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Topic

We Are Here: Healthcare Experiences of LGBTQ+ Individuals with Chronic Health Conditions Assigned Female at Birth

Social Dimensions of Health

Date & location

• Friday, December 12, 2025
• 10:30 A.M.
• Hut R, Room 103A

Examining Committee

Supervisory Committee

• Dr. Nathan Lachowsky, School of Public Health and Social Policy, ӣ��Ӱ�� (Co-Supervisor)
• Dr. Sarah Nutter, Counselling Psychology, UVic (Co-Supervisor)
• Dr. Allie Slemon, School of Nursing, UVic (Member)

External Examiner

•  Dr. Kimberley Wilson, Department of Family Relations and Applied Nutrition, University of Guelph

Chair of Oral Examination

• Dr. Caren Helbing, Department of Biochemistry and Microbiology, UVic

Abstract

People assigned female at birth (AFAB) and sexual and gender minority (SGM) individuals are disproportionately impacted by chronic health conditions. AFAB-SGM are less likely than cisgender heterosexual women or those assigned male at birth to access routine healthcare. Yet, the healthcare experiences of AFAB-SGM individuals with chronic health conditions remain largely underexplored, with most existing research focusing on a narrow range of identities and chronic health conditions.

This dissertation is a step towards filling this gap by exploring the experiences of navigating the healthcare systems by AFAB-SGM individuals living with chronic health conditions across Canada. I used data from the online cross-sectional Our Health 2022 study, the largest multilingual community health survey of the 2S/LGBTQIA+ communities in Canada, conducted by the Community Based Research Centre. I used a community-based participatory approach to this work, including convening and engaging a community advisory board.

The overall prevalence estimate of any chronic health condition among AFAB-SGM individuals was 62.9%. In subsequent analyses of various chronic health conditions applying a sex- and gender-based analysis using multivariate logistic regressions, AFAB-SGM and AFABGM individuals had higher odds of reporting most chronic conditions compared with assigned-male or cisgender sexual minority women, respectively. Exploring how AFAB-SGM individuals manage their chronic conditions, AFAB-GM individuals and those with chronic pain or mental health conditions were more likely to rely on community supports or self-management strategies. Exploring barriers to healthcare among AFAB-SGM individuals living with chronic conditions, AFAB-GM identities and those certain chronic conditions (i.e., chronic pain, gastrointestinal, multisystem conditions) were associated with greater odds of facing barriers and experiencing discrimination in care settings. The results across these papers highlight the range of chronic health conditions that impact AFAB-SGM individuals and ongoing systemic barriers that impede these individuals from seeking healthcare and managing their chronic health conditions. Further, these findings suggest the continued presence of sex-based biases in healthcare systems and the need to move beyond the narrow scope of identities and topics in health when we discuss and research SGM health.