Health Care Stereotype Threat During the COVID-19 Pandemic Among Sexual and Gender Minority Individuals.

Abstract

Objectives. To determine the levels and differentials in health care stereotype threat experienced during the COVID-19 pandemic by individuals with sexual or gender minority identities. Methods. The National Couples' Health and Time Use Study is a national cross-sectional US population‒ based sample of partnered individuals interviewed during the pandemic between September 2020 and April 2021 with oversamples of sexual and gender minority individuals. The analytic sample consisted of 3614 individuals (n = 2043 heterosexual and n = 1571 sexual minority individuals along with 3489 cisgender and 125 noncisgender people). Results. Individuals with sexual minority identities experienced significantly more health care stereotype threat than heterosexual people. Cisgender women and those with another gender identity experienced significantly more health care stereotype threat than cisgender men. These results persisted after the inclusion of indicators of health conditions, insurance, COVID-19 experience, and sociodemographic factors. Conclusions. Gender and sexual minority‒identifying people reported high levels of worries about health discrimination. Our work suggests that providing positive health care experiences may reduce these worries and offer a potential antidote to sexual and gender minority health disparities that are driven by structural and interpersonal discrimination. These findings support calls for the further education and transformation of health care provision and systems. (Am J Public Health. Published online ahead of print January 16, 2025:e1-e9. https://doi.org/10.2105/AJPH.2024.307926).