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Healthcare
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Health and Wellbeing in LGBT Populations
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Health and Wellbeing in LGBT Populations

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Environmental Factors and Global Health".

Deadline for manuscript submissions: closed (30 November 2021) | Viewed by 38259

Special Issue Editors

Prof. Dr. Catherine Meads

E-Mail Website
Guest Editor
Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge CB1 1PT, UK
Interests: sexual orientation and health; gender identity and health; leading and managing systematic reviews and health technology assessments; systematic reviews in complex interventions, diagnostics, prognosis, causality and health service delivery; health technology assessments incorporating a variety of systematic reviews with economic evaluations
Special Issues, Collections and Topics in MDPI journals
Prof. Jeffrey Grierson

E-Mail Website
Guest Editor
Anglia Ruskin University, United Kingdom
Interests: HIV/AIDS, particularly the lived experience of PLHIV; the relationship between PHLIV and clinicians and the wellbeing of PLHIV communities; sexuality and the dynamics of sexual communities; LGBT communities in developing countries; sexual health promotion; social drug use and drug-using communities; social network analysis

Special Issue Information

Dear Colleagues,

We are organising a Special Issue on LGBT health and wellbeing in the MDPI journal Healthcare (impact factor 1.916 (2019)). This is an open-access, peer-reviewed scientific journal that publishes original theoretical and empirical work in the interdisciplinary area of all aspects of medicine and healthcare research. For detailed information on the journal, we refer you to https://www.mdpi.com/journal/healthcare.

Improving health, wellbeing, and healthcare experiences for sexual and gender minority people around the world is an important objective. By sexual and gender minority people we include lesbian, gay, bisexual, asexual, MSM, WSW, MSWM, WSMW, trans, non-binary, intersex, queer or other non-heterosexual and/or non-cisgender people of all ages and ethnicities. People from these groups can often suffer multiple disadvantages due to intersectional issues. Improving health and wellbeing is an important objective for all who aspire to reducing health inequities (inequalities that are considered preventable). It is important to understand the various factors that contribute to sexual and gender minority peoples’ mental and physical health and wellbeing, and the mediators and moderators of these relationships. This Special Issue welcomes original contributions of relevance to this area of research. We are particularly interested in areas where little previous research has been published. We will consider primary qualitative or quantitative research, secondary data analyses and systematic reviews. The listed keywords suggest some of the many other possibilities.

Prof. Catherine Meads
Prof. Jeffrey Grierson
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sexual orientation
  • gender identity
  • LGBT
  • intersectionality issues
  • wellbeing
  • physical health
  • mental health
  • trauma, grief and loss
  • behaviours and risks
  • social determinants
  • communities
  • health behaviour and health seeking
  • quality of life
  • resilience
  • empowerment
  • social justice
  • self-efficacy
  • lived experience
  • holistic approaches
  • health knowledge, attitudes, practice
  • health literacy
  • human and civil rights
  • health improvement
  • social inclusion and sense of community
  • social participation
  • community participation
  • mediators and moderators of health and wellbeing
  • education of health and social care professionals

Published Papers (7 papers)

