"Little Red Flags": Barriers to Accessing Health Care as a Sexual or Gender Minority Individual in the Rural Southern United States-A Qualitative Intersectional Approach.
Layla Joudeh, Orlando O Harris, Ethan Johnstone and 2 others
PMID 33935190WHAT IT FOUND
Rural southern sexual and gender minority clients described avoiding care because of anticipated discrimination, Christian-centered providers, and racism.
They relied on vetted community referrals and an affirming mobile clinic to access services.
Key findings
01Participants described hesitancy to access care because of sexual and gender discrimination tied to living in the rural South.
02Participants said Christian-centered care made it harder to know whether a provider was affirming, and some avoided providers with visible religious markers.
03Black participants described racism and lack of racial representation as barriers, and seeing Black providers made care feel affirming.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The findings come from 12 clients of one mobile clinic, so they may not apply to sexual and gender minority people who do not use such services. All participants openly identified as sexual and gender minority people and spoke English, so experiences of people who are not open or do not speak English may differ. The study was limited to rural South Carolina and was conducted virtually during the pandemic, which may have affected who could take part and how interviews happened. It describes experiences and barriers, not outcomes or tested interventions.
Declared interests
The authors report no real or perceived vested interests that could be a conflict of interest. The article is listed as supported by NIH extramural research.
The easy way to misread this
Do not conclude that these barriers prove a specific provider training will improve care. The study describes clients' experiences and does not test an intervention.