Despite a recent influx of literature surrounding LGBTQ+ health disparities, few scholars have examined how different identity statuses become relevant or invisibilized within healthcare settings, or how identity salience in medical spaces influences the healthcare experiences of marginalized individuals. Drawing on 41 semi-structured interviews with LGBTQ+ people, I use concepts from sociological and social-psychological identity theories to frame the question: how do sexual and gender minorities describe their experiences with primary, mental, and specialist healthcare services? Specifically, which identities become salient across different healthcare contexts, and what are the related consequences of identity salience or erasure for LGBTQ+ patients? My findings suggest that LGBTQ+ individuals must navigate intersecting layers of discrimination in healthcare spaces, the experience of which varies depending on which identities are made salient through their interactions within healthcare spaces. Both visible and invisible identities had the potential to become salient via conversations with providers, health screenings, interactions with romantic partners, and more. At times, the identities that providers ascribed to patients were misaligned with patients' own claimed identities. In other instances, provider-ascribed and patient-claimed identities did align; however, ideas about which of these identities should become most salient during a healthcare encounter, when, and how, differed between patients and their providers. Both of these experiences contributed to reports of negative healthcare experiences for LGBTQ+ patients. This work contributes to health, gender, and sexuality scholarship by highlighting mechanisms that promote healthcare inequalities for sexual and gender minorities, which remain a persistent concern in all three fields of scholarship. Overall, evidence suggests that LGBTQ+ people's experiences of healthcare are characterized by a constant negotiation of priorities, desires, needs, self-advocacy, and personal identities.
Read
