Care of the Sexual or Gender Minority Community Living with Cystic Fibrosis: A Survey of United States and Canadian Multidisciplinary Health Care Providers

Abstract

PURPOSE: Lesbian, gay, bisexual, transgender, queer, intersex, asexual, or another sexual or gender minority (LGBTQIA+) people face health inequities and commonly report health care avoidance. We examined how multidisciplinary subspecialist providers care for LGBTQIA+ people with pediatric-onset chronic conditions, using cystic fibrosis (CF) as a model. METHODS: We conducted a survey of United States and Canadian CF providers regarding their LGBTQIA+ health knowledge, attitudes, comfort, and practices from January-September 2024. We analyzed results descriptively and compared responses by key variables using chi-square tests. RESULTS: Among 389 participants, 15% felt that there are only two genders and 6% reported discomfort working with LGBTQIA+ people based on personal beliefs. Nearly all (87%) agreed that asking about gender identity and sexual orientation is important to health care. Thirty percent felt unprepared to discuss concerns related to sexual orientation or gender identity, and 86% felt that they would be a better clinician if they had more training on supporting LGBTQIA+ people. Fifty-one percent reported asking their CF patients about their sexual orientation, 57% about their gender identity, and 73% about their affirmed name/pronouns. Forty-three percent of U.S. and 20% of Canadian respondents reported receiving training on supporting LGBTQIA+ people. CONCLUSION: CF providers valued addressing LGBTQIA+ health but lacked expertise, training, and resources to routinely do so. Future research should explore the experiences and health outcomes of LGBTQIA+ people with CF and develop needed provider education.