Association between homophobia and perceived discrimination in health care services among lesbians in Chengdu, China

Abstract

The lesbians and its unique subculture have always been excluded by the heterosexual society. In Chinese society, they are an invisible and neglected minority group. Internalized homophobia is common where they tend to reject themselves and afraid that the people will discriminate them because they are lesbians. This situation might occur in health care service which could lead into lower healthcare utilization by the lesbians. This study aimed to assess whether the internalized homophobia has an association with the perceived discrimination while receiving health care service among lesbians in China. A cross-sectional online survey was conducted in Chengdu, China from March to May 2021 involving adult lesbians above 18 years old and live in the study area for at least 6 months. A total of 196 participants (mean age 32.77 years old ± 7.99) were involved in this study. The mean total score of Internalized Homophobia was 31.14 ± 5.29 and is higher in masculine gender compared to female gender and non-significant. The mean of perceived discrimination total score was 63.78 ± 9.71. Feminine lesbian has the least average score of MSPD compared to non-significant whereas masculine type has the highest average. In the final model the masculine gender shows higher perceived discrimination (β -0.171 p=0.017). Interestingly, higher internalized homophobia was linear to perceived discrimination (β 0.316 p<0.001). However, the number of health care service ever used has no association with discrimination (β -0.007 p=0.915).This study results indicate that masculine-gender lesbians were prone to perceived discrimination because of their distinctive feature and internalized homophobia. This group should be managed accordingly in order to reduce their perceived discrimination.