普遍存在的系统性差异：美国 LGBTQ+ 群体中与医疗相关的煤气灯效应、创伤和不信任。
Pervasive systemic disparities: medical-related gaslighting, trauma, and distrust among LGBTQ+ people in the United States.
作者信息
Nowaskie Dustin Z, Blackwood Dehandra, Garcia Frank
机构信息
Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
Mailman School of Public Health, Columbia University, New York, NY, United States.
出版信息
Front Sociol. 2025 Feb 12;10:1488888. doi: 10.3389/fsoc.2025.1488888. eCollection 2025.
INTRODUCTION
Historically, LGBTQ+ people have and continue to endure discrimination across many contexts, including healthcare. Research and data from nationwide samples in the United States regarding medical-related stigma experienced by LGBTQ+ people are scant.
METHODS
A cross-sectional survey was distributed online to a national sample of United States residents. Participants answered questions about their healthcare, including experiences with medical-related gaslighting, trauma, and trust.
RESULTS
Compared to cisgender and heterosexual people ( = 857), LGBTQ+ people ( = 815) reported significantly higher rates of medical-related gaslighting (46.5% vs. 26.5%, 1.75-2.80) and trauma (18% vs. 8.9%, 1.63-2.66). Likewise, LGBTQ+ people conveyed significantly less trust ( 0.46-0.53) in primary care providers (59.8% vs. 74.1%), medical specialists (56.5% vs. 71.7%), pharmaceutical companies (17% vs. 28%), insurance companies (15.9% vs. 29.3%), and U.S. healthcare systems (17.8% vs. 30.4%).
DISCUSSION
Medical-related gaslighting, trauma, and distrust are pervasive systemic disparities among LGBTQ+ people. Addressing these challenges will require ongoing, lifelong motivation, dedication, and commitment for LGBTQ+ education, advocacy, and leadership to dismantle current prejudiced practices and foster more inclusive, supportive, affirming healthcare environments.
引言
从历史上看， LGBTQ+ 群体过去一直并仍在许多情况下遭受歧视，包括在医疗保健领域。关于美国全国样本中 LGBTQ+ 群体所经历的与医疗相关的耻辱感的研究和数据很少。
方法
对美国居民的全国样本进行了在线横断面调查。参与者回答了关于他们医疗保健的问题，包括与医疗相关的煤气灯效应、创伤和信任方面的经历。
结果
与顺性别和异性恋者（ = 857）相比，LGBTQ+ 群体（ = 815）报告的与医疗相关的煤气灯效应发生率（46.5% 对 26.5%，1.75 - 2.80）和创伤发生率（18% 对 8.9%，1.63 - 2.66）显著更高。同样，LGBTQ+ 群体对初级保健提供者（59.8% 对 74.1%）、医学专家（56.5% 对 71.7%）、制药公司（17% 对 28%）、保险公司（15.9% 对 29.3%）和美国医疗保健系统（17.8% 对 30.4%）的信任度明显更低（0.46 - 0.53）。
讨论
与医疗相关的煤气灯效应、创伤和不信任是 LGBTQ+ 群体中普遍存在的系统性差异。应对这些挑战需要持续一生的动力、奉献精神和对 LGBTQ+ 教育、宣传及领导力的承诺，以消除当前的偏见做法，营造更具包容性、支持性和肯定性的医疗保健环境。
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