EXPERIENCE OF GENDER MINORITY YOUTH WHEN ACCESSING HEALTH CARE IN TURKEY

• Published in: Journal of adolescent health 2020-02, Vol.66 (2S), p.S77
• Main Authors: Akgül, Sinem, Apalı, Özge Ceren, Baba, Ikranur, Bayrakcı, Fatma, Degerli, Deniz, Pekert, Sacit, Perk, Fatmagul, Sipahi, Irem Sibel, Senoğlu, Ezgi, Yılmaz, Salih, Zengin, Nur Yıldız, Erden, Arda
• Format: Article
• Language: English
• Subjects: Age; Bisexuality; Cisgender; Complaints; Discrimination; Gays & lesbians; Gender; Gender-affirming care; Health care; Health disparities; Health needs; Health risks; HIV; Homosexuality; Human immunodeficiency virus; Identity; Lesbianism; LGBTQ people; Medical personnel; Medical students; Men; Nurses; Physicians; Professional training; Sexual orientation; Stigma; Transgender persons; Young adults
• ISSN: 1054-139X; 1879-1972

Purpose: Lesbian, gay, bisexual, transgender and questioning(LGBTQ) patients report alarming rates of identity-based discrimination in healthcare settings. Despite the health risks and challenges impacting LGBTQ young adults, little is known about their healthcare experience, especially in Turkey. This study aimed to evaluate LGBTQ young individuals' experiences when accessing health care. Methods: LGBTQ participants were recruited from the division of Adolescent Medicine at Hacettepe University, Turkey and also from a LGBTQ support group based in Ankara. Participants' responses to open-ended items asking about their experiences in the healthcare setting in particular cases of discrimination and reasons for nondisclosure were assessed. Results: A total of 24 LGBTQ youth completed the interview. The participants ranged in age from 15 to 24 years (Mean age 21.1years). Three individuals(12.5%) identified as lesbian, 4(20.8%) as gay men, 9(37.5%) as bisexual, 2(3.57%) as pansexual and 6(25%) as transgender (4 transfemale, 2 transmale) one of the trans male individuals additionally identified as gay. Eighty-two percent reported seeing a health provider in the last year and all had seen one in the last 3 years. Of the 24 participants, 67(n=16) indicated that they had not disclosed their LGBTQ identity to their healthcare providers. The most commonly provided reason for not disclosing one's LGBTQ identity overall was that providers did not ask and secondly that they were trying to avoid discrimination. Twenty (%87) individuals reported postponing care as they felt they would be subjected to LGBTQ-based discrimination. Ten(42%) of the total participants including all 6 of the transgender participants reported experiencing discrimination and this was reported at all levels of care (primary, secondary and tertiary healthcare facilities) by all types of healthcare workers (attending physicians, physicians in training (fellows and residents), nurses, medical secretary). The most common encounters of discrimination for the LGB individuals were the assumption that the individual was HIV positive and that they needed to receive mental healthcare. For the trans individuals it was that the healthcare provider did not respect their chosen name and that they refused to give gender affirming care. None of the participants had made any formal complaints, mainly because they believed it would make little difference. Conclusions: To the best of our knowledge this is the first st