“You have to do mental gymnastics to get any form of care”: How Two Spirit, lesbian, bisexual, trans, and queer women and gender-diverse people navigate racism and cisheterosexism in Canadian healthcare

Access to healthcare is impacted by a range of factors, including assumptions about gender, sexuality, and race that are reproduced on individual and systemic levels. In this paper we show how cisheterosexism and racism shape healthcare access for Two Spirit and racialized lesbian, bisexual, trans, and queer women and gender diverse people in Canada. Drawing on findings from a broader community-engaged qualitative study focused on health and healthcare access experiences and priorities, we elaborate on how participants experienced barriers to equitable healthcare access in the form of queer erasure and assumptions; medical gaslighting; and denial and delay of care; while engaging in multiple forms of labour as resistance to access health care. Analyzing these experiences through lenses of biopolitics, structural racism, and cisheterosexism, we argue that the labour Two Spirit and racialized lesbian, bisexual, trans, and queer women and gender diverse people engage in to access care is best characterized as survival practices , in the face of oppressive systems. • Racism and cisheterosexism impact healthcare access for multiply-marginalized groups. • These groups undertake considerable labour to access care, impacting health. • “Medical gaslighting” occurs with erasure of identities and denial of care.