Symposia
LGBQT+
Shelby B. Scott, Ph.D.
University of Texas at San Antonio
San Antonio, Texas
Karie A. Gaska, Ph.D., MSW
Assistant Professor of Behavioral Sciences
Ross University School of Medicine
Atlanta, Georgia
Kayla Knopp, Ph.D.
Post-Doctoral Fellow
VA San Diego Health Care System
San Diego, California
Quyen A. Do, M.Ed.
Project Director | Graduate Research Assistant | Ph.D. Student
University of Texas at San Antonio
San Antonio, Texas
Joyce P. Yang, Ph.D.
Assistant Professor
University of San Francisco
San Francisco, California
Objective: Healthcare discrimination contributes to medical distrust among marginalized communities. Sexual minority women of color (SM-WOC) are marginalized at the intersection of their sexual orientation, gender, and race/ethnicity; however, research has yet to quantify the prevalence of discriminatory healthcare experiences within this population. Further, although healthcare discrimination is associated with poor health outcomes, scarce research has assessed mediation pathways to explain the mechanisms behind these associations. The present study addressed these gaps by providing prevalence rates of healthcare discrimination during most recent medical appointments among a national sample of Black, Hispanic, Asian American, Native American, and White SM women. We also compared the frequency of discriminatory treatment between SM-WOC to White SM women. Informed by the Health Equity and Promotion Model for SM health, we evaluated delayed care (e.g., postponing necessary medical visits) as a mediator between provider discrimination and poor health outcomes. Methods: We used nationally representative data from the American Association of Medical Colleges survey of healthcare services N = 1,499 SM women (n = 458 SM-WOC). We calculated prevalence rates of discriminatory treatment across race/ethnicity and used binary logistic regressions to compare frequencies of identity-based discrimination between each minoritized racial/ethnic group to White SM women. Mediation models were tested with lavaan structural equation modeling software. Results: Across the sample, 33% of SM-WOC reported discrimination during their last medical appointment compared to 19% of White SM women. Discriminatory treatment was more common among every minoritized racial/ethnic group of SM women compared to White SM women. Provider discrimination was associated with higher physical and emotional impairment, and these associations were partially mediated through delayed care. Conclusions: Although discriminatory treatment during the last medical appointment was common for all SM women, prevalence was higher for SM-WOC compared to White SM women. Findings have important implications for policy and practice to reduce harm and improve medical treatment for SM women. Results provide evidence of delayed care as a possible mediation pathway between provider discrimination and worse health in sexual minority women. Taken together, results indicate a need for policy change to reduce the harm of provider discrimination on sexual minority women.