Sexual Orientation-Based Discrimination in US Healthcare and Associated Health Outcomes: A Scoping Review

Introduction Sexual minorities may experience sexual orientation-based discrimination in healthcare settings, and recent literature has aimed to explore this phenomenon. However, the findings of related literature and their implications have never been reviewed. Methods A scoping review was conducted to identify the breadth of this literature, summarize findings, and appraise the tools being used to study perceived discrimination in healthcare. PubMed and Web of Science databases were searched for relevant literature published between 1992 and 2022. After duplicates were removed, the search yielded 3,467 results. After removing articles that did not meet inclusion criteria, fifty-eight papers remained and were assessed via full-text review for eligibility. Ultimately, twenty studies were determined to meet study criteria and were included in the present review. Results Articles published on sexual orientation-based perceived discrimination in US healthcare settings are fairly limited and vary in approach. Measures being used vary widely across studies and generally lack psychometric grounding; common issues include using single-item measures, adapting existing measures without validating them for use in sexual minority samples, and using measures that are not based in underlying theory or informed by existing research. Perceived discrimination in healthcare was inversely associated with some healthcare utilization behaviors. Conclusions Future research should use psychometrically evaluated instruments for studying perceived discrimination in healthcare due to sexual orientation. Policy Implications Culturally competent policies that promote equitable care for sexual minorities are crucial for reducing discrimination in healthcare.