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This project commenced in March 2016 and will end in March 2018.

The specific objectives of this pilot project are to:

• gain a better understanding of the specific health inequalities experienced by LGBTI people, focusing in particular on overlapping inequalities stemming from (intentional and unintentional) discrimination and unfair treatment on other grounds (for instance, due to older, younger, refugee, immigrant, disability, rural, poverty status)
• gain a better understanding of the barriers faced by health professionals when providing care to these groups
• raise awareness about the needs of LGBTI people and provide healthcare professionals with specific tools to ensure that they have the right skills and knowledge to overcome the identified barriers.

During the project lifespan, activities will include:

• a state‐of‐the‐art review of the health inequalities experienced by LGBTI people and the barriers faced by health professionals in providing healthcare for LGBTI people.
• two focus group studies in six geographically diverse EU Member States (Poland, Italy, UK, Belgium, Bulgaria and Lithuania) to map the barriers faced both by LGBTI people and health professionals. A further aim of the focus group studies is to generate data including stimulus materials to inform the development of training module(s) for healthcare professionals.
• development of training module(s) aimed at increasing the knowledge, attitudes and skills of healthcare professionals when providing healthcare to LGBTI people. The module will be developed in such a way so as to be potentially replicable across the EU.
• piloting of the training module(s) in the same Member States where the focus groups will be conducted, in order to fine-tune and finalise the modules.
• a final European conference, and wide dissemination and communication targeting civil society organisations representing or working with key population groups, healthcare professionals, European health organisations including the EU as well as national, regional and local policy and decision makers in the area of health.

Findings from a series of three inter-related studies, including a comprehensive scoping review, a scientific review and a focus group study, revealed the existence of key health inequalities, barriers and discrimination based on sexual orientation, gender identity and sex characteristics.

Overwhelmingly, the research demonstrates that there is a lack of knowledge and cultural competency regarding the lives and healthcare needs of LGBTI people. Despite these findings, health professionals assumed that LGBTI people did not face discrimination in accessing healthcare services and some believed that LGBTI people were contributing to their own marginalisation. Many were not aware that the assumptions they were making about LGBTI people were in themselves significant barriers to providing appropriate healthcare.

As well as the lack of knowledge and cultural competence on the part of health professionals, research found evidence of heterosexism, homophobia, biphobia, transphobia and interphobia creating significant barriers to healthcare, aggravated by systems ill-equipped to deal with the complexities of gender identity along with laws and policies restricting access to healthcare for trans people in particular, with some even being refused appropriate medical services.

LGBTI participants report that the ability to be open with health professionals, vital for the provision of good healthcare, is hampered by assumptions that all patients are heterosexual and that their gender identity matches the sex that they were assigned at birth, without an awareness that a patient may be intersex. A result of repeated negative experiences can result in some LGBTI patients avoiding healthcare services altogether.

An integral focus of this team’s research is to look at how health inequalities of this kind can be reduced. One such way is to ensure that health services are attuned through appropriate and mandatory training for staff and students across health systems including but not limited to, health professionals.