{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T06:27:40Z","timestamp":1786429660069,"version":"build-2736575974"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"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. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Literature shows that stigma against LGBTQ+ people in healthcare affects professionals as well as patients. Research indicates that discrimination is transversal to all healthcare professions; hierarchies and heteronormativity contribute to difficult visibility both with colleagues and with patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to explore the experiences of LGBTQ+ healthcare professionals in the workplace, analyzing their practices of (in)visibility, their experiences of discrimination and their relationships with patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected through semi-structured interviews to 17 healthcare professionals working in the public healthcare sector in Portugal and identifying as LGBTQ+. Data were analyzed through thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Healthcare professionals report challenges in managing visibility in the workplace and the relevance of verbal abuse in interprofessional relationships. They oscillate between reluctance to assume their identity publicly and micro-practices of resistance to discrimination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Limitations and future directions<\/jats:title>\n                    <jats:p>The findings of the study stress the importance of micro-practices in the definition of LGBTQ+-friendly healthcare environment and the need for further research on visibility in the healthcare workplace.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1903749","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T05:34:35Z","timestamp":1786426475000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Between reluctance and resistance: LGBTQ+ healthcare professionals and their experiences in the workplace"],"prefix":"10.3389","volume":"14","author":[{"given":"Mara","family":"Pieri","sequence":"first","affiliation":[{"name":"Centre for Social Studies, University of Coimbra","place":["Coimbra, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,11]]},"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":"4625","DOI":"10.1111\/jan.70201","article-title":"Scoping review of sexual and gender minority health research in Ireland","volume":"82","author":"Gilmore","year":"2025","journal-title":"J Adv Nurs"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1983","DOI":"10.1007\/s12119-023-10107-w","article-title":"Transgender clinic: the importance of a diverse medicine","volume":"27","author":"Nieva-Posso","year":"2023","journal-title":"Sex Cult"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1142","DOI":"10.1016\/j.radi.2021.06.003","article-title":"Coming out or staying in? Disclosure experiences of lesbian and gay radiation therapists in practice","volume":"27","author":"Bolderston","year":"2021","journal-title":"Radiography"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"pzab280","DOI":"10.1093\/ptj\/pzab280","article-title":"An exploration of the experiences of physical therapists who identify as LGBTQIA+: navigating sexual orientation and gender identity in clinical, academic, and professional roles","volume":"102","author":"Ross","year":"2021","journal-title":"Phys Ther"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.acap.2012.01.005","article-title":"On being gay in medicine","volume":"12","author":"Schuster","year":"2012","journal-title":"Acad Pediatr"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1958","DOI":"10.1080\/10826084.2020.1784946","article-title":"Substance use and minority stress in a population of lesbian, gay, and bisexual nurses","volume":"55","author":"Avery-Desmarais","year":"2020","journal-title":"Subst Use Misuse"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1016\/j.profnurs.2011.03.003","article-title":"Lesbian, gay, bisexual, transgender, and queer\/questioning nurses\u2019 experiences in the workplace","volume":"27","author":"Eliason","year":"2011","journal-title":"J Prof Nurs"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1374","DOI":"10.1111\/jan.14005","article-title":"Lesbian-, gay-, bisexual- and transgender-related inequalities within nursing: a neglected research area","volume":"75","author":"Younas","year":"2019","journal-title":"J Adv Nurs"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1097\/ACM.0000000000000657","article-title":"Sexual and gender minority identity disclosure during undergraduate medical education: \u2018in the closet\u2019 in medical school","volume":"90","author":"Mansh","year":"2015","journal-title":"Acad Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1111\/tct.13078","article-title":"Navigating medical culture and LGBTQ identity","volume":"16","author":"Toman","year":"2019","journal-title":"Clin Teach"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"2093692","DOI":"10.1080\/10872981.2022.2093692","article-title":"Assessment of lesbian, gay, bisexual, transgender, and questioning experiences within a large southeast training program","volume":"27","author":"Walker","year":"2022","journal-title":"Med Educ Online"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1089\/trgh.2019.0021","article-title":"Experiences of transgender and gender nonbinary medical students and