“I didn’t come here for your judgement” alongside “they understand you and encourage you”: Exploring the narratives of young black and mixed-race LGBTQ+ people who have a physical health condition and their experiences within physical health services

Abstract

Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ+) individuals experience health inequalities. Young people living with a health condition are also more likely to experience adverse mental health outcomes. Developing positive identity can help to mitigate the impact of this. Young black LGBTQ+ people have additional barriers to developing positive identity. Current research rarely considers the intersection of these identities for young people despite the discrimination they may face, and the impact this may have on their health. A narrative approach allows these voices to be heard in research. Eight participants were interviewed using a narrative approach. Interviews were analysed using content and thematic narrative analysis. Global summaries of each interview were developed and ‘plot lines’ emerged from these. A central plot related to identity development, with two plots embedded in these exploring experiences of illness and of healthcare. Participants had positive experiences of healthcare despite encountering stigma. Access to positive role models and being able link in with various communities allowed participants to integrate and accept their identities. A key discussion point in this study is the ways in which healthcare staff could become role models for young LGBTQ+ people and help them to integrate and accept their identities.

Plain language summary

Young LGBTQ+ people can experience discrimination which can impact on their health, including preexisting health conditions. Having a positive identity can help young people to be more resilient in the face of these difficulties. Current research has rarely given young black and mixed-race LGBTQ+ people with a physical health condition an opportunity to share their stories and explore their identity. Eight young people were interviewed using a narrative approach, which allowed them an opportunity to tell their whole life story. Shared plot lines emerged from the young people's life stories about identity development, experience of illness, and experiences of healthcare. The young people had all had positive experiences of healthcare staff as well as some negative experiences of discrimination. It was important to the young people to have positive role models who supported their identity and access to supportive communities. This study suggests that healthcare staff could be suited to become positive role models for the young people they care for.