Lesbian and bisexual women’s experiences of health care: “Do not say, ‘husband’, say, ‘spouse’”

Dimensions of cisheteronormativity that influence healthcare utilization practices in LGBTQ+ populations: A systematic review

INTRODUCTION

Cisheteronormativity in healthcare settings may further exacerbate existing health disparities between LGBTQ+ and non-LGBTQ+ populations. The aim of the current review is to identify dimensions of cisheteronormativity that manifest in healthcare settings to influence healthcare utilization by LGBTQ+ individuals.

METHOD

8148 articles were screened, with 53 remaining for inclusion.

RESULTS

Thematic synthesis identified five themes linked to negative healthcare use: 1) Lack of Provider LGBTQ+ Knowledge, 2) Endorsements of Cisheteronormativity, 3) Assumptions of LGBTQ+ experiences and assumptions of non-LGBTQ+ identity, 4) Negation, and 5) Abuse of Power.

CONCLUSION

Findings emphasize the need for provider education regarding LGBTQ+ identities and the dismantling of cisheteronormative structures in healthcare.

Casual Social Contacts: A Qualitative Study of the Experience and Reaction

Introduction There is a growing concern in the field of public health about the rise in social isolation in the United States. Given the prevalence and the associated adverse outcomes of loneliness and social isolation, the need for effective interventions is critical. Emerging research demonstrates that "casual contacts" may be a valuable approach to curbing the effects of loneliness and social isolation. Casual contacts, also referred to as "weak ties," reflect interactions and relationships with others who are neither family nor friends. The purpose of this study was to examine five variables associated with casual contacts: (i) who the contact is with, (ii) the impact's valence (i.e., positive or negative), (iii) the duration of the impact, (iv) the nature of the positive impact/type of support received, and (v) the nature of the negative impacts. Methods Our study examines qualitative data from a recent survey of 547 community-dwelling adults about their casual contacts. We recruited a convenience sample of English-speaking adults living in the United States, using the online platform SurveyMonkey (http://www.surveymonkey.com). There were no selection criteria beyond (a) language and location and (b) the sample being generally balanced for age and gender. To identify themes, one researcher thoroughly examined the responses and noted recurring issues, then reexamined the responses with these preliminary themes in mind, and either eliminated or verified and defined them. Preliminary themes and their definitions were sent to a second researcher for review and revision. These two researchers developed coding instructions and then independently coded the first 25 responses to test interrater reliability (IRR) and establish agreement using the theme definitions. The final percent agreement was 96% across the five themes. Results Five themes were identified: (1) who was the casual contact with, (2) the valence of the impact, (3) the duration of the impact, (4) the nature of positive contacts, and (5) the nature of negative contacts. The results indicate that casual contacts are common and typically involve interactions with acquaintances who are coworkers, neighbors, cashiers/clerks, and mail/delivery persons. Respondents reported that these contacts typically have a positive impact on self-worth and/or sense of belonging and rarely involve instrumental or material support. The majority of respondents report a positive reaction to casual contacts that typically lasts for hours. A minority of respondents commented on negative experiences with casual contacts, some of which involved reports of disrespectful behavior by others, reactions related to their own social anxiety, or that involved feeling sad or anxious about the problems described by the other person. Conclusions These results suggest that casual contacts can be a powerful source of positive social interaction and support but that intervention development should be informed by the potential for negative impacts.

Occupational Therapists in Australia Vary in Their Knowledge, Skills and Clinical Practices to Meet the Health Needs of the LGBTQIA+ Community

This study assessed the knowledge, skills, and practices of occupational therapists in Australia regarding the LGBTQIA+ community's health needs. A cross-sectional online survey gathered qualitative data from 130 occupational therapists practicing in Australia. Most participants were women (85%), with 7% identifying as LGBTQIA+. The survey identified four key themes: Understanding LGBTQIA+ identities; Embedding affirming care in practice; Specific occupational therapy skills and practices, and Individual occupational therapist factors. Results indicated that while occupational therapists showed high attitudinal awareness, many lacked the necessary education and training to deliver inclusive care, highlighting a need for enhanced education in this area.

Same-sex mothers' experiences of equal treatment, parenting stress and disclosure to offspring: a population-based study of parenthood following identity-release sperm donation

STUDY QUESTION

What are the experiences of same-sex mothers following identity-release sperm donation regarding equal treatment in society, parenting stress and disclosure to child?

SUMMARY ANSWER

Mothers predominantly reported equal treatment in society, low levels of parenting stress and early disclosure of the donor conception to the child, and half of the couples had also informed the child of his/her right to obtain the donor’s identity.

WHAT IS KNOWN ALREADY

The number of two-mother families is increasing, and previous studies have reported about challenges related to heteronormativity, discrimination and the status of the non-birth mother. Same-sex mothers have been found to disclose the child’s donor conception earlier than different-sex parents, but little is known regarding disclosure of the child’s right to obtain identifying information about the donor.

STUDY DESIGN, SIZE, DURATION

The present study concerns the fourth wave of data collection of a nation-wide longitudinal study. A total of 143 same-sex mothers (73% response rate) following identity-release sperm donation completed individual surveys when their donor-conceived child had reached age 7. These women represent a total of 82 couples who had undergone sperm donation treatment.

