Health care use and discrimination in young LGBTQ adults: sexual vs. gender minority differences
T Schädler, R Erhardt, T Kuhnert, P Krüger, A PfisterAbstract
Background
LGBTQ populations face higher burdens of physical and mental illness and structural barriers to care. Young adults additionally navigate the transition from paediatric to adult care. Guided by Andersen’s model (2014), we examine whether sexual minority (SM) and gender minority (GM) (non-binary and trans people) status predicts general practitioner (GP) visits, psychological service use, and experiences of healthcare discrimination among young LGBTQ adults in Switzerland.
Methods
In this secondary analysis, we used data from 560 LGBTQ young adults aged 18-25 years from the 2021 LGBT Health Survey in Switzerland. Multivariable binary logistic regression examined associations between GP visits, psychological service use, lifetime healthcare discrimination, and predisposing variables, comparing GM (n = 235) to SM (n = 323) as the reference group.
Results
In preliminary regression models, GM status was not associated with GP visits. GM had significantly higher odds of psychological service use compared to SM even after controlling for mental health status and hormone therapy use (OR 2.38, 95% CI [1.25, 4.60], p = .009). Healthcare discrimination experienced by GM was associated with five times higher odds of psychological visits (OR 5.14, 95% CI [2.16, 13.8], p < .001). GM had significantly higher odds of lifetime healthcare discrimination compared to SM in the fully adjusted model (OR 3.21, 95% CI [1.52, 6.85], p = .002).
Conclusions
These preliminary findings indicate that GM represent a particularly vulnerable subgroup within the LGBTQ population, further threatened by rising anti-gender rhetorics. To address these disparities, public health action should prioritize expanding access to gender-affirming care, mandatory LGBTQ competency training for healthcare professionals, and routine monitoring of discrimination experiences in health surveillance systems to safeguard equitable care for GM.