Wellbeing and healthcare access for sexuality and gender minority secondary school students with long-term health conditions

Objective: To explore the prevalence of long-term health conditions (which includes disorders such as asthma and diabetes, lasting six months or more) among sexuality and gender minority youth (SGMY) within Aotearoa New Zealand, and report on SGMY access to health care services.Method: We used data from a population-based survey (Youth'19) of 7,059 secondary school students in Aotearoa New Zealand. Multivariable logistic regression models were used to investigate the associations of five sex, gender and sexuality groups: heterosexual cisgender females (n = 3,127, 44.30%); heterosexual cisgender males (n = 2,934, 41.64%); sexuality minority cisgender females (n = 659, 9.34%); sexuality minority cisgender males (n = 216, 3.06%); and gender minority adolescents (n = 123, 1.74%), and the selected outcome variables (i.e., general health, long-term health conditions, difficulties accessing healthcare and talked to a health provider privately).Results: Gender minority adolescents reported the highest odds of having a long-term health condition (adjusted Odds Ratio/aOR = 6.69, 95% Confidence Intervals/CI 3.89-11.42) compared to heterosexual cisgender males. Sexuality minority cisgender females and males also had significantly higher odds of having a long-term health condition compared to heterosexual cisgender males. Gender minority youth reported the highest odds of experiencing difficulties accessing health care (aOR = 3.99, 95% CI 2.50-6.36) compared to heterosexual cis gender males. Sexuality minority cisgender females and males were also significantly more likely to experience difficulties accessing healthcare than heterosexual cisgender males.Conclusion: SGMY are more likely to report a long-term health condition compared to their peers and access to health care for SGMY is constrained. Health and social care service providers need to ensure their provisions are safe, accessible, inclusive, and appropriate for SGMY.