A review of lesbian, gay, bisexual, trans and intersex (LGBTI) health and healthcare inequalities

• Published in: European journal of public health Vol. 29; no. 5; pp. 974 - 980
• Main Authors: Zeeman, Laetitia, Sherriff, Nigel, Browne, Kath, McGlynn, Nick, Mirandola, Massimo, Gios, Lorenzo, Davis, Ruth, Sanchez-Lambert, Juliette, Aujean, Sophie, Pinto, Nuno, Farinella, Francesco, Donisi, Valeria, Niedźwiedzka-Stadnik, Marta, Rosińska, Magdalena, Pierson, Anne, Amaddeo, Francesco
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-10-2019; Oxford Publishing Limited (England)
• Subjects: Bisexuality; Collaboration; Differences of sex development; Discrimination; Female; Gays & lesbians; Gender inequality; Health care; Health care access; Health disparities; Health Services Accessibility - statistics & numerical data; Health Status Disparities; Healthcare Disparities - statistics & numerical data; Homosexuality; Humans; Income inequality; Intersex people; LGBTQ people; Literature reviews; Male; Medical personnel; Miscellaneous; Narratives; Pilot projects; Policy analysis; Professionals; Public health; Reviews; Sexual and Gender Minorities - statistics & numerical data; Stigma; Training; Transgender persons; Victimization
• ISSN: 1101-1262; 1464-360X; 1464-360X
• DOI: 10.1093/eurpub/cky226

Abstract
Background
Lesbian, gay, bisexual, trans and intersex (LGBTI) people experience significant health inequalities. Located within a European Commission funded pilot project, this paper presents a review of the health inequalities faced by LGBTI people and the barriers health professionals encounter when providing care.
Methods
A narrative synthesis of 57 papers including systematic reviews, narrative reviews, meta-analyses and primary research. Literature was searched in Cochrane, Campbell Collaboration, Web of Science, CINAHL, PsychINFO and Medline. The review was undertaken to promote understanding of the causes and range of inequalities, as well as how to reduce inequalities.
Results
LGBTI people are more likely to experience health inequalities due to heteronormativity or heterosexism, minority stress, experiences of victimization and discrimination, compounded by stigma. Inequalities pertaining to LGBTI health(care) vary depending on gender, age, income and disability as well as between LGBTI groupings. Gaps in the literature remain around how these factors intersect to influence health, with further large-scale research needed particularly regarding trans and intersex people.
Conclusion
Health inequalities can be addressed via changes in policy, research and in practice through health services that accommodate the needs of LGBTI people. With improved training to address gaps in their knowledge of LGBTI health and healthcare, health professionals should work in collaboration with LGBTI people to address a range of barriers that prevent access to care. Through structural change combined with increased knowledge and understanding, services can potentially become more inclusive and equally accessible to all.