Medicine, access, spirit, and survival: An intersectional look at concepts of health among a diverse sample of LGBTQ adults

Abstract

Research on lesbian, gay, bisexual, transgender/gender expansive, and queer (LGBTQ) health is dominated by disparities in disease, access, and risk behaviors. Such research is critical for examining the myriad factors that limit the lives of gender and sexual minorities. Few studies, however, have explored LGBTQ people's concepts of health. People's accounts of health are important, as they reveal insights into a person's relationship to the social world and are fundamental to accessing care. Semi-structured, in-depth individual interviews were conducted with a diverse sample of 40 LGBTQ-identified adults living in New York City, aiming to explore (a) how LGBTQ people conceptualize health, and (b) how participant constructions of health reflect personal, social, cultural, and political subjectivities as well as institutionalized discourses of health and illness. Through framework analysis, four primary themes were identified: (1) health as medicine; (2) health as mind-body-spirit; (3) health as survival; and (4) health as access. Implications for the health professions, including patient-centered care, shared decision-making, and provider training, are discussed.

Keywords

• Concepts of health
• Lay accounts of health
• Intersectionality
• LGBTQ people of color
• Disabled LGBTQ people
• Poor and low-income LGBTQ people