{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:16:50Z","timestamp":1787239010995,"version":"build-2736575974"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Access to equitable primary healthcare (PHC) for LGBTQI individuals remains a persistent challenge worldwide, yet little is known about how professional nurses (PNs) in rural South African contexts experience and navigate these challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The study aimed to explore and describe the lived experiences of professional nurses in providing PHC services to LGBTQI patients in Amahlathi Municipality, Eastern Cape Province, South Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>For this research, a descriptive phenomenological research design was used to obtain rich, in-depth accounts of the real-world experiences of nurses. A non-probability purposive sampling method was used to select 23 professional nurses working in PHC facilities in the Amahlathi Sub-district, Eastern Cape. Data were collected through semi-structured face-to-face interviews, which were then analyzed using Colaizzi\u2019s phenomenological data analysis method. Measures to ensure trustworthiness and ethical considerations were maintained throughout the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The findings showed that professional nurses face significant competency gaps, personal biases, and confusion about LGBTQI identities, which negatively affect the delivery of services. They also revealed that LGBTQI patients often fear discrimination, withhold sensitive information, and display defensive behaviors due to past negative experiences. Consequently, these combined provider- and patient-related challenges strain clinical interactions and hinder equitable primary healthcare access in Amahlathi.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study revealed that professional nurses in the rural Eastern Cape face both personal and systemic obstacles to providing inclusive care to LGBTQI individuals. Enhancing nurses\u2019 competencies through targeted LGBTQI-focused training, creating supportive clinical environments, and strengthening policy frameworks are critical to improving the quality of care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1763881","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T06:52:57Z","timestamp":1774421577000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["When care meets resistance: professional nurses\u2019 real-world struggles in providing primary health services to LGBTQI communities in Amahlathi, Eastern Cape Province, South Africa"],"prefix":"10.3389","volume":"13","author":[{"given":"M.","family":"Dube","sequence":"first","affiliation":[{"name":"Nursing Science Department, Faculty of Health Science, School of Health Care Science, University of Limpopo","place":["Polokwane, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. E.","family":"Manamela","sequence":"additional","affiliation":[{"name":"Nursing Science Department, Faculty of Health Science, School of Health Care Science, University of Limpopo","place":["Polokwane, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. O.","family":"Sumbane","sequence":"additional","affiliation":[{"name":"Nursing Science Department, Faculty of Health Science, School of Health Care Science, University of Limpopo","place":["Polokwane, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. W.","family":"Mokhwelepa","sequence":"additional","affiliation":[{"name":"Faculty of Health Science, School of Medicine, University of Limpopo","place":["Polokwane, South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"974","DOI":"10.1093\/eurpub\/cky226","article-title":"A review of lesbian, gay, bisexual, trans and intersex (LGBTI) health and healthcare inequalities","volume":"29","author":"Zeeman","year":"2019","journal-title":"Eur J Pub Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1016\/j.clinbiochem.2014.02.009","article-title":"Barriers to quality health care for the transgender population","volume":"47","author":"Roberts","year":"2014","journal-title":"Clin Biochem"},{"key":"ref3","volume-title":"Discrimination, Satisfaction, and Help-Seeking among Transgender and Gender-Diverse (TGD) Individuals after Psychiatric Hospitalization","author":"Kolak","year":"2025"},{"key":"ref4","volume-title":"Differences in Mental Health Outcomes and Services by Gender Identity among Sexual and Gender Minorities during the First Shelter-in-Place Order of the COVID-19 Pandemic in Texas, 2020","author":"Alvarez Ramirez","year":"2023"},{"key":"ref5","volume-title":"Examining the Impact of Healthcare Disparities: Mistreatment of LGBTQIA2S+ Individuals in Clinical Settings","author":"Casey","year":"2025"},{"key":"ref6","volume-title":"Health Care Providers LGBT Cultural Awareness and Attitudes toward LGBT Patients: Nonexperimental Quantitative