Obstacles to Obtain Care Among Sexual and Gender Minorities With Chronic Rhinosinusitis

Abstract

Objectives

This study aims to compare the prevalence of cost and non-cost barriers to healthcare access among sexual and gender minority (SGM) patients and non-SGM patients with chronic rhinosinusitis (CRS).

Methods

The All of Us Research Program was queried for CRS patients, defined as having at least two diagnoses of chronic sinusitis (ICD10: J32.x). Patients were categorized based on questions regarding gender identity, biological sex, and self-descriptions. The primary outcome was cost and non-cost barriers. Multivariable logistic regression was used to examine SGM status and experiencing barriers to care.

Results

7708 patients with CRS were included; 595 were SGM and 7113 were non-SGM. SGM patients were significantly more likely to delay primary care (AOR: 1.51, 95% CI: 1.09–2.11), specialist care (AOR: 1.54, 95% CI: 1.18–2.00), mental healthcare (AOR: 1.70, 95% CI: 1.29–2.24), and filling prescription medication (AOR: 1.31, 95% CI: 1.03–1.66). Regarding non-cost barriers, SGM patients were significantly more likely to delay care because of transportation problems (AOR: 1.84, 95% CI: 1.39–2.42), their provider having a different background (AOR: 1.48, 95% CI: 1.14–1.90) and due to a lack of respect by their providers (AOR: 1.42, 95% CI: 1.16–1.73).

Conclusion

SGM patients with CRS report multiple cost and non-cost barriers. While differences between CRS and non-CRS groups were modest, rhinologists and other healthcare practitioners treating SGM patients with CRS should be mindful of these disparities to address these barriers at a patient and system level.

Level of Evidence

Level III, 2025.