Background

A higher health burden in lesbian, gay, bisexual, trans/non-binary and queer (LGBTQ+) persons than in heterosexual and cis populations is documented internationally and in Switzerland. Young people are particularly affected. Due to specific needs and barriers to health care, LGBTQ+ specific health services have been established in Switzerland and elsewhere (e.g. Checkpoints). They have continuously expanded their range of services. In addition, universal services have to guarantee high-quality and effective treatment for all, and therefore follow an LGBTQ+ sensitive and inclusive approach to the treatment of LGBTQ+ people.

Aims

However, there are no studies in Switzerland on the pathways young LGBTQ+ people take in and through the health system, LGBTQ+ preferences for specific or universal services, nor LGBTQ+ expectancies and experiences of received services. It is also not known how LGBTQ+-specific services are defined and organised, how and whether LGBTQ+ sensitive approaches are maintained and practised in universal services (visible in structures, processes, professional actions, patient/client/professional interaction) and how the two types of services complement each other from a health system perspective and what gaps may still exist. Answering these questions is the focus of the current research project.

Method

In a low-threshold, participatory, mixed-methods research design involving LGBTQ+ people, cis heterosexual people, health professionals, organisational representatives, and government and policy actors, the pathways of LGBTQ+ young adults (18-25 years) in and through LGBTQ+ specific and universal outpatient services in German-speaking Switzerland will be assessed using electronic diaries, expert interviews, and organisational and service analysis. Data collection and analysis will be guided by the results of a secondary analysis of the Swiss LGBT Health Survey and sensitising concepts from health services research. Analyses will be conducted using qualitative structuring content analysis, descriptive statistical methods and participatory validation.

(Expected) Results

LGBTQ+ specific and universal care services for young LGBTQ+ people can, for the first time in Switzerland and internationally, be better understood from a holistic user, practitioner and organisational perspective. Jointly developed guidelines, cases and communities of practice will ensure immediate and sustainable implementation and impact.