What Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex Patients Say Doctors Should Know and Do: A Qualitative Study

This qualitative study explored the experiences of lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) people in health care and their recommendations for physicians. Six focus groups were conducted with LGBTQI people (N=48) in four U.S. cities between October 2013 and April 2014. Five overarching themes emerged regarding patients' suggestions for providers: be comfortable with LGBTQI patients; share medical decision-making; avoid assumptions; apply LGBTQI-related knowledge; and address the social context of health disparities. These core competencies differed in meaningful ways from competencies created by national organizations such as the Association of American Medical Colleges. Community-derived competencies(1) stressed the importance of collaborative patient-physician partnerships, particularly in the setting of hormone prescription for transgender patients, and prioritized addressing social determinants of health and focusing on marginalized subpopulations(2) and stigmatized needs of the community. Limitations, particular of sampling, were considered. Community input could improve medical education interventions to reduce health disparities in marginalized communities.