Homophobic Hostility by Healthcare Providers and Mental Health Outcomes in LGBTIQ+ Patients

Abstract Introduction According to the Pan American Health Organization, ensuring equity in healthcare is essential. Medical professionals play a key role in achieving this through the quality and inclusiveness of the care they provide. Objectives To assess the association between homophobic hostile behaviors by healthcare providers and the development of depression, anxiety, and stress in LGBTIQ+ patients. Methods A prospective cross-sectional study was conducted from August to December 2024, including LGBTIQ+ individuals aged 18 or older residing in Veracruz, Mexico, who had attended a medical consultation within the past year. The independent variable was the experience of homophobic hostile behavior during healthcare encounters. Dependent variables were depression, anxiety, and stress, assessed using the DASS-21 scale. Statistical analyses were performed using SPSS v27, including odds ratios (OR), 95% confidence intervals (CI), and significance set at p < 0.05. Results Thirty-one LGBTIQ+ participants were included. Depression prevalence was 93.54%, anxiety 80.64%, and stress 80.64%. Reporting ‘hostile responses from a healthcare provider during a consultation’ was significantly associated with depression (OR 6.2, CI 1.4-27.3). However, reporting ‘inappropriate or derogatory language from a provider due to sexual orientation or gender identity’ and ‘non-verbal expressions of rejection by a provider’ were not significantly associated with depression, anxiety, or stress (p > 0.05). Conclusions Verbal hostility from healthcare providers toward LGBTIQ+ individuals increases the risk of depression, underscoring the urgent need for inclusive and respectful healthcare practices. Key messages • Verbal hostility from healthcare providers increases depression risk in LGBTIQ+ patients, highlighting a gap in inclusive care. • Promoting respectful, non-discriminatory care is essential to reduce mental health disparities in sexual and gender minorities.