PARTICIPANTS/MATERIALS, SETTING, METHODS

The study is part of the longitudinal Swedish Study on Gamete Donation (SSGD). Couples accepted for gamete donation treatment at seven Swedish University hospitals were recruited between 2005 and 2008 and were requested to complete postal surveys during four waves of data collection. The present study sample includes same-sex mothers who completed a survey when their donor-conceived child had reached 7 years of age. Data were collected with the Swedish Parenting Stress Questionnaire (SPSQ), and study-specific items on experiences of treatment in society and disclosure behavior. Group comparisons (birth mothers vs non-birth mothers) were conducted using Chi²-tests, independent t-tests and Mann–Whitney U-tests, and written comments provided for open-response items were analyzed by qualitative content analysis.

MAIN RESULTS AND ROLE OF CHANCE

The mothers were generally open about the child’s donor conception and the large majority (>80%) reported being treated positively and in the same way as other parents. However, satisfaction with treatment in health care settings was significantly lower than that reported in contacts with the child’s school and recreational activities (P < 0.001) and open-response comments indicate that this may be related predominantly to heteronormative language and assumptions. Birth mothers and non-birth mothers reported similar treatment in society and similar levels of parenting stress. All but one couple had already talked with their 7-year-old child about his/her conception with donor sperm. Half of the couples had also informed the child about his/her opportunity to obtain identifying information about the donor, and remaining couples planned later disclosure. Children’s reactions were generally described as neutral, positive or characterized by interest and curiosity.

LIMITATIONS, REASONS FOR CAUTION

The present study was performed within the context of the Swedish legislation on identity-release donation, which limits the generalizability to same-sex couples using anonymous or known sperm donors. Although no evidence of attrition bias was found, it is possible that those couples who initially declined participation in the SSGD (23%) or dropped out at the fourth wave of data collection (27%) differ from the study sample in terms of variables that we were unable to control for.

WIDER IMPLICATION OF THE FINDINGS

The present finding that most same-sex mothers in a population-based sample experience equal treatment in society is encouraging and validates previous results from predominantly qualitative studies. Nevertheless, the fact that a subgroup experiences discrimination and less favorable treatment indicates that further action is needed, particularly in child health care settings. The present study is the first to report on the timing of parents’ disclosure of the child’s right to identifying donor information and suggests that disclosure during preschool ages is feasible and does not appear to be related to negative consequences. In view of the increased availability and use of identity-release donation, there is a pressing need to investigate parents’ intentions, behaviors and needs with regard to talking with their child about his/her opportunity to obtain the donor’s identity.

STUDY FUNDING/COMPETING INTEREST(S)

Financial support from the Swedish Research Council (2013-2712) and the Swedish Research Council for Health, Working Life and Welfare (2014-00876). There are no conflicts of interest to declare.

TRIAL REGISTRATION NUMBER

N/A.

Alcohol and tobacco consumption among Australian sexual minority women: Patterns of use and service engagement

BACKGROUND

Sexual minority women consume both alcohol and tobacco at higher rates than heterosexual women. However, various sociodemographic and cultural factors associated with these practices among sexual minority women in Australia are not well understood, nor are the factors associated with seeking alcohol-related support.

METHODS

This study utilised data from cisgender sexual minority women respondents of Private Lives 3: a national, online, cross-sectional survey of the health and wellbeing of LGBTIQ adults in Australia aged 18+ conducted in 2019. Multivariable analyses were performed to identify co-existing smoking and alcohol use, sociodemographic factors associated with smoking, alcohol consumption and seeking alcohol-related support.

RESULTS

Of 2,647 sexual minority women respondents, 16.90% were currently smoking tobacco, 7.67% smoking tobacco daily and 60.50% reported potentially risky patterns of alcohol consumption. Tobacco and potentially risky alcohol consumption were found to frequently co-occur. Women who identified as queer were more likely than lesbian identifying women to currently smoke tobacco and to smoke tobacco daily. Tobacco consumption was associated with increased age, unemployment, low-mid range income and secondary-school education, while potential risky drinking was associated with living in outer urban or rural areas and being Australian born . Self-reporting having struggled with alcohol in the past twelve months was associated with residential location. Less than 3% of the sample has sought help for alcohol use. Seeking support was more likely as women aged, and with potentially risky drinking, and much more likely with self-perceived struggles with alcohol.

CONCLUSIONS

The findings highlight the need for future alcohol and tobacco use health promotion strategies focussing on sexual minority women to attend to within group differences that relate to risk of higher consumption. They also highlight the need for approaches that empower sexual minority women to self-identify when they are struggling with alcohol use and encourage seeking support with organisations that are affirming of sexual minority women.

Associations between heteronormative information, parental support and stress among same-sex mothers in Sweden-A web survey

Aim

The aim was to investigate same‐sex mothers’ self‐assessed experiences of forming a family, and the association between heteronormative information, parental support and parenting stress.

Design

A quantitative, cross‐sectional study.

Methods

In a web survey conducted in Sweden in 2019, same‐sex mothers (N = 146) with a child aged 1–3 years answered questions about their experiences of forming a family through assisted reproduction and questions about parenting stress. Descriptive statistics describes the process of forming a family. Pearson's correlation analyses and independent sample t tests were used to test hypotheses about heteronormative information, parental support and parenting stress.

Results

Same‐sex mothers experienced going through assisted reproduction treatment as stressful, and parental groups as not being supportive. Heteronormative information correlated with both lower perceived parental support and higher perceived parenting stress. Non‐birth mothers experienced less acknowledgement and support than birthmothers.