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Reproductive Health Care Priorities and Barriers to Effective Care for LGBTQ People Assigned Female at Birth: A Qualitative Study.
Womens Health Issues. 2018 Jul - Aug; 28(4):350-357.WH

Abstract

BACKGROUND

Little research documents the self-identified reproductive health priorities and health care experiences of lesbian, gay, bisexual, transgender, queer (LGBTQ)-identified individuals who may be in need of services.

METHODS

We conducted in-depth interviews with a diverse sample of 39 female-assigned-at-birth individuals (ages 18-44) who also identified as lesbian, bisexual, queer, and/or genderqueer, or transmasculine. Interviews were primarily conducted in person in the Bay Area of California, and Baltimore, Maryland, with 11 conducted remotely with participants in other U.S.

LOCATIONS

We asked participants about their current reproductive health care needs, topics they felt researchers should pursue, and past reproductive health care experiences. Data were analyzed using a framework method, incorporating deductive and inductive thematic analysis techniques.

RESULTS

Reproductive health care needs among participants varied widely and included treatment of polycystic ovary syndrome and irregular menses, gender-affirming hysterectomies, and fertility assistance. Many faced challenges getting their needs met. Themes related to these challenges cross-cutting across identity groups included primary focus on fertility, provider lack of LGBTQ health competency relevant to reproductive health priorities and treatment, and discriminatory comments and treatment. Across themes and identity groups, participants highlighted that sexual activity and reproduction were central topics in reproductive health care settings. These topics facilitated identity disclosures to providers, but also enhanced vulnerability to discrimination.

CONCLUSIONS

Reproductive health priorities of LGBTQ individuals include needs similar to cisgender and heterosexual groups (e.g., abortion, contraception, PCOS) as well as unique needs (e.g., gender affirming hysterectomies, inclusive safer sex guidance) and challenges in pursuing care. Future reproductive health research should pursue health care concerns prioritized by LGBTQ populations.

Authors+Show Affiliations

Advancing New Standards in Reproductive Health, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, Oakland, California. Electronic address: erin.wingo@ucsf.edu.CSU East Bay, Department of Sociology, Hayward, California.Advancing New Standards in Reproductive Health, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, Oakland, California.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29661698

Citation

Wingo, Erin, et al. "Reproductive Health Care Priorities and Barriers to Effective Care for LGBTQ People Assigned Female at Birth: a Qualitative Study." Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health, vol. 28, no. 4, 2018, pp. 350-357.
Wingo E, Ingraham N, Roberts SCM. Reproductive Health Care Priorities and Barriers to Effective Care for LGBTQ People Assigned Female at Birth: A Qualitative Study. Womens Health Issues. 2018;28(4):350-357.
Wingo, E., Ingraham, N., & Roberts, S. C. M. (2018). Reproductive Health Care Priorities and Barriers to Effective Care for LGBTQ People Assigned Female at Birth: A Qualitative Study. Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health, 28(4), 350-357. https://doi.org/10.1016/j.whi.2018.03.002
Wingo E, Ingraham N, Roberts SCM. Reproductive Health Care Priorities and Barriers to Effective Care for LGBTQ People Assigned Female at Birth: a Qualitative Study. Womens Health Issues. 2018 Jul - Aug;28(4):350-357. PubMed PMID: 29661698.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reproductive Health Care Priorities and Barriers to Effective Care for LGBTQ People Assigned Female at Birth: A Qualitative Study. AU - Wingo,Erin, AU - Ingraham,Natalie, AU - Roberts,Sarah C M, Y1 - 2018/04/13/ PY - 2017/10/20/received PY - 2018/03/05/revised PY - 2018/03/06/accepted PY - 2018/4/18/pubmed PY - 2018/10/4/medline PY - 2018/4/18/entrez SP - 350 EP - 357 JF - Women's health issues : official publication of the Jacobs Institute of Women's Health JO - Womens Health Issues VL - 28 IS - 4 N2 - BACKGROUND: Little research documents the self-identified reproductive health priorities and health care experiences of lesbian, gay, bisexual, transgender, queer (LGBTQ)-identified individuals who may be in need of services. METHODS: We conducted in-depth interviews with a diverse sample of 39 female-assigned-at-birth individuals (ages 18-44) who also identified as lesbian, bisexual, queer, and/or genderqueer, or transmasculine. Interviews were primarily conducted in person in the Bay Area of California, and Baltimore, Maryland, with 11 conducted remotely with participants in other U.S. LOCATIONS: We asked participants about their current reproductive health care needs, topics they felt researchers should pursue, and past reproductive health care experiences. Data were analyzed using a framework method, incorporating deductive and inductive thematic analysis techniques. RESULTS: Reproductive health care needs among participants varied widely and included treatment of polycystic ovary syndrome and irregular menses, gender-affirming hysterectomies, and fertility assistance. Many faced challenges getting their needs met. Themes related to these challenges cross-cutting across identity groups included primary focus on fertility, provider lack of LGBTQ health competency relevant to reproductive health priorities and treatment, and discriminatory comments and treatment. Across themes and identity groups, participants highlighted that sexual activity and reproduction were central topics in reproductive health care settings. These topics facilitated identity disclosures to providers, but also enhanced vulnerability to discrimination. CONCLUSIONS: Reproductive health priorities of LGBTQ individuals include needs similar to cisgender and heterosexual groups (e.g., abortion, contraception, PCOS) as well as unique needs (e.g., gender affirming hysterectomies, inclusive safer sex guidance) and challenges in pursuing care. Future reproductive health research should pursue health care concerns prioritized by LGBTQ populations. SN - 1878-4321 UR - https://www.unboundmedicine.com/medline/citation/29661698/Reproductive_Health_Care_Priorities_and_Barriers_to_Effective_Care_for_LGBTQ_People_Assigned_Female_at_Birth:_A_Qualitative_Study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1049-3867(17)30599-6 DB - PRIME DP - Unbound Medicine ER -