Enhancing Health Care Experiences for Racially Diverse, Lesbian, and Bisexual Older Women: Insights on Perceived Inclusivity and Equity

Patient-clinician communication and experiences of lesbian, gay, bisexual, transgender, and queer (LGBTQ+) older adults, particularly lesbian and bisexual (LB) women, in health care settings have historically been fraught with challenges, including discrimination and lack of inclusivity. This qualitative study, employing a community-based participatory research approach, aimed to explore the experiences and recommendations of LB older women and their chosen care partners in the Deep South. Two focus groups conducted over Zoom revealed seven recurring themes and three sub-themes, highlighting crucial aspects of health care delivery. Themes included the importance of initial interaction, collaboration with patients, effective communication, extended patient-doctor time, equitable treatment, training on bedside manner and self-awareness, and addressing disparities within the health care system. Findings underscore the significance of patient-centered care, shared decision-making, and recognition of patient values in improving health care experiences and outcomes for LGBTQ+ older adults, particularly LB women. Findings highlight the crucial role of initial interaction in fostering trust and cooperation, collaboration in decision-making processes, and allocating adequate time for comprehensive care delivery. Effective communication strategies, including thorough explanation of medical processes, inclusive language, and patient-centered communication, emerged as vital components. The study underscores the significance of recognizing diverse identities and intersectional experiences, particularly for African American LB older women, and advocates for promoting inclusive health care practices to improve health equity and patient satisfaction. Implementing these insights into clinical practice and policy development can lead to more inclusive health care environments tailored to the needs of LB older women.