physicians","volume":"4","author":"Dimant","year":"2019","journal-title":"Transgender Health"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"41","DOI":"10.15446\/revfacmed.v62n1.43693","article-title":"Estigma y discriminaci\u00f3n a profesional de la salud transg\u00e9nero","volume":"62","author":"Campo-Arias","year":"2014","journal-title":"Rev Fac Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"e2219791","DOI":"10.1001\/jamanetworkopen.2022.19791","article-title":"Experiences of transgender and gender expansive physicians","volume":"5","author":"Westafer","year":"2022","journal-title":"JAMA Netw Open"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1007\/s11606-007-0461-4","article-title":"The dilemma of disclosure: patient perspectives on gay and lesbian providers","volume":"23","author":"Lee","year":"2008","journal-title":"J Gen Intern Med"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-022-00573-0","article-title":"Supporting sexual and gender minority health-care workers","author":"Mackenzie","year":"2022","journal-title":"Nat Rev Nephrol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1007\/s13178-018-0336-y","article-title":"Teaching and learning about sexual diversity within medical education: the promises and pitfalls of the informal curriculum","volume":"16","author":"Murphy","year":"2019","journal-title":"Sex Res Social Policy"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1111\/maq.12289","article-title":"The irrelevance narrative: queer (in)visibility in medical education and practice","volume":"31","author":"Robertson","year":"2017","journal-title":"Med Anthropol Q"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1111\/josi.12223","article-title":"Identity concealment and social change: balancing advocacy goals against individual needs","volume":"73","author":"Pasek","year":"2017","journal-title":"J Soc Issues"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1016\/j.socscimed.2017.05.048","article-title":"You do not cross them: hierarchy and emotion in doctors\u2019 narratives of power relations in specialist training","volume":"186","author":"Crowe","year":"2017","journal-title":"Soc Sci Med"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/13561820.2023.2203722","article-title":"What do you mean, \u2018negotiating\u2019? Patient, physician, and healthcare professional experiences of navigating hierarchy in networks of interprofessional care","volume":"37","author":"Macdonald","year":"2023","journal-title":"J Interprof Care"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1138628","DOI":"10.3389\/fsoc.2023.1138628","article-title":"Ah, it\u2019s best not to mention that Here: experiences of LGBTQ+ health professionals in (heteronormative) workplaces in Canada","volume":"8","author":"Bizzeth","year":"2023","journal-title":"Front Sociol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1080\/00918369.2017.1328224","article-title":"Coping with stress as an LGBTQ+ health care professional","volume":"65","author":"Eliason","year":"2018","journal-title":"J Homosex"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"119","DOI":"10.4324\/9781351258807-9","volume-title":"The Routledge Handbook of LGBTQIA Administration and Policy","author":"Parker-Der Boghossian","year":"2018"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1136\/bmj.322.7283.422","article-title":"Wellbeing of gay, lesbian, and bisexual doctors Commentary: the medical profession should face up to its own homophobia","volume":"322","author":"Burke","year":"2001","journal-title":"BMJ: British Medical Journal"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1355","DOI":"10.1080\/00918369.2011.614902","article-title":"Lesbian, gay, bisexual, and transgender (LGBT) physicians\u2019 experiences in the workplace","volume":"58","author":"Eliason","year":"2011","journal-title":"J Homosex"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"100114","DOI":"10.1016\/j.ssmqr.2022.100114","article-title":"LGBTQ+ identity concealment and disclosure within the (heteronormative) health professions: \u2018do I? Do I not? And what are the potential consequences?\u2019","volume":"2","author":"Beagan","year":"2022","journal-title":"SSM Qual Res Health"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1089\/lgbt.2021.0276","article-title":"Mental health disparities among sexual and gender minority frontline health care workers during the height of the COVID-19 pandemic","volume":"9","author":"Wojcik","year":"2022","journal-title":"LGBT Health"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"100973","DOI":"10.1016\/j.lana.2024.100973","article-title":"Intersectionality and diversity, equity, and inclusion in the healthcare and scientific workforces","volume":"41","author":"Mosley","year":"2025","journal-title":"Lancet Reg Health Am"},{"key":"ref31","volume-title":"The Allied Health Professions: A Sociological Perspective","author":"Nancarrow","year":"2021"},{"key":"ref32","volume-title":"Distrust, Fear, and Science-Denial in Medicine and Healthcare","author":"Wolfensberger","year":"2025"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1177\/13505068221090424","article-title":"When vulnerability got mainstream: reading the pandemic through disability and illness","volume":"29","author":"Pieri","year":"2022","journal-title":"Eur J Womens Stud"},{"key":"ref34","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-031-22071-5","volume-title":"LGBTQ+ People