Association Between Sexual Orientation and the Impact, Diagnosis, and Treatment of Endometriosis.

IF 3.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Shea E O'Donnell, Linda Abarbanell
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Abstract

Purpose: This study examined the association between sexual orientation and the impact, diagnosis, and treatment of endometriosis. Methods: An online survey was conducted in 2023 with 150 adults in the United States diagnosed with endometriosis, 119 of whom identified as heterosexual and 31 with a minority sexual orientation. The impact of endometriosis was measured using the Endometriosis Impact Questionnaire (EIQ), consisting of eight subscales. We also assessed factors related to diagnosis and treatment satisfaction. Data were analyzed using independent samples t-tests and multiple linear regression. Results: Participants with a minority sexual orientation had a higher average impact of endometriosis on the EIQ physical, psychological, and social subscales than heterosexual participants but a lower impact on the fertility subscale, all with medium effect sizes. They took an average of 5 years longer to be diagnosed, with 83.9% of sexual minority versus 45.4% of heterosexual participants receiving at least one misdiagnosis. More sexual minority versus heterosexual participants also reported feeling dismissed or disbelieved (96.8% vs. 64.4%), not feeling listened to by providers (96.8% vs. 62.2%), and having difficulty communicating with providers (90.3% vs. 55.5%). The association between sexual orientation and the EIQ physical, psychological, and social subscales could be explained, in particular, by having been misdiagnosed. Conclusions: These results highlight the need for better medical education and inclusive gynecological care to promote timely diagnosis and treatment of endometriosis. They also suggest that provider biases and discrimination may contribute to a greater impact of endometriosis on sexual minority patients.

性取向与子宫内膜异位症的影响、诊断和治疗之间的关系。
目的:本研究探讨性取向与子宫内膜异位症的影响、诊断和治疗之间的关系。方法:在2023年对150名被诊断为子宫内膜异位症的美国成年人进行了一项在线调查,其中119人被确定为异性恋,31人被确定为少数性取向。使用子宫内膜异位症影响问卷(EIQ)测量子宫内膜异位症的影响,该问卷由八个分量表组成。我们还评估了与诊断和治疗满意度相关的因素。数据分析采用独立样本t检验和多元线性回归。结果:与异性恋参与者相比,少数性取向的参与者子宫内膜异位症对EIQ生理、心理和社会分量表的平均影响更高,但对生育分量表的影响较低,均为中等效应。他们平均多花了5年的时间才被诊断出来,83.9%的性少数群体和45.4%的异性恋参与者至少被误诊过一次。与异性恋者相比,更多的性少数参与者也表示感到被忽视或不被信任(96.8%对64.4%),感觉没有被提供者倾听(96.8%对62.2%),并且与提供者沟通困难(90.3%对55.5%)。性取向和EIQ生理、心理和社会分量表之间的联系可以通过被误诊来解释。结论:这些结果强调了加强医学教育和全面妇科护理以促进子宫内膜异位症的及时诊断和治疗的必要性。他们还认为,医生的偏见和歧视可能导致子宫内膜异位症对性少数患者的影响更大。
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来源期刊
LGBT health
LGBT health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -
CiteScore
6.60
自引率
6.20%
发文量
80
期刊介绍: LGBT Health is the premier peer-reviewed journal dedicated to promoting optimal healthcare for millions of sexual and gender minority persons worldwide by focusing specifically on health while maintaining sufficient breadth to encompass the full range of relevant biopsychosocial and health policy issues. This Journal aims to promote greater awareness of the health concerns particular to each sexual minority population, and to improve availability and delivery of culturally appropriate healthcare services. LGBT Health also encourages further research and increased funding in this critical but currently underserved domain. The Journal provides a much-needed authoritative source and international forum in all areas pertinent to LGBT health and healthcare services. Contributions from all continents are solicited including Asia and Africa which are currently underrepresented in sex research.
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