Investigating the relationship between social support and health care barriers among sexually and gender diverse young adults in the United States

Abstract

Purpose: Recognizing the necessity of supportive health care systems, we used strengths-based approaches to explore the potential protective nature of social support against health care barriers among sexually and gender diverse (SGD) young adults. Methods: Using data spanning May 2018 to July 2022 from the National Institutes of Health's All of Us Research Program, we created a sample of and produced descriptive estimates for 2417 SGD young adults between 20 and 35 years of age. Using logistic regressions, we calculated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to measure the association between two outcomes-delaying health care and reported discrimination in medical settings-and instrumental/emotional social support. We adjusted for age, gender identity, race and ethnicity, housing stability, and income. Results: Of our sample, 70.8% endorsed at least one reason for delaying care, and 45.0% reported discrimination in medical settings "rarely" or more frequently, with significant differences by gender identity, sexual orientation, race and ethnicity, housing stability, income, and education for both outcomes. More social support was associated with fewer reasons for delaying health care (instrumental: aOR = 0.78, 95% CI 0.71-0.86; emotional: aOR = 0.71, 95% CI 0.63-0.79) and fewer reports of discrimination in medical settings (instrumental: aOR = 0.72, 95% CI 0.66-0.78; emotional: aOR = 0.64, 95% CI 0.58-0.70). Conclusion: Our results suggest that social support might serve as a protective factor against health care barriers for SGD young adults. More strengths-based research is needed to understand intersectionality in SGD health care.