Perceptions of Trans and Gender Non-Conforming People on General Health Care in the Being LGBTQI+ in Ireland Study

Aim: To examine if trans and gender non-conforming participants perceive greater healthcare inequities in their interactions with healthcare practitioners than cisgender sexual minority participants, and analyse free text responses from transgender and gender non-conforming participants to gain possible insight into causes of inequities. Design: A cross-sectional study. Methods: An anonymous online survey of over 2800 self-selecting LGBTQI+ participants, 30% of whom identified as trans and gender non-conforming. The research team devised closed and open-ended questions about perceptions of healthcare provision and analysed quantitative responses using SPSS and open-ended data through thematic analysis. Results: Over half of trans and gender non-conforming participants reported having had occasion to educate healthcare professionals about LGBTQI+ identities and a majority reported that healthcare professionals made incorrect assumptions about their LGBTQI+ identity. Invalidation and pathologisation of participants' trans and gender non-conforming identity and unhelpful therapeutic approaches were some of the negative health experiences cited. Conclusion: Trans and gender non-conforming populations experience significant barriers to healthcare relative to their cisgender sexual minority peers. Cisnormative thinking in healthcare practice together with a lack of knowledge of trans and gender non-conforming people's experiences leads to substandard care and acts as a barrier to disclosure and help seeking. Implications: Culturally responsive healthcare is critical to ending health inequities experienced by trans and gender non-conforming people. Impact: Problem addressed: Healthcare inequities among trans and gender non-conforming participants. Main findings: Trans and gender non-conforming participants reported more negative perceptions of their healthcare experiences compared to cisgender sexual minority participants. Where and on whom will the research have an impact? Healthcare educators/practitioners. Reporting Method: Strobe. Public or Patient Contribution: Members of the LGBTQI+ community were part of the research advisory group and inputted into paper authorship. Paper Contribution to the Wider Global Clinical Community: Highlights the need for training to increase cultural competency among healthcare providers.