Sexual Health Concerns and Health Care Experiences of LGBTQ+ Patients with Inflammatory Bowel Disease

Background Sexual dysfunction is common among patients with inflammatory bowel disease (IBD). For lesbian, gay, bisexual, transgender, or queer (LGBTQ+) patients, these challenges may be compounded by health disparities related to sexual health, stigma, and fear of discrimination in the clinical setting. There has been little research related to sexual health and IBD among this patient demographic. Methods Patients with IBD who receive care at Massachusetts General Hospital and the Brigham and Women’s Hospital were invited to participate in a 4-part survey on sexual health via an electronic patient portal messaging system and outpatient clinic flyers. Patients from the broader IBD community were invited to participate via social media outlets. Demographic data, IBD disease characteristics, and information related to health care experiences and interactions with IBD providers were collected. Sexual history information was obtained using an adapted version of the IBD-Specific Sexual Dysfunction Scale. Results In total, 340 patients completed the survey, of which 20.3% (n = 69) identified as LGBTQ+. The majority of patients (75%, n = 255) reported distress in their sexual life due to IBD; however, only 5% (n = 17) of respondents had previously discussed the topic of sexual health with their IBD provider. One in 4 LGBTQ+ patients listed fear of discrimination as a source of discomfort in these discussions, and a similar proportion expressed uncertainty regarding whether their sexual and/or gender identity negatively impacted their IBD care. Conclusions Further research and enhanced provider awareness of sexual health challenges related to IBD among LGBTQ+ patients may serve as an important step toward advancing inclusive and culturally sensitive care for this patient population.