Almost all lesbian and queer-identified women who participated in a Manitoba study reported experiencing homophobia or transphobia when accessing health-care services in the province.
The University of Manitoba's Deborah McPhail, who trains medical students in LGBT health care, and Claudyne Chevrier, a graduate student in community health sciences, conducted the study in 2015.
It involved interviewing more than 40 women in Winnipeg, asking questions about how participants' sexual and gender identities impacted their health-care experiences.
Overall, the study found that mandatory training for all health-care staff — everyone from doctors to receptionists — is necessary in health-care facilities in the province and beyond.
While some women reported positive experiences while seeking health care, almost all participants reported homophobia or transphobia.
There were also other forms of discrimination, including sexism and racism, McPhail said.
"Sometimes these experiences were quite overt," she said.
"One participant had Bible verses read to her by a doctor who told her she was 'unclean.'"
Most reports described covert discrimination, however.
"Many people talked about how health-care practitioners would not look them in the eye, seemed flustered by them or just generally communicated through body language that they were uncomfortable," McPhail said.
Direct impact on health care
Participants in the study reported avoiding emergency rooms or clinics where they had been mistreated. This directly impacted their health care, McPhail said.
Others put off going to the doctor for fear of discrimination and there were cases where women were misdiagnosed — or not diagnosed at all — because those treating them lacked understanding about queer women's realities and identities, she said.
"[Participants described] walking into a clinic and the practitioner would be so uncomfortable with the person, which the patient perceived as being about homophobia, that they tried to get that person ot of their clinic as quickly as possible," McPhail said.
"It led to a lack of diagnosis."
Need for safe spaces
Another of the study's strong messages was that in Winnipeg, there is a need for safe clinical spaces for LGBT people, McPhail said.
"One of the things people talked about a lot was about how health-care environments could be improved," she said.
"One particularly interesting thing was that people were disturbed or put off by religious iconography such as crosses in hospitals and clinics."
McPhail said the discomfort arises from "historical and ongoing disdain of LGBTQ people preached by many Christian denominations."
Still, there is a way to reconcile religious views with treating patients who are LGBT, McPhail said.
"You can still be religious and open to all people's sexual practices. That's where the training comes in," she said.
"A good way to communicate that you've had that training would be to put up a positive space sticker, which could go right beside your cross."