RNSystematic ReviewThe journal of nursing research : JNR2026

Health Care Experiences Among LGBTQ+ Adults: A Qualitative Systematic Review and Meta-Synthesis.

Yen-Fan Lee, Te-Sheng Chang, Wan-Ru Wu and 1 others

PMID 42200644

WHAT IT FOUND

LGBTQ+ adults delayed or avoided care after stigma, providers assuming they were heterosexual, and being misidentified.

Inclusive language, forms, signage, and respectful communication were described as supporting trust and continued care.

Key findings

01Participants described delaying care, switching providers, or leaving treatment after discrimination, exclusion, or neglect.

02Marginalization was intensified when LGBTQ+ identity overlapped with ethnicity, age, gender, or health status, and when patients came from immigrant families or conservative religious regions.

03Affirming care environments, including respectful communication and visible inclusivity, were described as fostering trust and engagement.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

The review included only English and Chinese studies, so perspectives from other languages and regions may be missing. Most studies were from high-income countries, especially the United States, so findings may not fit other health systems. The synthesis mapped findings to minority stress theory retrospectively, and some primary studies did not originally use that framework. Qualitative evidence describes experiences and cannot show that affirming care improves outcomes. Participants spanned many identities and health conditions, so the themes may not apply equally to every subgroup.

The easy way to misread this

Do not read these themes as proof that inclusive language, forms, or signage improve clinical outcomes. The review synthesizes patient experiences from qualitative studies and cannot show that any practice change caused better care.

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Health Care Experiences Among LGBTQ+ Adults: A Qualitative Systematic Review and Meta-Synthesis. — Applied Evidence