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Research

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16 pages, 529 KiB  
Article
Care of Transgender Patients: A General Practice Quality Improvement Approach
by Isabel Boyd, Thomas Hackett and Susan Bewley
Healthcare 2022, 10(1), 121; https://doi.org/10.3390/healthcare10010121 - 7 Jan 2022
Cited by 30 | Viewed by 16558
Abstract
Primary care must ensure high quality lifelong care is offered to trans and gender minority patients who are known to have poor health and adverse healthcare experiences. This quality improvement project aimed to interrogate and audit the data of trans and gender minority [...] Read more.
Primary care must ensure high quality lifelong care is offered to trans and gender minority patients who are known to have poor health and adverse healthcare experiences. This quality improvement project aimed to interrogate and audit the data of trans and gender minority patients in one primary care population in England. A new data collection instrument was created examining pathways of care, assessments and interventions undertaken, monitoring, and complications. General practitioners identified a sample from the patient population and then performed an audit to examine against an established standard of care. No appropriate primary care audit standard was found. There was inconsistency between multiple UK gender identity clinics’ (GIC) individual recommended schedules of care and between specialty guidelines. Using an international, secondary care, evidence-informed guideline, it appeared that up to two-thirds of patients did not receive all recommended monitoring standards, largely due to inconsistencies between GIC and international guidance. It is imperative that an evidence-based primary care guideline is devised alongside measurable standards. Given the findings of long waits, high rates of medical complexity, and some undesired treatment outcomes (including a fifth of patients stopping hormones of whom more than half cited regret or detransition experiences), this small but population-based quality improvement approach should be replicated and expanded upon at scale. Full article
(This article belongs to the Special Issue Health and Wellbeing in LGBT Populations)
9 pages, 213 KiB  
Article
Why Are the Proportions of In-Vitro Fertilisation Interventions for Same Sex Female Couples Increasing?
by Catherine Meads, Laura-Rose Thorogood, Katy Lindemann and Susan Bewley
Healthcare 2021, 9(12), 1657; https://doi.org/10.3390/healthcare9121657 - 30 Nov 2021
Viewed by 4218
Abstract
Same-sex female couples who wish to become pregnant can choose donor insemination or in-vitro fertilization (IVF)—a technique intended for infertile women. In general, women in same-sex female partnerships are no more likely to be infertile than those in opposite sex partnerships. This article [...] Read more.
Same-sex female couples who wish to become pregnant can choose donor insemination or in-vitro fertilization (IVF)—a technique intended for infertile women. In general, women in same-sex female partnerships are no more likely to be infertile than those in opposite sex partnerships. This article investigates data available from the Government Regulator of UK fertility clinics—the Human Fertilization and Embryology Authority, which is the only data available worldwide on same-sex female couples and their fertility choices. IVF is increasing both in absolute numbers and relative proportions year on year in the UK, compared to licensed donor insemination for same-sex female couples. As IVF has greater human and financial costs than donor insemination, policies should not encourage it as the first choice for fertile women requiring sperm. Commercial transactions are taking place where fertile lesbians receive cut price, and arguably unnecessary, IVF intervention in exchange for selling their eggs to be used for other infertile customers. If women are not told about the efficacy of fresh vs. frozen semen, and the risks of egg ‘sharing’ or intra-couple donation, exploitation becomes possible. Full article
(This article belongs to the Special Issue Health and Wellbeing in LGBT Populations)
14 pages, 818 KiB  
Article
Out of the Closet, Not Yet Out of the House: Gay Men’s Experiences of Homonegativity and Internalized Homonegativity
by Jack Thepsourinthone, Tinashe Dune, Pranee Liamputtong and Amit Arora
Healthcare 2021, 9(11), 1479; https://doi.org/10.3390/healthcare9111479 - 30 Oct 2021
Cited by 3 | Viewed by 3413
Abstract
This paper explores how Australian gay men experience gender and sexuality in relation to heteronormative gender norms, specifically masculinity. A sample of 32 gay men 22–72 years of age participated in an online interview, using a videoconferencing software, on masculinity and homosexuality. Thematic [...] Read more.
