Anticipated Stigma is Associated with Lower Healthcare Access and Longer Diagnostic Delay in LGBTQ+ Patients with Endometriosis Symptoms

Objective: It is important to understand the barriers that lead to an endometriosis diagnosis, to reduce the diagnostic delay. This study aimed to examine whether endometriosis-related anticipated stigma is associated with healthcare access and diagnostic delay in an LGBTQ+ sample. Sexual orientation concealment and conformity to feminine norms were explored as moderators. Methods: This study was a quantitative design. 145 participants who identified as a sexual orientation minority (including gender minorities) with endometriosis symptoms, completed an online questionnaire. Linear regression, moderation, and moderated moderation analyses examined the relationships between variables. Results: Participants waited on average eight years for a diagnosis after first visiting a healthcare provider. Higher levels of endometriosis-related anticipated stigma were associated with lower levels of healthcare access and longer clinical diagnostic delay. There was a moderating effect of sexual orientation concealment on the relationship between endometriosis-related anticipated stigma and clinical diagnosis time dependent on levels of conformity to feminine norms related to romantic relationships. Conclusions: Anticipated endometriosis stigma delays accessing care and diagnosis. This relationship may be shaped by societal structures that systematically marginalise certain populations. Interventions to reduce delays should consider demographic factors such as sexual orientation to ensure interventions are effective for all with endometriosis.