Healthcare, Vol. 14, Pages 114: Bias at the Bedside: A Comprehensive Review of Racial, Sexual, and Gender Minority Experiences and Provider Attitudes in Healthcare

Healthcare doi: 10.3390/healthcare14010114

Authors:
Emily J. R. Carter
Roberto Sagaribay
Aditi Singh
Lorraine S. Evangelista
Deborah A. Kuhls
Jennifer R. Pharr
Kavita Batra

Background/Objectives: Persistent inequities in healthcare experiences and outcomes among marginalized racial/ethnic groups and sexual and gender minority (SGM) populations have been well documented. However, disparities in perceptions of discrimination and bias between patients and health providers remain insufficiently understood. This review synthesizes the current evidence on how these groups differently perceive discrimination, how bias manifests in clinical encounters, and how intersecting identities shape healthcare experiences. Methods: A comprehensive review using SANRA guidelines examined racial/ethnic discrimination, SGM-related bias, provider implicit attitudes, minority stress processes, and structural determinants of inequity in healthcare settings. Articles were identified through systematic search strategies across major databases, and their conceptual, methodological, and theoretical contributions were analyzed. Results: Across studies, marginalized patients consistently reported discrimination, stigma, and mistrust in healthcare, whereas providers often underestimated the prevalence and impact of these experiences. Evidence indicates that implicit pro-White biases among providers influence communication quality, clinical decision-making, and patient comfort. Structural racism and intersecting minority statuses further compound disparities, contributing to delayed care, unmet health needs, and poorer outcomes. Limited alignment between patient and provider perceptions suggests a gap in recognition of inequitable treatment and its drivers. Conclusions: Healthcare inequities arise from interconnected, interpersonal, and structural mechanisms. Addressing these disparities requires multilevel interventions targeting provider training, institutional policy reform, and system-level barriers. Integrating both patient and provider perspectives is essential for developing equitable, affirming models of care and improving health outcomes for racial/ethnic and SGM populations.

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Emily J. R. Carter www.mdpi.com