Barriers Faced by Sexual and Gender Minority Patients with Chronic Skin Conditions

Original Article: Barriers to Care Among Sexual and Gender Minority Individuals With Chronic Inflammatory Skin Diseases in the US

What are the key takeaways of this article?

A recent study published in JAMA Dermatology delves into the healthcare disparities experienced by Sexual and Gender Minority (SGM) patients with Chronic Inflammatory Skin Diseases (CISDs) in the United States. Analyzing extensive data from almost 20,000 participants from the All of Us Research Program, the authors shed light on the prevalent cost and non-cost barriers encountered disproportionately by SGM compared to non-SGM patients.

SGM patients with CISDs, especially those identifying as non-Hispanic Black or Hispanic/Latino, faced significant delays in accessing specialist and mental health care, with cost being a substantial deterrent. For instance, SGM patients were 1.23 times more likely to delay specialist care, and 1.62 times more likely to delay mental health care due to cost implications compared to their non-SGM counterparts. Non-cost barriers were equally impactful, with SGM patients often postponing care due to transportation issues and a lack of healthcare practitioners who shared their background in terms of race, religion, language, sexual orientation, and gender identity.

The intersectionality of race, gender identity, and sexual orientation was particularly stark, with non-Hispanic Black and Hispanic/Latino SGM patients experiencing heightened barriers, reflecting the compound inequalities and systemic issues prevalent in the healthcare system. This study brings attention to the urgency of addressing these disparities through enhanced diversity and cultural competence within the medical community, promoting culturally responsive care, and advocating for changes at the systemic level to ensure equitable access to healthcare.

Socioeconomic status was another determinant, often exacerbating the barriers to healthcare access. Interestingly, the lack of diversity among healthcare practitioners was highlighted as a significant reason for the delay in seeking care, emphasizing the crucial need for increased representation and inclusivity in the field of medicine, especially dermatology.

While the study offers profound insights, it also acknowledges its limitations such as the potential non-representativity of the sample and the general applicability of the findings beyond dermatological care. However, it undeniably serves as a pivotal catalyst for discussions and reforms aimed at diminishing the multifaceted barriers faced by SGM patients in accessing healthcare, urging medical practitioners and policymakers to act promptly and effectively.

Publication Date: October 15th, 2023

Reference: Nock MR, Kamal K, Zampella JG, Roberson ML, Cohen JM, Barbieri JS. Barriers to Care Among Sexual and Gender Minority Individuals With Chronic Inflammatory Skin Diseases in the US. JAMA Dermatol. Published online September 27, 2023. doi:10.1001/jamadermatol.2023.3328

Summary by: Parsa Abdi