Research","author":"Lopez-Ravenna","year":"2024"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1080\/09540261.2022.2075256","article-title":"Barriers in care pathways and unmet mental health needs in LGBTIQ+ communities","volume":"34","author":"Silveri","year":"2022","journal-title":"Int Rev Psychiatry"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1837","DOI":"10.1186\/s12889-023-16739-9","article-title":"Disrupted identities, invisibility and precarious support: a mixed methods study of LGBTQI adolescents and young adults with cancer","volume":"23","author":"Ussher","year":"2023","journal-title":"BMC Public Health"},{"key":"ref9","volume-title":"The Right to Health for the Lesbian, Gay, Bisexual and Transgender (LGBT) Population in Nigeria? An Exploration of Access to, and Delivery of Healthcare Services","author":"Sekoni","year":"2020"},{"key":"ref10","first-page":"42","article-title":"Public morality and constitutionalism in restricting LGBTQ+ rights: a legal analysis of Nigeria, Ghana, and Uganda","volume":"1","author":"Ehirim","year":"2025","journal-title":"Int J Constit Adm Law"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/s12912-023-01208-w","article-title":"Nurses reflections on caring for sexual and gender minorities pre-post stigma reduction training in Uganda","volume":"22","author":"Muwanguzi","year":"2023","journal-title":"BMC Nurs"},{"key":"ref12","first-page":"1","article-title":"Analysis of Uganda\u2019s anti-homosexuality act (AHA) and its implications on access to healthcare services by the LGBTQI+ communities","volume":"7","author":"Segale","year":"2025","journal-title":"J Psychol Neurosci"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"2208","DOI":"10.3390\/healthcare10112208","article-title":"Primary healthcare nurse\u2019s barriers and facilitators to providing sexual and reproductive healthcare services of LGBTQI individuals: a qualitative study","volume":"10","author":"Seretlo","year":"2022","journal-title":"Healthcare"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"1279409","DOI":"10.1155\/2023\/1279409","article-title":"LGBTQI+ experience of HIV management services at primary healthcare facilities in Gauteng Province; South Africa","volume":"2023","author":"Mulemfo","year":"2023","journal-title":"Adv Public Health"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2174\/18744346-v16-e221129-2022-48","article-title":"Preparedness of professional nurses rendering HIV healthcare services to LGBTIQ+ people in Gauteng Province, South Africa","volume":"16","author":"Mulemfo","year":"2022","journal-title":"Open Nurs J"},{"key":"ref16","volume-title":"Exploring Experiences of Healthcare Workers Providing Psychosocial Support to Homosexual Men Living with HIV in Polokwane","author":"Moraka","year":"2024"},{"key":"ref17","first-page":"51","article-title":"The role of cultural norms in shaping gender-responsive healthcare communication in Nasarawa state","volume":"4","author":"Maga","year":"2025","journal-title":"Niger J Commun Rev"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2468317","DOI":"10.1080\/21642850.2025.2468317","article-title":"Human rights violation of trans women in Umlazi township, South Africa: an interpretive phenomenological analysis study","volume":"13","author":"Luthuli","year":"2025","journal-title":"Health Psychol Behav Med"},{"key":"ref19","first-page":"279","article-title":"Dignity versus diagnosis: sexual orientation and gender identity differences in reports of one\u2019s greatest concern about receiving a sexual health exam","volume":"7","author":"Hoskin","year":"2016","journal-title":"Psychol Sex"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1007\/s10508-023-02730-3","article-title":"Invisibility and stigma: experiences of transgender and gender non-conforming individuals in South Korea","volume":"53","author":"Kim","year":"2024","journal-title":"Arch Sex Behav"},{"key":"ref21","first-page":"15","article-title":"Community-led monitoring and the role of Ritshidze in improving the quality of primary healthcare in South Africa","volume":"114","author":"Govender","year":"2024","journal-title":"S Afr Med J"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1002\/9781119375517.ch7","volume-title":"Affirmative Counselling with LGBTQI+ People","author":"Ginicola","year":"2017"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1080\/01488376.2019.1711295","article-title":"Meeting the sexual health needs of LGBT youth: perceptions and experiences of university students in KwaZulu-Natal, South Africa","volume":"47","author":"Mkhize","year":"2021","journal-title":"J Soc Serv Res"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1177\/109019817400200405","article-title":"The health belief model and preventive health behavior","volume":"2","author":"Rosenstock","year":"1974","journal-title":"Health Educ Monogr"},{"key":"ref25","first-page":"113","volume-title":"Cambridge Handbook of