A Spanish study of young LGBTQ+ adults finds they reported more discrimination in healthcare and greater delays in seeking care than cisgender heterosexual peers. The findings matter beyond the consulting room: if patients worry about misgendering or judgement, they may be less willing to share information or book an appointment. But the researchers also stress that discrimination alone did not explain every outcome.
What the Spanish study found
In a survey of 217 people aged 18 to 40, LGBTQ+ participants reported more perceived discrimination in healthcare than cisgender heterosexual participants. The difference was not a simple divide between people who experienced discrimination and those who did not: cisgender heterosexual respondents also described being treated unfairly.
The open-access research paper, published by Springer, reports that the LGBTQ+ group also described greater psychological distress, lower trust in healthcare providers and more delays in seeking care. These findings show a troubling pattern, but not a tidy cause-and-effect story: in adjusted statistical models, discrimination was not an independent predictor of those outcomes.
Misgendering and judgement can make appointments harder
Participants’ accounts included trans patients being addressed by former names, incorrect pronouns despite requests, and assumptions or moral judgements about gay, lesbian and bisexual people. Such encounters can make a routine appointment feel like something to brace for, rather than a place to ask for help.
The UK LGBT Foundation’s primary-care report describes similar kinds of problems, including incorrect assumptions about partners or family, mistakes about pronouns and gaps in staff knowledge. Its findings concern UK services, not the Spanish study’s participants, but they show why inclusive, respectful communication matters in day-to-day care.
Concealing identity can bring its own risks
Some LGBTQ+ participants in the Spanish study said they concealed their sexual orientation or gender identity during consultations. That may feel like a way to avoid prejudice, but it can also leave clinicians with less information to work with. The Outrage Magazine report notes concerns that concealment may contribute to incomplete information, misdiagnosis or less effective treatment, while disclosure itself may expose patients to bias.
Evidence from other settings adds useful context, without proving the same pattern applies everywhere. KFF’s US survey found that LGBT adults more often reported unfair or disrespectful treatment by healthcare providers than non-LGBT adults, and some said a negative encounter made them less likely to seek care. A separate study of 633 LGBT participants, published through Cardiff University’s repository, found that provider support was associated with greater trust and adherence, while discrimination was associated with lower trust and adherence in several contexts.
Why the findings need careful reading
The Spanish study is cross-sectional, based on an online survey, and captures participants’ reported experiences at one point in time. Its results point to associations, but they don’t establish that discrimination alone caused distress or delayed care. The researchers’ statistical analysis puts an important brake on any stronger claim.
Nor should findings from Spain, the US and the UK be treated as interchangeable. The populations, survey methods and healthcare settings differ. A study of primary-care use among transgender and gender-nonconforming people attending a community sexual-health clinic, indexed by PubMed Central, offers relevant background on access, but it does not directly test the reasons for delays reported in the Spanish survey.
Better training starts with everyday practice
The researchers argue for more training and updated protocols, with education beginning at university and woven through relevant subjects. The UK LGBT Foundation also calls for more inclusive services, reflecting patient reports of knowledge gaps and identity-related barriers in primary care.
For patients, a practical step may be to look for a service that explains how it handles names, pronouns and confidentiality, and to share only what feels safe and relevant to the consultation. For providers, the message is simpler: ask respectfully, listen carefully and avoid assumptions. That won’t solve every structural barrier, but it can make care feel more individual and welcoming.
Good healthcare should give people room to seek help without having to weigh up whether being themselves will make the appointment harder.
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