Table 2.

The studies viewing healthcare from the perspective of SGM youth

Reference	Country	Study aim	Design	Study sample	Method/s	Key findings	Quality score with MMAT (%)
Scherzer (2000)	United States	Examine young lesbian and bisexual women’s constructions of health and their lived experiences focused on the medical healthcare interactions	A qualitative descriptive study	Lesbian and bisexual women aged 18–21. Sample size n=8	Semi-structured interviews	Three themes related to barriers to lesbian and bisexual women seeking medical care were highlighted: (1) the agency exercised by young lesbian and bisexual women, (2) the impact of healthcare providers on women’s access to and utilisation of medical care, and (3) reflections of healthcare interactions to larger power dynamics in society	100
Ginsburg et al. (2002)	United States	Examine factors that make sexual minority youth feel safe in healthcare settings	A mixed-methods study	LGBTQ youth aged 14–23 years. Sample sizes in four-stage research process; in Stage 1 n=8, Stage 2 n=72, Stage 3 n=94, and in Stage 4 n=41	Stage 1 Expert focus groups, Stage 2 Nominal group technique, Stage 3 Survey, and Stage 4 Open focus groups	Most of important factors for LGBTQ youth were the same as for other youth, and factors were related to healthcare professional’s characteristics, and professionals should meet youth open-mindedly. Professionals should also have more knowledge about sexual minority youth	25
Hoffman et al., (2009)	United States and Canada	Determine preferences of LGBTQ youth regarding healthcare providers, healthcare settings and health issues which are important for youth to discuss with a healthcare provider	A quantitative descriptive study	LGBTQ youth aged 13–21 years. Sample size n=733	A cross-sectional web-based questionnaire	Most important quality in a healthcare provider was interpersonal skills. Most important things in healthcare settings were general things such as cleanliness. Mental health, physical health and STD issues were the most important topics to discuss with a provider	75
Rasberry et al., (2015)	United States	Help inform school-centred strategies for connecting Black and Latino young men who have sex with men (YMSM) to HIV and STD prevention services. This was provided by describing (1) the willingness and safety of YMSM to discuss sexual health and sexual orientation-related topics, (2) the experiences of YMSM with school nurses discussing about sexual health-related topics	A mixed-methods study	Black and Latino YMSM aged 13–19 years. Sample size n=447	A web-based questionnaire, and in-depth, semi-structured interviews that covered same topics as the questionnaire	YMSM were willing to talk school staff about sexual health topics. However, they were not willing to talk if staff’s opinions about sexual minorities were uncertain, or they lacked knowledge in LGBTQ issues. YMSM felt least safe to talk about their sexual orientation to school nurses. The school nurse was often described as a limited care provider, a rare visitor in the school, and whose personality did not seem to be open and caring	75
Arbeit et al. (2016)	United Sates	Analyse bisexual female youth’s experiences accessing sexual health information and services provided by a doctor, nurse, or a counsellor	A mixed-methods study	Cisgender, bisexual female youth aged 14–17 years. Sample size n=40	An online questionnaire and asynchronous online focus groups	Aspects in provider’s behaviour affecting mostly participants’ experiences were: (1) negative bias to adolescent sexual behaviour and same-sex attraction, (2) heterosexual assumptions about youth, (3) missed opportunities to screen for HIV and STIs. Bisexual stigma within families was associated with the disclosure to a provider. School-based sexual health information was limited on abstinence and condoms	25
Fuzzell et al. (2016)	United Sates	Examine sexual minority and majority youth and young adult’s experiences of communication with a physician about sexuality, and what advice youth give for improving interactions	A qualitative descriptive study	Sexual minority and majority youth and young adults aged 12–31. Sample size n=40	Semi-structured interviews	Five main themes arose from the interviews: (1) need for increased quantity of sexual communication, (2) need for increased quality of sexual communication, (3) concerns about confidentiality/privacy, (4) comfort, and (5) inclusivity	75
Snyder et al. (2016)	Canada	Determine LGBTQ youth’s experiences with primary care physicians, identify gaps in primary healthcare services and areas for improvement	A mixed-methods study	LGBTQ youth aged 14–18+ years. Sample size n=60	A paper-pencil survey and focus-groups discussion	LGBTQ youth’s healthcare needs were not met well, and they had experiences of poor patient-provider communication, disrespect, and lack of discussions about important topics such emotional and sexual health. Concern of confidentiality and inappropriate comments were identified as barriers to care. The same items stated above were also mentioned as areas for improvement	50
Rose and Friedman (2017)	United States	Examine African American sexual and gender minority youth males’ perceptions about school sexual health education and services	A qualitative descriptive study	African American sexual and gender minority youth aged 18–21 years. Sample size n=42	Semi-structured focus groups and in-depth interviews	Participants indicated that schools have missed opportunities to educate sexual and gender minority youth about sexual health including sexual orientation. Participants had controversial perceptions about school-based health services, only limited information was offered to them, and school nurses did not always have knowledge about health issues that impact this youth	50