Psychology, Health and Medicine","author":"Strecher","year":"1997"},{"key":"ref26","volume-title":"Research Design: Qualitative, Quantitative and Mixed Methods Approaches","author":"Creswell","year":"2014"},{"key":"ref27","first-page":"643","article-title":"Colaizzi\u2019s descriptive phenomenological method","volume":"28","author":"Morrow","year":"2015","journal-title":"Psychologist"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1080\/15398285.2017.1353304","article-title":"Supporting the health care needs of the LGBTQI community","volume":"21","author":"Pierce","year":"2017","journal-title":"J Consum Health Internet"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1080\/02615470600565244","article-title":"Social work students' attitudes toward homosexuality and their knowledge and attitudes toward homosexual parenting as an alternative family unit: an Australian study","volume":"25","author":"Camilleri","year":"2006","journal-title":"Soc Work Educ"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"S137","DOI":"10.1057\/jphp.2011.29","article-title":"You become afraid to tell them that you are gay: health service utilization by men who have sex with men in south African cities","volume":"32","author":"Rispel","year":"2011","journal-title":"J Public Health Policy"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1080\/00918369.2019.1617602","article-title":"The lesbian, gay, bisexual, and transgender development of clinical skills scale (LGBT-DOCSS): establishing a new interdisciplinary self-assessment for health providers: correction","volume":"66","author":"Bidell","year":"2019","journal-title":"J Homosex"},{"key":"ref32","volume-title":"Transexual Woman on the Journey of Sexual Re-Alignment in a Hetero-Normative Healthcare System in the Western Cape","author":"Newman-Valentine","year":"2015"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.socscimed.2013.02.019","article-title":"Managing uncertainty: a grounded theory of stigma in transgender health care encounters","volume":"84","author":"Poteat","year":"2013","journal-title":"Soc Sci Med"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/978-3-030-36222-5_4","volume-title":"Cultural Differences and the Practice of Sexual Medicine: A Guide for Sexual Health Practitioners","author":"Fuller","year":"2020"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"1174488","DOI":"10.3389\/fsoc.2023.1174488","article-title":"Gender and sexuality in mental health: perspectives on lesbians, gays, bisexuals, and transgender (LGBT) rights and mental health in the ASEAN region","volume":"8","author":"Alibudbud","year":"2023","journal-title":"Front Sociol"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/978-3-030-16395-2_8","volume-title":"Trauma and Human Rights: Integrating Approaches to Address Human Suffering","author":"Elze","year":"2019"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"4420","DOI":"10.3390\/ijerph20054420","article-title":"Exploring the mental health challenges and coping behaviour of lesbian, gay, and bisexual students at an institution of higher learning","volume":"20","author":"Sumbane","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1089\/jayao.2019.0021","article-title":"Overlooked minorities: the intersection of cancer in lesbian, gay, bisexual, transgender, and\/or intersex adolescents and young adults","volume":"8","author":"Clarke","year":"2019","journal-title":"J Adolesc Young Adult Oncol"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"e169","DOI":"10.1093\/geront\/gnz012","article-title":"Provider and LGBT individuals\u2019 perspectives on LGBT issues in long-term care: a systematic review","volume":"60","author":"Caceres","year":"2020","journal-title":"Gerontologist"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"918","DOI":"10.1093\/tbm\/iby105","article-title":"Encouraging patients to disclose their lesbian, gay, bisexual, or transgender (LGBT) status: oncology health care providers\u2019 perspectives","volume":"10","author":"Banerjee","year":"2020","journal-title":"Transl Behav Med"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s13178-018-0365-6","article-title":"\u201cAll the gays are liberal?\u201d sexuality and gender gaps in political perspectives among lesbian, gay, bisexual, mostly heterosexual, and heterosexual college students in the southern USA","volume":"17","author":"Worthen","year":"2020","journal-title":"Sex Res Soc Policy"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1763881\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T06:53:03Z","timestamp":1774421583000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1763881\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,25]]},"references-count":41,"alternative-id":["10.3389\/fmed.2026.1763881"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1763881","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,25]]},"article-number":"1763881"}}