Qualitative analysis reveals insights from clinicians providing care for LGBTQ+ individuals, suggesting a need for systemic changes.
Aim To explore how nurse practitioners and physicians providing primary care for LGBTQ+ people experience and make sense of their practice. Design Qualitative study using Interpretative Phenomenological Analysis. Methods In‐depth, semi‐structured interviews were conducted with 12 clinicians (four nurse practitioners, eight physicians) working in LGBTQ+‐focused primary care across diverse U.S. regions. Interviews were online, audio‐recorded via Zoom, and lasted 50–90 min. Reflexive notes were maintained. Analysis followed Smith and Nizza's six‐stage Interpretive Phenomenological Analysis (IPA) process from close reading to experiential statements, clustering to personal experiential themes, development of group experiential themes, and synthesis, supported by memoing and peer debriefing. Results Four Group Experiential Themes: (1) Belonging, Affirmation, and the Power of LGBTQ+‐Centred Spaces: clinicians practised as their full selves and modelled culturally safe care; (2) Personal Pain as Professional Purpose: personal histories of marginalisation informed a reparative ethic that fostered empathy, trust, and safety; (3) Expanding the Boundaries of Health Work: care routinely extended beyond clinic walls to advocacy, harm reduction, administrative support, and navigation of social determinants amid political precarity; (4) Resistance Within Broken Systems: persistent, invisible labour was required to navigate heteronormative and cisnormative infrastructures. Conclusion LGBTQ+‐focused primary care operates as clinical practice and social justice work. Clinicians translate lived experience into reparative, relational care while constantly negotiating systemic constraints and policy volatility. Implications for the Profession and/or Patient Care Embed LGBTQ+‐affirming competencies and reflexivity in education; redesign digital/administrative systems for affirmed names/pronouns and streamlined access; resource and protect services and staff wellbeing in hostile policy climates. Impact Problem : Persistent inequities and under‐recognised experiential labour in LGBTQ+ primary care. Main Findings : Belonging and affirmation; reparative ethic; expanded health work; daily systemic workarounds. Impact Audience : Nurses, physicians, educators, leaders, and policymakers. Reporting Method : COREQ. Patient or Public Contribution No Patient or Public Contribution.
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Gilmore et al. (2026) studied this question.
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