This paper explores how Australian gay men experience gender and sexuality in relation to heteronormative gender norms, specifically masculinity. A sample of 32 gay men 22–72 years of age participated in an online interview, using a videoconferencing software, on masculinity and homosexuality. Thematic analyses revealed that gay men experience gender and sexuality-related strain across all levels of their socioecological environment through social regulation, homophobic discrimination/harassment, and anti-effeminacy prejudice. The gay men expressed feelings of self-loathing, shame, internalized homonegativity, and isolation as a result. In examining interactions at each level of the socioecological environment, future research and practice may gain understanding in the social phenomena and how to ameliorate such strain. Full article
(This article belongs to the Special Issue Health and Wellbeing in LGBT Populations)
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10 pages, 225 KiB  
Article
Sexual Orientation and the Incidence of COVID-19: Evidence from Understanding Society in the UK Longitudinal Household Study
by Cara L. Booker and Catherine Meads
Healthcare 2021, 9(8), 937; https://doi.org/10.3390/healthcare9080937 - 26 Jul 2021
Cited by 4 | Viewed by 2033
Abstract
COVID-19 infection rates and severity are worse in marginalised groups, although, for sexual and gender minorities, there are no data on infections, hospitalisations or deaths, but there may be worse rates. This study uses information from Understanding Society: The UK Household Longitudinal Study [...] Read more.
COVID-19 infection rates and severity are worse in marginalised groups, although, for sexual and gender minorities, there are no data on infections, hospitalisations or deaths, but there may be worse rates. This study uses information from Understanding Society: The UK Household Longitudinal Study (UKHLS) to derive COVID-19 symptoms and positive tests by sexual orientation. Data came from all seven UKHLS COVID-19 survey waves in 2020 and 2021, and sexual orientation in main UKHLS waves 3 and 9. Numbers ranged from 17,800 to 12,000. Covariates in the regression models were gender, age, highest educational qualification, ethnicity, diagnosed medical condition, and key worker status. Compared to heterosexual individuals, more sexual minorities experienced symptoms, and bisexual individuals reported a greater number of symptoms. Gays and lesbians were no more or less likely to have been tested, but a larger proportion of bisexual individuals were tested. Regression models showed that differences mostly disappeared when other characteristics were considered. A small sample size means that principal questions remain, so health inequalities have been largely unnoticed and therefore not addressed. Suitable action should be taken to minimise their future risks. Why sexual and gender minorities have been omitted needs to be explored, and action needs to be taken to ensure this does not happen again. Full article
(This article belongs to the Special Issue Health and Wellbeing in LGBT Populations)
14 pages, 238 KiB  
Article
A Mixed Methods Study Describing the Quality of Healthcare Received by Transgender and Gender Nonconforming Patients at a Large Integrated Health System
by Suma Vupputuri, Stacie L. Daugherty, Kalvin Yu, Alphonse J. Derus, Laura E. Vasquez, Ayanna Wells, Christine Truong and E. W. Emanuel
Healthcare 2021, 9(5), 530; https://doi.org/10.3390/healthcare9050530 - 2 May 2021
Cited by 7 | Viewed by 2296
Abstract
Transgender and gender nonconforming (TGNC) patients have been seeking medical care in higher numbers and have faced unique social, personal, and health issues that affect the quality of care they receive. The purpose of this study was to conduct a mixed-methods study to [...] Read more.
Transgender and gender nonconforming (TGNC) patients have been seeking medical care in higher numbers and have faced unique social, personal, and health issues that affect the quality of care they receive. The purpose of this study was to conduct a mixed-methods study to describe TGNC care at Kaiser Permanente Mid-Atlantic States, a large integrated health system. We used a transgender registry to describe a TGNC patient population and compared healthcare utilization between TGNC patients and non-TGNC patients. Four focus groups were also conducted among 28 patients. Atlas.ti software was used to code and analyze themes for the qualitative analysis. Among the 282 adults TGNC patients, the mean age was 32.6 years. Of the study sample, 59% were White, and 27% were Black. TGNC patients demonstrated an increased use of email/telephone visits and the online patient portal and more cancellations and no-shows compared to non-TGNC controls. Of the 28 TGNC patients who participated in the focus groups, 39% identified as female, 21% as a transman, and 18% as non-binary/genderqueer. Participants were predominantly White (68%), highly educated (74%), and reported use of hormones (89%). Themes that emerged from our qualitative analysis included: limited availability of TGNC information; positive and negative sentiments regarding patient–provider interactions; issues with case management; limited access to care; lack of coordination of care; negative staff experiences. We identified specific areas in a health system to improve the quality of care of TGNC patients, including specific TGNC training for providers and staff, a source of TGNC information/resources, and hiring and training TGNC-specific case managers. Full article
