Exploring community preference for LGBT Healthcare in Ireland

Introduction

This project will explore how members of the LGBT community in Ireland, would like their healthcare delivered to them. Gender and Sexual Minority communities face specific health inequalities and disparities when compared to the general population, and this is often confounded by poor experiences in healthcare due to homophobia, biphobia and transphobia. Many LGBT people choose not to come out in healthcare environments and knowledge around how to care for gender and sexual minority communities is poor in many areas of healthcare practice. By identifying how members of the community would like healthcare to be provided to them, consideration can be given to specialised service development and delivery, policy and strategy development, as well as education and training of healthcare professionals.

This project has been funded by UCD Seed funding for Equality Diversity and Inclusion Research and is supported by MPOWER at HIV Ireland. LINC and Transgender Equality Network of Ireland.

Dr John P Gilmore is a Fulbright HRB Ireland Health Impact Scholar and in 2023 will be based at the Center for Gender and Sexual Minority Health at University of California San Francisco where he will research enablers and barriers to community-based LGBT healthcare.

Project Outline

Background

Lesbian, Gay, Bisexual, Transgender, Intersex and other gender and sexual minority groups face health inequalities and disparities when compared to the general population. We know that there are disparities in health outcomes related to mental health, sexual health, some areas of cancer, obesity, substance use disorders and sexual health. However there are many unknowns, as sexual orientation and gender identity data often isn’t captured in medical and health related research.

Confounding these disparities in health outcomes are inequalities in access, with many LGBT+ people reporting issues of discrimination and poor care from healthcare providers, and in Ireland over 40% of LGBTI people have not disclosed their sexual orientation or gender identity to any healthcare provider according to the EU Fundamental Rights Agency LGBTI Survey (2020).

In many places there are specialist and specific healthcare services for LGBT+ people, however in Ireland this is limited to a single specialist service for gender affirming therapy for the Trans community and a single sexual health service targeting gay and bisexual men. Neither of which are community-based services.

This project will work with communities of LGBT+ people to ascertain what kind of healthcare they would like to see provided to them.

Research Aims and Objectives

To identify how Lesbian, Gay, Bisexual and Transgender (including non-binary) people in Ireland wish their healthcare to be delivered.
To identify areas of healthcare practice where specialist LGBT services may be seen as beneficial to the communities.
To explore what factors are important to LGBT people in the provision of healthcare services.

Methodology

In order to attain the views of members of LGBT+ communities in Ireland in a meaningful and engaging way, Asynchronous Online Focus Groups are being used.

This novel methodology combines elements of online survey design with focus group methodologies and can enhance accessibility and quality of research participation. Participants can engage in their own time, from a place where they are comfortable and can take time to reflect on their answers to the prompt questions, while also engaging with other participants perspectives and views.

MURAL online collaboration software is being used to facilitate the focus groups, with three distinct groups, one for Gay and Bisexual Men, one for Lesbians and Bisexual Women, and one for Trans and Non-binary people. Participants who consent to take part in the focus groups choose the group which most aligns to their identity and healthcare needs and can login to the MURAL as many times as they wish over a four week period. Participants are encouraged not only to give their own views but also to respond to the views of others in their group.

Project Outputs

Along with peer-reviewed journal publications and conference outputs a report of the findings will be provided to community partners for advocacy purposes.

It is hoped that the research will act as a springboard for the further development of research into LGBT+ healthcare in Ireland and for the development of specialist healthcare services for gender and sexual minority communities.

All-Ireland LGBT+ Health Symposium

The first All-Ireland symposium was held on 24th November 2022 with guest speakers Professor Rusi Jaspal University of Brighton and Dr. Mel Duffy Dublin City University.

Picture of event speakers L to R Sean Kearns UCD, Dr Andras Kolto University of Galway, Mark Doyle HIV Ireland, Dr Chris Noone University of Galway, Phil Harper Arden University, Jamie Howell Maynooth University, Dr Mel Duffy DCU, Siobhan Thomas UCC, Catherine O’Sullivan University of Galway, David Comer University of Galway, David Field University of Aberdeen, Dr John Gilmore UCD, Prof Rusi Jaspal University of Brighton (missing from photo Sean Saifa Wall University of Huddersfield, Fernandos Ongolly UCD.

All Ireland LGBT+ Symposium