, false assumptions about the de-sexualization of disabled people, or ignorance about LGBTQ+ identities.

摘要

目的

本研究旨在考察女同性恋、男同性恋、双性恋、跨性别者、酷儿及其他(LGBTQ+)残疾人士在与医疗保健专业人员就其性别认同、性取向和残疾状况进行互动时的生活经历。

对象与方法

历史上被边缘化的群体在医疗保健方面面临诸多不平等。然而,鉴于LGBTQ+残疾人士可能遭遇多种边缘化情况,对于他们在接受医疗保健时的交叉经历却知之甚少。数据通过2019年全国健康与残疾调查(NSHD)收集,样本包括197名居住在美国的LGBTQ+残疾受访者。定量数据和人口统计学数据采用描述性方法进行分析。定性数据采用演绎法和归纳法进行分析。

结果

72.2%的LGBTQ+残疾受访者避免与医疗保健提供者讨论其性别或性取向,其中9.8%从未透露过自己的身份。定性分析揭示了围绕与医疗保健提供者负面互动经历的主题,包括恐惧、不信任和回避治疗(40.1%)、拒绝或否认治疗(30.5%)以及攻击或侵犯行为(4.1%),不过也有一些人表示没有问题或无需讨论其LGBTQ+或残疾身份(14.7%)。

结论

LGBTQ+残疾人士报告称,在向医疗保健提供者透露性别或性取向和/或残疾状况时,负面经历的发生率很高。需要进一步研究以确定与医疗提供者的负面互动是否可能是由于缺乏医学理解、对残疾人去性化的错误假设或对LGBTQ+身份的无知所致。

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