Co‐producing knowledge of lesbian, gay, bisexual, trans and intersex (LGBTI) health‐care inequalities via rapid reviews of grey literature in 27 EU Member States

Abstract

Background The health inequalities experienced by lesbian, gay, bisexual, trans and intersex (LGBTI) people are well documented with several reviews of global research summarizing key inequalities. These reviews also show how the health‐care needs of LGBTI people are often poorly understood whilst suggesting that targeted initiatives to reduce inequalities should involve LGBTI people. Objectives To determine what is known about the health‐care inequalities faced by LGBTI people? What are the barriers faced by LGBTI people whilst accessing health care, and health professionals when providing care? What examples of promising practice exist? Design Rapid reviews of grey literature were co‐produced with LGBTI people in 27 countries followed by a thematic analysis and synthesis across all data sets. The review included grey literature from each country that might not otherwise be accessible due to language barriers. Main results Rapid reviews showed that LGBTI people faced various inequalities and barriers whilst accessing health care. Where heterosexuality, binary gender and assumed male/female sex characteristics were upheld as the norm, and where LGBTI people differed from these norms, discrimination could result. In consultations where LGBTI people feared discrimination and did not disclose their LGBTI status, health professionals lacked the information required for appropriate assessments. Conclusion With greater understanding of sexual orientation (LGB people), gender identity (trans people) and sex characteristics (intersex people), combined with access to contemporary knowledge and training, health professionals can work in collaboration with researchers, policymakers and LGBTI people to develop systems that are better attuned to the needs of all service users.

A Systematic Review of the Health and Healthcare Inequalities for People with Intersex Variance

“…Where this is unattainable and LGBTI research includes people with intersex variance, their goals should be actively prioritised in the research [ 4 ]. Co-producing research with peers who have experiential knowledge and lived experience should be a priority, by involving people with intersex variation at every level from conception, design to undertaking the research [ 2 ]. This kind of research should co-constitute materiality with more intersubjective methodologies and ethically accountable healthcare practice.…”

“…Recent global public health research reflects significant health inequalities for lesbian, gay, bisexual, trans and intersex (LGBTI) people compared to the general population. Large scale international reviews collating these research findings include studies of LGBTI health inequalities [ 1 , 2 ], the disease burden in gender and sexual minorities [ 3 ], intersex health [ 4 ], the global health burden and needs of transgender populations [ 5 ], the health profile of sexual minority women [ 6 ], and more recently, loneliness and social support in older LGB communities [ 7 ]. These studies share a common denominator of an increasing concern over how diverse identities and bodies intersect and experience health inequalities in LGBTI populations.…”

“…Health professionals commonly accept male/female binary sex as a norm and express surprise when they learn of intersex variance [ 14 ], but feel unsure of how to accommodate the specific health needs of these individuals. Their health needs are often poorly understood by health professionals due to limited knowledge and understanding [ 2 ]. Opportunities for learning are inadequate as people may avoid disclosing their intersex variance mostly out of fear of curiosity or comments of health professionals [ 4 , 20 ].…”

Identification and Reporting of Patient and Public Partner Authorship on Knowledge Syntheses: Rapid Review

“…In others, they were identified as members of a panel or advisory council. Some studies identified partner as members of a panel or advisory group; in 11% (n=4) of the articles, a panel or other body was named as an author rather than individual contributors [14,[33][34][35]. Finally, in 27% (n=10) of articles, it was either impossible or difficult to tell whether an author was a partner solely from the affiliation, and confirmation was found elsewhere in the article.…”

“…Recognizing partners as authors indicates that they had substantial involvement in the research; however, partners may not accept or receive authorship for various reasons. For instance, the authors may want to preserve their anonymity, as was noted in the review by Sherriff et al [35], where the coauthor was a collective entity (Health4LGBTI Network) and individuals were not named. Furthermore, many health journals require authors to meet the 4 ICMJE criteria, and some partners may be unable or unwilling to fulfill all of these criteria [66,67].…”