Healthcare Disparities in the LGBTQIA+ Community: A Scoping Review of Community vs Provider Experiences

Background: It is well-established that healthcare disparities exist in the LGBTQIA+ community. The divide is a growing concern exacerbated by recent changes in the healthcare and sociopolitical climate. To eliminate this divide and find ways to deliver better outcomes to the LGBTQIA+ is a dire need. This report analyzes the possible reasons from the community as well as the providers perspective, with a goal to find best practices that could be implemented in both components. Methods: A scoping literature review was carried out as described below to collect perspectives from both sides: patients as well as providers. Results: From patient experiences, positive experiences include affirmation, collaborative interaction and inclusive approach; negative experiences were lack of resources/knowledge, insensitive and less-than-adequate care and loss of trust. From the provider perspective, major problems were due to the attitude, rooted in bias created by heteronormative beliefs. TNB, bisexual and lesbian patients are, very often, most affected by these attitudes. These were exacerbated by lack of preparation and training from UME through residency. Conclusions: Training programs with dedicated hours through all levels and implementation of affirming language are suggested as first steps