Stigma, medical gaslighting, and heterosexism: barriers to accessing healthcare and diagnosis in LGBTQ+ people with endometriosis symptoms

On average it takes around 9 years to get an endometriosis diagnosis, but there is limited research that explores why this delay occurs for LGBTQ+ people who may have unique healthcare needs. 133 LGBTQ+ people with endometriosis symptoms answered open-ended text questions via an online questionnaire. Using qualitative content analysis, 23 barriers were identified. Medical gaslighting, limited diagnosis and treatment options, and the normalisation of symptoms were most frequently mentioned. Seven barriers were LGBTQ+ specific, including assumptions made about patients’ sexuality and the healthcare needs of people in same-sex relationships. The Social Ecological Model demonstrated that barriers occurred across the domains, with the majority categorised at the interpersonal level. Therefore, interventions to reduce the delay should not only target patients’ ability to access care but also consider focusing on the wider social structures that influence interactions in healthcare settings. Wider implications for LGBTQ+ sensitive endometriosis care are discussed.