Occupational Therapy in LGBTQ + Affirming Primary Care: Referral, Intervention, and Outcomes
Michelle LeRoy, Bridget Farrell, Colton SayersImportance
LGBTQ + clients experience healthcare barriers that may shape daily routines, health management, and participation. Little is known about occupational therapy referral pathways and outcomes in LGBTQ + affirming primary care.
Objective
To describe referral characteristics, occupational performance concerns, intervention focus, and client-reported outcomes among LGBTQ + clients referred to occupational therapy.
Design
Retrospective pilot program evaluation using clinical documentation and outcome data from July 2025 through March 2026, with a June 2026 analysis cutoff.
Setting
Two Midwestern primary care settings where occupational therapy screening and referral processes were developed; ongoing intervention occurred through outpatient occupational therapy.
Participants
Thirty-nine referred clients were included in descriptive analyses; 38 received intervention beyond evaluation; 21 had complete baseline and follow-up Canadian Occupational Performance Measure data.
Intervention
Individualized outpatient occupational therapy focused on client-identified concerns.
Outcomes and Measures
Referral and treatment characteristics, occupational performance concerns, coded occupational focus, and Canadian Occupational Performance Measure Performance and Satisfaction ratings.
Results
Common concerns included instrumental activities of daily living (94.9%), health management/self-management (92.3%), activities of daily living (82.1%), and work or school participation (82.1%). The most common primary intervention focus was health management and chronic condition self-management (65.8%). Among participants with outcome data, COPM Performance scores improved by 2.29 points and Satisfaction scores improved by 2.58 points.
Conclusions and Relevance
Occupational therapy may support LGBTQ + clients referred from primary care by addressing needs related to health management, routines, self-care, and participation through individualized outpatient intervention. Prospective multisite research is needed.