A nationwide cross-sectional study of 15,611 lesbian, gay and bisexual people in China: disclosure of sexual orientation and experiences of negative treatment in health care

Abstract

Background: Lesbian, gay and bisexual (LGB) people often face individual-and system-level barriers in health care. However, LGB people's experiences of health care in non-European and non-American settings have been scarcely studied. In China, while it has been estimated that there are at least 70 million gender and sexual minorities, there has been no larger-scale study on LGB people's experiences of health care beyond a focus on gay men and HIV. This study is the first larger-scale quantitative study to investigate LGB people's experiences of health care in China, where non-heterosexuality is officially silenced and the needs of non-heterosexual people are largely ignored by service providers. Methods: An online survey was designed in joint partnership by academic, community groups and the United Nations Development Programme. Targeted and snowball sampling was adopted for participant recruitment. Such unique cross-sectoral partnership made this research possible in the authoritarian state of China where data collection on LGB people is extremely rare. For the analysis in this paper, a sample of 15,611 Chinese LGB people were included. Frequency and descriptive statistics were conducted to describe the LGB respondents' demographic characteristics and their experiences in health care settings. Chi-square tests were conducted to test how experiences vary across LGB people with different demographic characteristics. Results: More than three quarters of the respondents said they would be willing to disclose to their medical care providers their sexual orientation if asked. However, only 5.7% of the respondents said that medical care providers ever asked them about their sexual orientation. About 8.0% of the LGB people surveyed reported having experienced negative treatment in medical care settings. Six percent (5.7%) of the Chinese LGB people said in accessing mental health care services, they were recommended, coaxed into, or provided conversion therapy for sexual orientation, gender identity or gender expression.

Association of sexual minority status, gender nonconformity with childhood victimization and adulthood depressive symptoms: A path analysis

“…Also, homosexuality was classified as a sexual disorder until it was eliminated from the Chinese Classification of Mental Disorders (CCMD) in 2001 (Wu, 2003). Nonetheless, diagnosis of "ego-dystonic sexual orientation" was still retained in CCMD, and unfortunately, nearly 6% of Chinese sexual minorities reported that they had been recommended by their mental health care providers to receive conversion therapy (Suen & Chan, 2020). Besides, some traditional customs, such as the filial piety, which values the continuation of family strain, may lead to some negative attitudes toward sexual minorities (Kwok & Wu, 2015).…”

Understanding and caring for lesbian, gay, bisexual, and transgender patients in dermatologic clinics: A dermatologist’s perspective from China

“…However, in China, things look less rosy. It is estimated that China has over 70 million gender and sexual minorities 5 . They still face substantial challenges to safeguard their health and rights due to cultural and other factors existing for a long time 6 .…”

“…The Chinese Government has contributed a lot in specific areas, such as the screening and prevention of HIV and syphilis among men who have sex with men 6 . However, many mental health workers in China still regard homosexuality as sexual perversion, and about 8.0% of the lesbian, gay, and bisexual people reported having experienced negative treatment in healthcare settings 5 . Sexual minorities are more vulnerable to underutilized health service, refusals of health care, and delayed or sub‐standard care 5 .…”

“…However, many mental health workers in China still regard homosexuality as sexual perversion, and about 8.0% of the lesbian, gay, and bisexual people reported having experienced negative treatment in healthcare settings 5 . Sexual minorities are more vulnerable to underutilized health service, refusals of health care, and delayed or sub‐standard care 5 . Underutilization of needed health care was mainly caused by stigma and discrimination from healthcare staff 5 .…”

“…Sexual minorities are more vulnerable to underutilized health service, refusals of health care, and delayed or sub‐standard care 5 . Underutilization of needed health care was mainly caused by stigma and discrimination from healthcare staff 5 . These phenomena are probably due to the lack of training program or training course on LGBT health care for clinicians, especially those in specific departments, such as psychological medicine, psychiatry, infectious disease, dermatology, and venereology.…”