Celebrating Pride month – highlighting research into LGBTQ+ health published in BMJ Open

The Intersex-Inclusive Progress Pride Flag

Pride month is a time to celebrate the diversity of love, gender identity and acceptance, no matter who we are. It is also a time to raise awareness of the inequality, discrimination and difficulties that members of the LGBTQ+ community face on a daily basis. In this blog, we take a look at some impactful research into health and the LGBTQ+ community over the past four years.


The critical appraisal of International clinical practice guidelines for the healthcare of trans and gender minority people

Altmetric graph showing a score of 218In their article, Dahlen et al. aimed to identify and critically appraise current clinical practice (CPG) guidelines regarding the healthcare of trans and gender minority people. The authors conducted a systematic review and searched six databases and six CPG websites. In addition to this, the authors approached International Key Opinion Leaders in order to identify any further guidelines. The quality of the included CPGs was then appraised using AGREE II. Dahlen et al. concluded that guidance on the healthcare of trans and gender minority people seemed to be limited to guidance on HIV and transition related interventions. The authors also highlighted the need for CPGs to address an increased range of healthcare topics to be included in CPGs where trans and gender minority people are considered.


Examining LGBTI+ inclusive sexual health education

O’Farrell et al. conducted a systematic review and narrative synthesis in order to synthesise and critically appraise evidence regarding the receipt and delivery of LGBTI+ inclusive sexual health education. The authors found that LGBTI+ youth and sexual health education facilitators are turning to online sources of information as current sexual health programmes operate from a mainly heterosexual perspective. They also found that this was compounded by the lack of inclusive curricula and training, which leaves facilitators ill-equipped to deliver inclusive sexual health education. O’Farrell et al. highlight the need to standardise sexual health curricula so that it is LGBTI+ inclusive. Since its publication, this article has been cited in the Comprehensive Sexuality Education study, which was commissioned by the European parliament, and the World Health Organisation’s Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations


Lesbian parents’ experiences with accessing healthcare for their adopted children in England  

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Kelsall-Knight interviewed six lesbian adoptive parents about their experiences accessing healthcare for their adopted children in England using a three-stage interview process. Eight themes emerged from the interviews, including navigating heteronormativity, strategies for accessing heteronormative healthcare and having an ‘adopted’ status. The themes also discuss intersectionality, how lesbian parents and adoptive families are reflected in healthcare and professional expectations. Kelsall-Knight concludes that the challenges and needs of accessing healthcare for lesbian adoptive families may be different to heterosexual and/or biological families and that further training is needed for healthcare professionals.   


The impact of COVID-19 on sexual and gender minority populations in the UK 

The aim of this systematic review, conducted by McGowan et al., was to review all published and unpublished evidence of the impact of the COVID-19 pandemic on the wellbeing and health of sexual and gender minority populations in the UK. The authors found no published research on any of the included outcomes, including COVID-19 incidence, hospitalisation rates, illness severity and death rates. Although grey literature was identified, the included reports were found to be of low quality and only four of these grey literature reports had heterosexual/cisgender comparators. The grey literature showed that sexual and gender minority populations in the UK had worse mental health and well-being, health behaviours, safety, social connectedness and access to routine healthcare. The authors highlight that the lack of research raises significant concerns in light of the pre-existing health inequities experienced by sexual and gender minority populations. McGowan et al. conclude that the scarcity of evidence is driven by the lack of routinely collected sexual orientation and gender identity data. Since its publication, this article has been cited in the COVID-19 impact on gender equality in research & innovation policy report by the European Commission’s Expert Group and in the Wales’ long-term COVID-19 transition from pandemic to endemic report from the Welsh Government. 


Demographic characteristics, long-term health conditions and healthcare experiences of trans and non-binary adults in England

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Using self reported data from the GP Patient Survey, Saunders et al. sought to identify the characteristics, long-term health conditions and healthcare experiences of trans and non-binary adults in England. The authors found that trans and non-binary adults tended to be younger, were more likely to be from Asian, black, mixed or other ethnic groups and more likely to live in more economically deprived parts of the country. Saunders et al. also found that inequalities in long-term health conditions were greater for autism, dementia, learning disabilities and mental health, varying by age. Larger disparities in healthcare experience were found in interpersonal communication rather than access. Since its publication, the article has been cited in the Equality and Human Rights Monitor 2023, which details the UK’s Equality and Human Rights Commission’s five-yearly progress report on equalities and human rights. 


Social and economic vulnerabilities among transgender women participating in HIV research in the USA 

In this qualitative study, Reisner et al. aimed to understand the experiences, perceptions, barriers and facilitators of trans women participating in HIV research. The authors held seven online focus groups and participants were recruited from across the USA using a mix of methods including social media and peer referrals. The sample of trans women who participated in the focus groups was geographically diverse, with 34% identifying as Black African American and 29% as Hispanic/Latina. Reisner et al. found that social and economic factors shaped the participation in HIV research for trans women. Limited research opportunities, mistrust, fear of mistreatment, safety and confidentiality, competing priorities and HIV stigma were identified as barriers to participating in HIV research. Whereas, peer involvement and engagement, monetary and non-monetary incentives, flexibility and choices, multiple modalities and methods, and transcenteredness were identified as facilitators to HIV research participation.  


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