Health Care Experiences Among LGBTQ+ Adults: A Qualitative Systematic Review and Meta-Synthesis

Background: LGBTQ+ (lesbian, gay, bisexual, transgender, and queer) adults often face multilayered discrimination, structural barriers, and cultural exclusion in health care settings that limit their access to care and adversely affect their health outcomes. However, comprehensive syntheses of their health care experiences remain limited. Purpose: This study was designed to systematically synthesize the health care experiences of LGBTQ+ adults in formal care settings using the Joanna Briggs Institute’s meta-synthesis approach, with a focus on their stressors, care-related challenges, and identity negotiations. These experiences were then interpreted through the lens of the Minority Stress Model to deepen the understanding of health care providers of the primary structural stressors and their implications in health care. Methods: A qualitative systematic review and meta-aggregation were conducted following the Joanna Briggs Institute (JBI) methodology. Chinese and English databases were searched, and studies were screened, appraised, and synthesized using standard JBI procedures and a ConQual confidence assessment. Results: Twenty-three qualitative studies were included, yielding 70 findings, 15 categories, and 7 synthesized findings. Key themes identified included heteronormative assumptions, internalized stigma, identity concealment, structural inaccessibility, health care alienation, and care withdrawal. Conversely, affirming care environments and formal/informal social support were identified as enhancing patient trust and identity empowerment. Conclusions: LGBTQ+ patient experiences reflect structural stress and intersectional inequities in the health care they receive. Structural reforms in clinical practice, health policies, and professional education are needed to promote culturally sensitive, equity-oriented care for LGBTQ+ populations.