P4907 - A National Representation of Patient Perspectives of Digestive Healthcare Among Sexual and Gender Minority Individuals

Jenna Clukey, BA¹, Alexander Goldowsky, MD², Taylor Boyd, MD³, Christopher Brokus, BA⁴, Andrew Suchan, MD⁵, Muhammad Adnan Haider, MD⁶, Rhea W. Teng, BS⁷, Christopher Velez, MD^3
1Center for Neurointestinal Health, Massachusetts General Hospital, Boston, MA; ²Beth Israel Deaconess Medical Center, Harvard Medical School, Jamaica Plain, MA; ³Massachusetts General Hospital, Boston, MA; ⁴Massachusetts General Hospital, Harvard Medical School, Jamaica Plain, MA; ⁵Johns Hopkins University School of Medicine, Baltimore, MD; ⁶Florida Atlantic University, Charles E. Schmidt College of Medicine, Boca Raton, FL; ⁷Massachusetts General Hospital, Harvard Medical School, Boston, MA

Introduction: Health inequities are present in the sexual and gender minority communities (SGM), as well as increased risk for adverse social determinants of health such as prior trauma and decreased healthcare access. Little is known about the patient experience surrounding gastroenterology-specific disparities and barriers to care. We describe a semi-structured interview study of SGM patients across the United States to assess barriers and solutions to accessing gastroenterology care.

Methods: Patients that identified as SGM and had a gastrointestinal disorder were recruited from a random sample of 18 states using United States census regions (2 states per region, 1 patient per state), as well as 8 patients from our home institution. Participants underwent a 30-minute semi-structured interview about digestive healthcare barriers in the SGM community. Interviews were transcribed using TranscribeMe and coded using constant comparative method of iterative data acquisition in NVivo 14.0.

Results: Twenty-six patients were interviewed. Participants included 2 transgender men, 2 transgender women, 4 cisgender men, 8 cisgender women, 9 non-binary persons, and 1 who identified as something else. Patients reported wanting to seek care at institutions where inclusive language, correct names and pronouns were used, and where patients felt providers listened to their concerns. Negative experiences patients reported included experiencing bias based on gender identity, providers using incorrect names and pronouns, and not being believed due to being assigned female at birth. They also reported differences in bias based on the region in which they live and whether their healthcare facility had a religious affiliation. Ideas to improve SGM digestive healthcare included improved provider education on SGM digestive health and having conversations about GI symptom impact on sexual health.

Discussion: A national sample of SGM patients demonstrates regional differences in bias SGM patients face when seeking digestive healthcare, while other barriers remain consistent across geographic location. Patients agree that improved provider education on SGM digestive health and a positive open relationship with the provider can lead to better healthcare experiences for SGM patients. This supports enacting educational interventions in order to improve SGM-related digestive health. Thematic saturation was not achieved, and we are continuing recruitment for this study.


Disclosures:


Jenna Clukey, BA¹, Alexander Goldowsky, MD², Taylor Boyd, MD³, Christopher Brokus, BA⁴, Andrew Suchan, MD⁵, Muhammad Adnan Haider, MD⁶, Rhea W. Teng, BS⁷, Christopher Velez, MD³. P4907 - A National Representation of Patient Perspectives of Digestive Healthcare Among Sexual and Gender Minority Individuals, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.