Findings highlight the importance of diversifying the health care workforce

Identity discordance between patients and clinicians is associated with worse self-rated patient experience and less receipt of necessary care. Prior studies have focused on racial discordance. However, it is not currently known whether these phenomena extend to sexual and gender minority (SGM) adults, who experience worse health outcomes than their non-SGM counterparts.

Researchers performed a cross-sectional analysis of national data from the National Institutes of Health’s All of Us Research Program. Specifically, the study evaluated the prevalence of care avoidance due to patient-clinician identity discordance and its potential association with health care discrimination among SGM adults.

The research is published in The Annals of Family Medicine journal.

They found that SGM adults across the United States are significantly more likely to avoid care because of perceived patient-clinician identity differences.

One in five sexual minority adults and more than one-third of gender minority adults shared this experience. These rates were 58% and 100% higher than those of their non-SGM counterparts, respectively.

Notably, exposure to discrimination in health care settings was more prevalent among SGM adults and was dose-dependently associated with higher rates of identity-based care avoidance.

This study is among the first to quantitatively demonstrate that SGM patients prefer clinicians who share similar sexual orientations and/or gender identities, likely due to more affirming care, desire for expertise specific to SGM health, and perceptions of safety, comfort, and solidarity.

The findings highlight the importance of diversifying the health care workforce, expanding SGM-related clinical training, and preventing health care discrimination against SGM patients.