Sexual and Gender Minority Migrants' Experiences of Health Service Access and Utilisation: A Qualitative Meta-Synthesis.
Maria Gottvall, Osszián Péter-Szabó, Rummage Isaac and 3 others
PMID 39952788WHAT IT FOUND
Sexual and gender minority migrants described avoiding care because of cost, language, confidentiality fears, stigma and discrimination.
They described safe, affirming, private encounters with health professionals as making services feel more accessible.
Key findings
01In 81% of included reports, migrants faced external barriers to health service access, and in 57% they faced internal barriers such as fear and shame.
02In 62% of included reports, migrants described acceptance and affirmation from health professionals, while 24% described non-affirming behaviour or discrimination.
03Participants described feeling heard and accepted when care was attentive, respectful, trauma-aware and non-judgmental.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Most included reports were conducted in North America, so the findings may not apply to migrants in other regions. Few participants identified as other than cisgender gay men, so bisexual people, lesbian women and transgender or gender non-conforming migrants may be under-represented. Migration status was not presented for almost half of participants, and the review did not examine differences by legal migration status. Quality appraisal was done by two senior researchers, and many included studies did not describe how the researchers' own background and relationship with participants may have affected the findings. The searches were limited to English-language articles published from 2013 to 2024, and relevant studies could have been missed. Translation in the original studies may have shaped the findings.
Declared interests
The authors declared no conflicts of interest. Funding was named as Forskningsrådet om Hälsa, Arbetsliv och Välfärd.
The easy way to misread this
Do not read the 62% figure as evidence that affirming care improves health outcomes. It is the proportion of included qualitative reports describing affirmation, not a measured treatment effect.