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Trans and intersex individuals are often not considered in obstetric care—neither in practice nor in research. This quantitative study used an online survey to compare the experiences of pregnant trans men, non-binary individuals, and intersex people with those of endosex cisgender individuals who received care in obstetrics. Trans men and non-binary individuals reported discrimination during pregnancy and childbirth on the interactional, institutional, and structural level: for example, they reported more unsatisfactory encounters with health care personnel and more barriers in the structure of health care services and facilities. Trans and intersex individuals had less access to information relevant to them concerning pregnancy and birth compared to cisgender endosex individuals. Although it happened less frequently, cisgender endosex individuals also reported negative experiences, such as discrimination or violence during birth in a hospital. Our findings indicate a need for change concerning several aspects of the obstetric care spectrum—especially, but not exclusively, for trans, non-binary, and intersex people. Some suggestions for improvement include the following: On the hospital level, measures should be implemented to reduce structural discrimination and to ascertain one-on-one care during active labor. Inclusive information material should be developed and disseminated and health care institutions should raise awareness among their staff regarding care for their LGBTIQ patients. More studies on obstetric issues concerning queer, trans, and especially intersex people should be conducted and diversity and inclusion should be implemented as core topics in the training curricula for midwives, physicians, and nurses. [ABSTRACT FROM AUTHOR]

Background: LGBTIQ asylum-seekers face multiple health risks. Yet, little is known about their healthcare needs. In 2016, Berlin opened the only major shelter for LGBTIQ asylum-seekers in Germany. This preliminary study describes health and healthcare utilization by asylum-seekers living in Berlin's LGBTIQ shelter. To identify particular healthcare needs, we compared our results to asylum-seekers from other shelters., Methods: We surveyed residents of the LGBTIQ shelter and 21 randomly selected shelters in Berlin, using a validated questionnaire in nine languages (n = 309 respondents, including 32 respondents from the LGBTIQ shelter). Bivariate tests and generalized linear mixed models were applied to examine differences in health and healthcare utilization between the two groups., Results: Residents of the LGBTIQ shelter show high rates of chronic and mental illness. They use ambulatory and mental health services more frequently than asylum-seekers from other shelters, including a significantly higher chance of obtaining psychotherapy/psychiatric care in case of need. Emergency room utilization is also higher in the LGBTIQ group., Conclusions: Asylum-seekers from the LGBTIQ shelter face high chronic and mental health burdens. Tailored services in the LGBTIQ shelter help obtain adequate healthcare; they should be scaled up to maximize their potential. Yet, unmet needs remain and warrant further research.