Table 3 Prioritized research themes
Themes in priority order Points indicate aggregated ranking scores across two small groups | Key reflections and different topics within each theme |
|---|---|
Health services delivery 16 points | Primary care emerged as a very important part of health services delivery, and often the ‘first port of call’, therefore sensitive and helpful interactions were considered important areas for research improving experiences. • Primary care (GP) is the front door, coming out can be exhausting and potentially risky • Training, guidance and support for front line workers (primary care included) in health and social care • Balance between making sure you acknowledge LGBTQ+ identity (and don’t project heteronormative assumptions), also don’t focus entirely on LGBTQ+ identity in service provision. • Mental health support needed, for example domestic violence support lines • Focus on older people is missing in this theme and add in care homes as a feature of services, stories about LGBTQ people in care homes being marginalized • Social care and fostering and adoption overlooked |
Preventing ill health 11 points | Preventing ill health is a broad topic, including areas of cancer screening to violence, substance misuse and stress. Intersectional issues were thought to be generally under reported and addressed. • Under reporting of violence especially in transgender community • Substance and alcohol misuse is a big issue for LGBTQ+ people • Stress from being part of a minority group – leading to mental health crisis • Cancer screening • Reducing HIV |
Particular challenges /intersectionality 8 points | Race, ethnicity and the impact of socioeconomic status were the most commonly cited and discussed challenges in intersectionality. • Mixed race, social class (working class often not represented in LGBTQ+ work) • Lack of emphasis on BAME communities being LGBTQ – stigma in particularly Asian communities about coming out • Neuro diversity and disability • Double stress of racism and homophobia/transphobia • Disparities between black and white trans people are significant • So many inequalities added onto being homosexual including race, ethnicity • Experiencing racism at work, in treatment, homosexuality on top of that feels like you are • Queer trans and intersex people of colour need to be part of the research conversation, otherwise intersectionality will not be taken seriously • Socioeconomic inequality has led to multigenerational health issues • LGBTQ elderly care could be included in this category as age intersects with sexuality? • These issues have a massive influence in affecting how people experience healthcare |
LGBT+ Specific issues 5 points | Focus on youth in this theme with the prevention of future health issues with early and appropriate interventions and policy that addresses homophobia and bullying (e.g., in school and care settings). • Sense of isolation overlaps with mental health issues which continue to be very high in LGBTQ+ young people. • Body image and pressures to conform to LGBTQ+ stereotypes • Eating disorders, under discussed but very important topic that has lifelong implications • Intervening in younger years such as preventing suicide etc. but timing is crucial and flexible methods are essential. |
Developing or evaluating treatments & interventions 1 point | • Tensions between family and schools an assumption that they all work together – they don’t! • Person-centered treatments important – should be targeted to how we live our lives. |
Health and social policy 1 point | Whilst some participants felt distant from policy and its implications for LGBTQ+ people, there were strong views in connection to racism and policy, inadequate counting of LGBTQ+ people and policy in settings such as prisons. • Policy can shape lives so important to understand what helps and what doesn’t – however Health and Social policy is complicated which drives which, the undercurrents or the policy? E.g., the equal pay act was enacted years ago, but women still don’t have equal pay. • You need something in addition to the policy, such as the general demand in society to make things better. • Focus on mental health • Poor ‘counting’ which means difficult to assess and prevent ill health in this group (see similar comment in LGBT+ specific issues) • Settings such as prisons, immigration centres important • Stronger focus on how structural racism and colonialism impacts LGBTQ+ health care and health care options |
Health condition specific 0 points | • Are there disparities in provisions for older LGBTQ+ people with health conditions? • Alzheimer’s research going on at the moment, will be interesting to see how it intersects with queer identities • Mental health |