(This article belongs to the Special Issue Health and Wellbeing in LGBT Populations)
16 pages, 1546 KiB  
Article
Conceptualizing “Family” and the Role of “Chosen Family” within the LGBTQ+ Refugee Community: A Text Network Graph Analysis
by Seohyun Kim and Israel Fisseha Feyissa
Healthcare 2021, 9(4), 369; https://doi.org/10.3390/healthcare9040369 - 25 Mar 2021
Cited by 10 | Viewed by 6000
Abstract
This study analyzed meaning attributions regarding “family” and “chosen family” by Lesbian, Gay, Bisexual, Pansexual, Transgender, Gender Queer, Queer, Intersex, Agender, Asexual, and other Queer-identifying community (LGBTQ+) refugees. The meaning and significance of a chosen family in the newly established life of the [...] Read more.
This study analyzed meaning attributions regarding “family” and “chosen family” by Lesbian, Gay, Bisexual, Pansexual, Transgender, Gender Queer, Queer, Intersex, Agender, Asexual, and other Queer-identifying community (LGBTQ+) refugees. The meaning and significance of a chosen family in the newly established life of the refugees was also pin-pointed for its value of safekeeping the wellbeing and settlement process. We analyzed narrative statements given by 67 LGBTQ+ refugees from 82 YouTube videos. Using InfraNodus, a text graph analysis tool, we identified pathways for meaning circulation within the narrative data, and generated a contextualized meaning for family and chosen family. The conceptualization process produced a deduction within family relationships, exploring why people, other than in biological relationships, appear to be vital in their overall wellbeing and settlement, as well as the process through which this occurs. Biological family is sometimes associated with words that instigate fear, danger, and insecurity, while the concept of chosen family is associated with words like trusting, like-minded, understanding, welcoming, loving, committed, etc. The results of the study are intended to add knowledge to the gap by showing the types and characteristics of family relationships in LGBTQ+ refugee settings. It is also a call for the relevant research community to produce more evidence in such settings, as this is essential for obtaining a better understanding of these issues. Full article
(This article belongs to the Special Issue Health and Wellbeing in LGBT Populations)
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6 pages, 216 KiB  
Study Protocol
Long-Term Care Preferences and Sexual Orientation: Protocol for a Systematic Review
by Elżbieta Buczak-Stec, Hans-Helmut König, Lukas Feddern and André Hajek
Healthcare 2020, 8(4), 572; https://doi.org/10.3390/healthcare8040572 - 18 Dec 2020
Cited by 2 | Viewed by 1954
Abstract
Background: With increasing age, the health status of older individuals commonly deteriorates and their care needs greatly increase. Therefore, many individuals are in need for formal or informal long-term care. In order to plan suitable long-term care settings, it is important to know [...] Read more.
Background: With increasing age, the health status of older individuals commonly deteriorates and their care needs greatly increase. Therefore, many individuals are in need for formal or informal long-term care. In order to plan suitable long-term care settings, it is important to know the long-term care preferences of an ageing population (both heterosexuals and sexual minorities). The aim of this study is to systematically review the literature for evidence on preferences regarding long-term care and the potential differences with regard to sexual orientation. Methods and analysis: This study protocol for a systematic review is reported according to the PRISMA-P guidelines. A comprehensive search of published studies will be conducted using PubMed, Web of Science and PsycINFO bibliographic databases. Following predefined inclusion criteria, two authors will screen the titles and abstracts of the studies independently. Afterwards, we will obtain and screen full-text articles of eligible studies using the predefined inclusion criteria. Discrepancies will be resolved by consensus or consultation with a third researcher. Data will be extracted and synthesised. Extracted data will be categorised based on study design, type of long-term care preferences and the group (sexual orientation) which is addressed. The quality of reporting of the studies included will be assessed. Full article
(This article belongs to the Special Issue Health and Wellbeing in LGBT Populations)
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