Overview and Aims:

Sexual and Reproductive Health (SRH) care should be adapted to sexual and gender minorities, as they present specific and unique needs. We aimed to understand the perspective of SRH professionals providing care to the Lesbian, Gay, Bisexual, Transexual/Transgender, Queer, Intersexual, Asexual and Others (LGBTQIA+) community, evaluating their clinical experience, level of knowledge and training needs.

Study design, Population and Methods:

Nationwide survey using an online questionnaire distributed to Gynecology/Obstetrics (G/O) and General Practice (GP) physicians between September 2021 and April 2022. A total of 324 physicians have completed the survey (G/O 55.6%; GP 44.4%). The majority were female (81.8%), specialist (57.7%) and under 35 years-old (55.3%).

Results:

In 40.8% and 23.5% of cases, physicians ‘rarely’/‘never’ used to address patients’ sexual orientation and sexual behavior, respectively. Over a third (37.0%) considered their level of preparedness to provide SRH care to LGBTQIA+ individuals as ‘poor’/‘none’, pointing the professional’s inexperience (58.0%) and lack of information (51.9%) as the main difficulties. Only 24.2%, 5.6% and 23.8% believed that LGBTQIA+ people often use contraceptives, have more unwanted pregnancies and multiple partners, respectively. Fear of stigmatization (81.5%) and providers without training (66.7%) were considered barriers for healthcare access. Most (96.0%) recognized the importance of holding trainings/workshops in this field. GP specialty, younger age, fewer years of clinical practice and working in the Centre region/Islands were negatively associated with knowledge and practices.

Conclusions:

Portuguese physicians have insufficient knowledge and clinical experience addressing SRH care in sexual and gender minorities, highlighting the imperious need of training and skills’ development within this domain.

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