1. Introduction

Chapter Summary

Individuals who are SGM are more likely to suffer from health disparities than heterosexual and cisgender people, including poorer mental health, substance misuse, sexually transmitted infections, and other conditions that are often first identified in primary care.

Health disparities among SGM people are linked to minority stress, which happens when people experience stigma and discrimination in their daily lives because of their minority identities, including at work and in public places and healthcare settings. These experiences can be harmful to health.

Providers and staff who work in the healthcare field may harbor negative attitudes and beliefs about SGM people. Many are not trained to provide quality care to members of this population.

SGM people face numerous challenges to getting primary care services and sometimes avoid seeking care altogether because they worry that they will not be treated well.

Primary care clinics have roles to play in ensuring that SGM people benefit from equitable access to care, meaning that all patients can safely seek and receive services that are responsive to who they are as a person, including their unique needs as an SGM individual.

Included in this Chapter: An overview of SGM health disparities and their causes, followed by an orientation to the toolkit and a process model to guide clinic-based organizational change efforts.