(In)visibility of LGBTQIA+ people and relationships in healthcare: A scoping review

Abstract

Objective: To identify and map research into the visibility of LGBTQIA+ people and their relationships in healthcare, with the view to inform future research and practice. Method: Five databases were systematically searched for published and grey literature. Primary research reporting on visibility of LGBTQIA+ people in healthcare was included. Two reviewers independently screened the studies until an acceptable level of agreement was reached. A narrative synthesis was conducted and findings mapped to a taxonomy of microaggressions involving three sub-categories: microinsults, microassaults and microinvalidations. Results: The microaggressions identified included Microinsults: ‘Perception of health professionals’ knowledge and comfort’ and ‘Disclosure’; Microassaults: ‘Discrimination and stigma’; Microvalidations: ‘Accessing and navigating through services’, ‘Encounters of assumptions and stereotypes’, ‘Validating identities and including relationships’, and ‘Reading the environment’. Conclusion: Despite growing societal acceptance, microaggressions still exist within healthcare. Groups within LGBTQIA+ communities have varying levels of visibility in research and healthcare based on the studies included. Practice implications: The limited visibility of LGBT and lack of visibility of QIA+ people and their relationships in healthcare highlight the need to include the views of all LGBTQIA+ communities in research, and to ensure health professionals and clinical services are equipped to address this (in)visibility gap.