The influence of care continuity and disclosure of sexual orientation in general practice on lesbian, bi+ and queer cisgender women’s engagement with mental health services

Abstract

Background. Lesbian, bisexual+ and queer (LBQ+) cisgender women have considerable unmet mental health needs. The aims of this study were to examine LBQ+ cisgender women’s prior engagement with general practitioners (GPs), and how this relationship shaped their mental health service use. Method. Data from 2707 cisgender LBQ+women were drawn from a national survey of adults who are lesbian, gay, bisexual, trans, intersex, queer or questioning, asexual and other diverse sexuality and gender identities (LGBTIQA+) in Australia. Multivariable logistic regression analyses examined demographic predictors of continuity of care with GPs and GPs’ awareness of LBQ+ women’s sexual orientation. The relationship between these variables and recent mental health service use was then analysed, comparing LBQ+ women’s engagement with services known to be LGBTIQA+ inclusive and those without an inclusive reputation. Results. LBQ+ cisgender women with a regular GP had greater odds of having accessed mental health services in the last 12 months. Two-thirds had a regular GP, with the lowest odds among women aged 18-35 years and highest odds among women with a disability. LBQ+ women who did not believe their regular GP knew of their sexuality had lower odds of having accessed LGBTIQA+ inclusive mental health services. These| individuals were typically aged below 25 years, bisexual+ or queer identified, had below undergraduatelevel education, earned