Does one have to be queer to care for queer patients? A qualitative interview study with general practitioners in Germany

LGBT* (lesbian, gay, bisexual, trans, others) individuals are known to experience poorer health and restricted access to healthcare compared to cisgender-heterosexual individuals. As General Practitioners (GPs) are a patient’s first point of contact with the healthcare system in Germany, this study examines GPs’ perspectives on LGBT healthcare. In this qualitative study, we conducted 19 semi-structured episodic interviews with GPs in urban and rural areas of Germany. The interviews were analysed using framework analysis. Our study shows LGBT* doctors feel more responsible for LGBT* healthcare than their cis-heterosexual colleagues. There is a perceived lack of knowledge and learning opportunities on LGBT* health needs for most interviewees. Cis-heterosexual GPs often feel unprepared to provide specific healthcare interventions to LGBT* patients and believe they lack the resources to improve their education on the topic. LGBT*-specific primary healthcare seems to be delivered by a small number of GP practices and primarily by LGBT* doctors. These LGBT* doctors recommend more widespread knowledge of LGBT* primary care and lives, to allow their colleagues to provide better care for these patients. There is a lack of knowledge on LGBT health needs and challenges among GPs in Germany, which needs to be addressed through structured training in medical school, and on a postgraduate level. This lack of knowledge leads to cis-heterosexual GPs feeling more insecure in providing care to LGBT* patients and LGBT* GPs providing a bigger share of LGBT* healthcare than their cis-heterosexual colleagues. LGBT* or queer GPs feel more responsible and equipped in providing care to LGBT* patients than cis-heterosexual GPs. Cis-heterosexual GPs often feel unprepared to provide specific healthcare interventions like gender affirming hormone therapy to LGBT* patients. While many cis-heterosexual GPs believed their number of LGBT* patients to be too low for it to be worth the time to educate themselves on caring for them, structured medical training is needed to allow all GPs to care for all members of their communities.