Conectar
To explore how nurse practitioners and physicians providing primary care for LGBTQ+ people experience and make sense of their practice.
Qualitative study using Interpretative Phenomenological Analysis.
In-depth, semi-structured interviews were conducted with 12 clinicians (four nurse practitioners, eight physicians) working in LGBTQ+-focused primary care across diverse U.S. regions. Interviews were online, audio-recorded via Zoom, and lasted 50–90 min. Reflexive notes were maintained. Analysis followed Smith and Nizza's six-stage Interpretive Phenomenological Analysis (IPA) process from close reading to experiential statements, clustering to personal experiential themes, development of group experiential themes, and synthesis, supported by memoing and peer debriefing.
Four Group Experiential Themes: (1) Belonging, Affirmation, and the Power of LGBTQ+-Centred Spaces: clinicians practised as their full selves and modelled culturally safe care; (2) Personal Pain as Professional Purpose: personal histories of marginalisation informed a reparative ethic that fostered empathy, trust, and safety; (3) Expanding the Boundaries of Health Work: care routinely extended beyond clinic walls to advocacy, harm reduction, administrative support, and navigation of social determinants amid political precarity; (4) Resistance Within Broken Systems: persistent, invisible labour was required to navigate heteronormative and cisnormative infrastructures.
LGBTQ+-focused primary care operates as clinical practice and social justice work. Clinicians translate lived experience into reparative, relational care while constantly negotiating systemic constraints and policy volatility.
Embed LGBTQ+-affirming competencies and reflexivity in education; redesign digital/administrative systems for affirmed names/pronouns and streamlined access; resource and protect services and staff wellbeing in hostile policy climates.
Problem: Persistent inequities and under-recognised experiential labour in LGBTQ+ primary care. Main Findings: Belonging and affirmation; reparative ethic; expanded health work; daily systemic workarounds. Impact Audience: Nurses, physicians, educators, leaders, and policymakers. Reporting Method: COREQ.
No Patient or Public Contribution.
FreshRSS 