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Setchell J1, Ross MH1
1The University of Queensland, School of Health and Rehabilitation Science, Brisbane, Australia
Background: Lesbian, gay, bisexual, transgender, intersex and queer (and other related identities: LGBTIQ+) civil rights have been a topic of social and political debate in many countries over recent years. Although this debate has resulted in reduced discrimination including within policy changes, such as legalisation of same sex marriage in some countries, stigma and inequity still exist. Health and access to healthcare remain an important area of inequity for LGBTIQ+ individuals and communities. Reasons for these health disparities include that LGBTIQ+ individuals face significant societal stigma which contributes to individual, interpersonal and structural (e.g. policy) barriers to accessing quality healthcare. Research has highlighted that LGBTIQ+ patients feel judged, inferior and receive suboptimal care in a variety of health professions including medicine and nursing, mental health, and peri-natal care. Although similarities between physiotherapy and other health professions do exist and previously identified barriers may apply to all forms of healthcare, it is likely that there are specific barriers unique to physiotherapy due to the nature of the profession. The extent to which LGBTIQ+ individuals experience issues accessing physiotherapy had not yet been investigated.
Purpose: To understand perceived barriers and key concerns from the LGBTIQ+ perspective, and to provide physiotherapists with the opportunity to improve (where required) the provision of care to LGBTIQ+ individuals.
Methods: Primarily qualitative design using a custom-built online survey. Open responses were analysed with thematic analysis and quantitative responses with descriptive statistics. One hundred and fourteen people responded to the study with 108 meeting inclusion criteria (aged 18 or older, self-identification as LGBTIQ+, attended physiotherapy in Australia).
Results: Four main themes were identified in the analysis, with almost all participants reporting experiences relating to at least one of the following themes:
1) 'assumptions' about participants sexuality or gender identity;
2) 'proximity/exposure of bodies' including discomfort about various aspects of physical proximity, touch, undressing and/or observing the body;
3) 'discrimination' including overt and implicit discrimination as well as fear of discrimination; and
4) 'lack of knowledge about transgender health issues'.
Across the four themes, positive encounters with physiotherapists were also evident at times. Participants' also suggested or supported ways to improve physiotherapy encounters, including: using non-binary terms when discussing partners, demonstrating respect for diverse lives, providing open options for gender identity on forms, diversity training for physiotherapists, and education specific to the LGBT population (particularly transgendered health).
Conclusion(s): Our findings highlight that people who identify as LGBTIQ+ experience challenges when attending physiotherapy including: erroneous assumptions, discomfort, explicit and implicit discrimination and a lack of knowledge specific to their health needs. Positive findings and participant suggested changes offer ways forward for improving physiotherapy for LGBTIQ+ individuals.
Implications: These study highlights specific issues relating to individuals who identify as LGBTIQ+ in the physiotherapy context and potential options for improving the physiotherapy experiences of this population and align with moves towards an inclusive and diverse profession.
Keywords: LGBTIQ, stigma, patient experiences
Funding acknowledgements: JS is funded by an NHMRC Early Career Fellowship and MR by a University of Queensland Research Training Program Scholarship.
Purpose: To understand perceived barriers and key concerns from the LGBTIQ+ perspective, and to provide physiotherapists with the opportunity to improve (where required) the provision of care to LGBTIQ+ individuals.
Methods: Primarily qualitative design using a custom-built online survey. Open responses were analysed with thematic analysis and quantitative responses with descriptive statistics. One hundred and fourteen people responded to the study with 108 meeting inclusion criteria (aged 18 or older, self-identification as LGBTIQ+, attended physiotherapy in Australia).
Results: Four main themes were identified in the analysis, with almost all participants reporting experiences relating to at least one of the following themes:
1) 'assumptions' about participants sexuality or gender identity;
2) 'proximity/exposure of bodies' including discomfort about various aspects of physical proximity, touch, undressing and/or observing the body;
3) 'discrimination' including overt and implicit discrimination as well as fear of discrimination; and
4) 'lack of knowledge about transgender health issues'.
Across the four themes, positive encounters with physiotherapists were also evident at times. Participants' also suggested or supported ways to improve physiotherapy encounters, including: using non-binary terms when discussing partners, demonstrating respect for diverse lives, providing open options for gender identity on forms, diversity training for physiotherapists, and education specific to the LGBT population (particularly transgendered health).
Conclusion(s): Our findings highlight that people who identify as LGBTIQ+ experience challenges when attending physiotherapy including: erroneous assumptions, discomfort, explicit and implicit discrimination and a lack of knowledge specific to their health needs. Positive findings and participant suggested changes offer ways forward for improving physiotherapy for LGBTIQ+ individuals.
Implications: These study highlights specific issues relating to individuals who identify as LGBTIQ+ in the physiotherapy context and potential options for improving the physiotherapy experiences of this population and align with moves towards an inclusive and diverse profession.
Keywords: LGBTIQ, stigma, patient experiences
Funding acknowledgements: JS is funded by an NHMRC Early Career Fellowship and MR by a University of Queensland Research Training Program Scholarship.
Topic: Professional issues; Service delivery/emerging roles
Ethics approval required: Yes
Institution: The University of Queensland
Ethics committee: Human Ethics Board
Ethics number: 2018000797
All authors, affiliations and abstracts have been published as submitted.
