Reviewing challenges in access to oral health services among the LGBTQ+ community in Indiana and Michigan: A cross-sectional, exploratory study

Abstract

Objective: In healthcare settings, lesbian, gay, bisexual, transgender, and queer (LGBTQ+) populations often experience discrimination, leading to decreased healthcare services utilization. In this study we have tried to identify oral healthcare providers (OHP)'s perceptions toward LGBTQ+ patients, perceived barriers for LGBTQ+ patients in accessing oral health services, and whether they were open to inclusive oral healthcare practices. In addition, the experiences of LGBTQ+ patients in oral healthcare settings including their oral healthcare seeking behaviors and beliefs were also explored. Methods: Descriptive, quantitative surveys were administered to OHPs and LGBTQ+ patients within Indiana and Michigan. Surveys contained questions about participant demographics, including gender and sexual minority status, and the presence of inclusive healthcare practices within the oral healthcare settings. Descriptive analyses and regression modeling were used to explore the distribution of participant responses and to identify predictors associated with patient comfort and OHP's attitudes toward LGBTQ+ patients. Results: Overall, 71% of LGBTQ+ patients reported regularly attending dental appointments; however, 43% reported feeling uncomfortable going to appointments and 34% reported being treated unfairly during appointments because of sexual orientation. Among OHPs, 84% reported that the healthcare settings where they practiced were welcoming for LGBTQ+ populations and 84% reported willingness to improve LGBTQ+ care. The presence of inclusive healthcare practices predicted comfort for LGBTQ+ patients (P < 0.10). Additionally, OHPs who either identified as an ally or as having a family member or close friend in the LGBTQ+ community had higher odds of feeling responsible to treat LGBTQ+ patients. Conclusion: Many LGBTQ+ patients often experience discomfort in oral healthcare settings. While OHPs were largely unaware of this, evidence suggests the need for cultural competency training for OHPs.