with Chronic Illness: Chroniqueers in Southern Europe","author":"Pieri","year":"2023"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/healthcare10010146","article-title":"The light at the end of the tunnel: experiences of LGBTQ+ adults in Portuguese healthcare","volume":"10","author":"Pieri","year":"2022","journal-title":"Healthcare (Basel)"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"129","DOI":"10.17575\/rpsicol.v26i1.266","article-title":"As Experi\u00eancias dos Cuidados de Sa\u00fade de Pessoas Transexuais em Portugal: Perspetivas de Profissionais de Sa\u00fade e Utentes","volume":"26","author":"Pinto","year":"2012","journal-title":"Psicologia"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1057\/s41285-019-00102-3","article-title":"(re)making gender in the clinical context: a look at how ideologies shape the medical construction of gender dysphoria in Portugal","volume":"17","author":"Hil\u00e1rio","year":"2019","journal-title":"Soc Theory Health"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"297","DOI":"10.15446\/rcp.v23n2.38657","article-title":"Exploring medical personnel\u2019s discourses on the sexual health of lesbian and bisexual women in greater Lisbon, Portugal","volume":"23","author":"Oliveira","year":"2014","journal-title":"Rev Colomb Psicol"},{"key":"ref39","volume-title":"Sa\u00fade em Igualdade: Pelo Acesso a Cuidados de Sa\u00fade Adequados e Competentes para Pessoas LGBT","author":"Pinto","year":"2015"},{"key":"ref40","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-031-13508-8","volume-title":"LGBTQ+ Intimacies in Southern Europe: Citizenship, Care and Choice","author":"Santos","year":"2023"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"172","DOI":"10.3390\/socsci14030172","article-title":"Discriminated and violent? The social representations of minorities in the rise of radical right populist parties in Portugal and Italy","volume":"14","author":"Rebelo","year":"2025","journal-title":"Soc Sci"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual Res Psychol"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"16094069231205789","DOI":"10.1177\/16094069231205789","article-title":"A step-by-step process of thematic analysis to develop a conceptual model in qualitative research","volume":"22","author":"Naeem","year":"2023","journal-title":"Int J Qual Methods"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1327","DOI":"10.1007\/s10508-024-02807-7","article-title":"LGBTQ young adults\u2019 identity disclosure in the workplace: a longitudinal qualitative analysis of disclosure intentions and outcomes","volume":"53","author":"Ueno","year":"2024","journal-title":"Arch Sex Behav"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1177\/2041386617734582","article-title":"The benefit of full disclosure: a meta-analysis of the implications of coming out at work","volume":"8","author":"Wax","year":"2018","journal-title":"Organ Psychol Rev"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1227","DOI":"10.1136\/bmj.38071.774525.EB","article-title":"Interaction strategies of lesbian, gay, and bisexual healthcare practitioners in clinical examination of patients: qualitative study","volume":"328","author":"Riordan","year":"2004","journal-title":"BMJ"},{"key":"ref47","volume-title":"WMA Declaration of Geneva","year":"2017"},{"key":"ref48","volume-title":"European Proceedings of Social and Behavioural Sciences: State and Law in the Context of Modern Challenges","author":"Blinova","year":"2022"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1007\/s11920-022-01398-1","article-title":"Violence against physicians in the workplace: trends, causes, consequences, and strategies for intervention","volume":"24","author":"Caruso","year":"2022","journal-title":"Curr Psychiatry Rep"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"103727","DOI":"10.1016\/j.amsu.2022.103727","article-title":"Workplace violence in healthcare settings: the risk factors, implications and collaborative preventive measures","volume":"78","author":"Lim","year":"2022","journal-title":"Ann Med Surg"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"ckz185.782","DOI":"10.1093\/eurpub\/ckz185.782","article-title":"Populist radical right parties, welfare policy and population health in Europe","volume":"29","author":"Rinaldi","year":"2019","journal-title":"Eur J Pub Health"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"101545","DOI":"10.1016\/j.jacadv.2024.101545","article-title":"Experiences of lesbian, gay, bisexual, transgender, and queer cardiology physicians and fellows in training","volume":"4","author":"Cook","year":"2025","journal-title":"JACC Adv"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1007\/s13178-020-00521-2","article-title":"LGBT+ training needs for health and social care professionals: a cross-cultural comparison among seven European countries","volume":"19","author":"Baiocco","year":"2022","journal-title":"Sex Res Soc Policy"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1903749\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T05:34:37Z","timestamp":1786426477000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1903749\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,11]]},"references-count":53,"alternative-id":["10.3389\/fpubh.2026.1903749"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1903749","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,11]]},"article-number":"1903749"}}