Date Presented 04/21/2023

Sexual and gender minorities with a disability have significantly higher rates of health care discrimination than those without. Understanding such disparities can help OT practitioners promote occupational justice and health equity.

Primary Author and Speaker: Kelsey A. Gately

Contributing Authors: Allyson Baker, Monique Dawes, Jennifer Swanberg, Samantha Rosenthal

This study examines the relationship between disability status and healthcare discrimination among sexual and gender minorities (SGMs) through the lens of minority stress and occupational justice. The IRB-approved Health of Sexual and Gender Minorities Study’s cross-sectional digital survey was conducted February-March 2022 using a sample of 1,330 adult SGMs living in the US recruited from Reddit. Participants entered a raffle of 6 $100 gift cards. Sexual and gender identity, disability status (none, visible, invisible), frequency and type of healthcare discrimination (adapted Everyday Discrimination Scale), and demographics were measured. Data from n = 902 participants who reported identity-based healthcare discrimination were described by demographics and disability status, and multivariable linear regression was conducted on log-transformed healthcare discrimination score. The full sample was described by types of healthcare discrimination experiences and disability status. Disability status varied by sexual and gender identity (p = 0.007), and the mean healthcare discrimination score varied by disability status (p < 0.001). Having a visible disability and having an invisible disability were independently associated with a significant increase in log-transformed healthcare discrimination score (β = 0.25, 95% CI: 0.19, 0.32 and β = 0.16, 95% CI: 0.11, 0.20, respectively). Among all participants, 53.5% (n = 711) reported having a disability. Those with any disability were significantly more likely to have experienced all types of healthcare discrimination (p < 0.001), such as unnecessary physical exams or denial of medical testing. SGMs with disabilities, particularly visible disabilities, are at significantly higher risk for healthcare discrimination than SGMs without. Understanding this association is vital for occupational therapy practitioners to promote health equity, facilitate occupational participation, and further research efforts (AOTA, 2020; Ayhan Balik et al., 2020).


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