The Nature of LGBT-friendly Healthcare in Lebanon: a comparative analysis of stakeholder experiences and perspectives Open Access

Chahine, Amanda (Spring 2018)

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Background: LGBT health is overall poor and progressively worsens with the lack of proper access to quality healthcare. Not much is known about the experiences or perspectives of the LGBT community in Lebanon. Additionally, literature that examines and addresses the disconnect between LGBT health stakeholders is lacking, and could provide a holistic and multidisciplinary scope to the improvement of LGBT healthcare.

Methods: We examined semi-structured interviews with three key stakeholders of LGBT health--five physicians, six activists, and nine LGBT patients (N = 20)--regarding their perspectives on Lebanese healthcare. Thematic analysis was used to look at the various interview responses and draw conclusions based on core and connective themes.

Results: According to participant responses, three main themes surfaced across groups: barriers to LGBT-friendly healthcare and their consequences, defining what LGBT acceptance in healthcare should look like, and the ways LGBT individuals experience healthcare in Lebanon. Overall, participants reported that two core connective themes gave context to and explained the nature of LGBT healthcare in Lebanon: lack of LGBT awareness among healthcare providers as well as the LGBT community exacerbate the health consequences of a non-LGBT-friendly system; and social factors heavily influence the barriers faced by LGBT patients as well as how they receive healthcare.

Conclusion: Activists, patients, and physicians alike call for Lebanese healthcare policy and reform that explicitly condemns discrimination in healthcare and implements LGBT-inclusive standards of care. There is a need for reform in graduate medical education to include specific training in LGBT health topics and treatment.

Table of Contents

Table of Contents

Abstract    3

Introduction    4

Glossary    5

Literature Review    7

Methods    14

Study Design & Context    14

Target Populations    15

Recruitment & Eligibility    15

Instruments & Data Collection Procedures    18

Plans for Analysis    22

Ethical Considerations    23

Risks & Benefits    23

Results    25

Primary Findings    25

Barriers to Healthcare    25

LGBT Healthcare Experience    30

Defining “LGBT Acceptance” in Healthcare    33

Connective Themes    34

Lack of LGBT Awareness    34

Social Factors    37

Discussion    41

Interpretations & Supporting Evidence    41

Limitations    45

Recommendations    46

Policy-Level    46

Institutional-Level    47

Interpersonal-Level    49

Conclusion/Future Implications    51

Appendices    52

References    55


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