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We conducted latent class analysis of seven indicators of clinical and cultural competency to identify patterns of LGBTQ+ patient experiences. Outcomes included the proportion of respondents with lifetime and recent influenza vaccination, HIV testing, and colorectal cancer screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources and Analytic Sample<\/jats:title><jats:p>Data come from Waves 1 and 2 of the LGBTQ+ Social Networks, Aging, and Policy Study collected between April 2020 and October 2022. The sample included 954 LGBTQ+ adults ages 50\u201376 living in Tennessee, Georgia, Alabama, or North Carolina at baseline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Principal Findings<\/jats:title><jats:p>We identified three patterns of LGBTQ+ patient experiences. 34% of the sample reported LGBTQ+ affirming care, 60% reported neutral care, and 6% reported discriminatory care. Gender identity, sexual orientation, race and ethnicity, state of residence, and HIV status predicted patterns of patient experiences (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Compared to patients with affirming care, patients with neutral care were 12.4 percentage points less likely to have ever been tested for HIV (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and 17.1 percentage points less likely to have been recently tested for HIV (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001); patients reporting discriminatory care were 12.2 percentage points less likely to have recently received an influenza vaccination (<jats:italic>p<\/jats:italic>\u2009=\u20090.024) and 14.8 percentage points less likely to have recently completed a colorectal cancer screening (<jats:italic>p<\/jats:italic>\u2009=\u20090.035).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In the absence of explicitly <jats:styled-content style=\"fixed-case\">LGBTQ<\/jats:styled-content>+ affirming patient experiences, <jats:styled-content style=\"fixed-case\">LGBTQ<\/jats:styled-content>+ midlife and older adults are less likely to receive preventive services such as colorectal cancer screenings, influenza vaccinations, and <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> testing. Interventions to increase the capacity of health systems to provide <jats:styled-content style=\"fixed-case\">LGBTQ<\/jats:styled-content>+ affirming care are needed to advance health equity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1475-6773.14632","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:30:07Z","timestamp":1746405007000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Patterns of Lesbian, Gay, Bisexual, Transgender, and Queer Patient Experiences and Receipt of Preventive Services"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6222-032X","authenticated-orcid":false,"given":"Nathaniel M.","family":"Tran","sequence":"first","affiliation":[{"name":"Division of Health Policy and Administration University of Illinois Chicago School of Public Health  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4054-6564","authenticated-orcid":false,"given":"Gilbert","family":"Gonzales","sequence":"additional","affiliation":[{"name":"Department of Health Policy Vanderbilt University Medical Center  Nashville Tennessee USA"},{"name":"Department of Medicine, Health, and Society Vanderbilt University  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0661-847X","authenticated-orcid":false,"given":"Carrie E.","family":"Fry","sequence":"additional","affiliation":[{"name":"Department of Health Policy Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3907-9196","authenticated-orcid":false,"given":"Stacie B.","family":"Dusetzina","sequence":"additional","affiliation":[{"name":"Department of Health Policy Vanderbilt University 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