Abstract / Summary
Abstract Background International research indicates that lesbian patients often face poorer patient experiences and encounter barriers to health care, yet research on this issue remains scarce in the German context, particularly within primary care. This study aimed to explore how lesbian patients perceive and navigate primary care in Germany. Methods We used a qualitative, grounded theory-informed approach and conducted 22 episodic semi-structured interviews with lesbian patients in Berlin and Brandenburg, Germany; one participant later withdrew consent, resulting in a final sample of 21. Data were analysed using thematic coding following Flick and type construction according to Kluge. Results Across the dataset, participants shared common experiences in the general practitioner (GP)–patient relationship: barriers included heteronormative assumptions, outing pressure, and limited GP knowledge of lesbian health, whereas facilitating factors comprised open communication, inclusive language, and both symbolic and structural signs of support. Within the context of these shared experiences, participants navigated primary care in different ways, reflected in two idealised analytical poles. One, a protective concealment orientation, involved heightened vigilance and anticipated discrimination. The other, an affirmed identity orientation, was marked by greater agency, identity integration, and reliance on personal and social resources. Conclusions Our findings align with the minority stress model and the concept of cultural humility. GPs should reflect on their own communication, moving towards open and unbiased communication free of heteronormative assumptions; in addition, structural change is needed, including provider training and national care guidelines, alongside further research. Trial registration: Not applicable.