Sexual and Gender Minority University Students Report Distress Due to Discriminatory Health Care Policies

"Religious conscience" or "health care denial" policies allow health care providers and institutions to refuse to provide services in the name of religious freedom. Denial policies are a form of structural stigma that could impede access to health care for sexual and gender minority (SGM) populations, particularly SGM young adults. This study describes SGM university students' response to policies permitting health care providers to deny care based on their religious beliefs. Data were obtained from 8,322 SGM students at 38 colleges and universities who participated in the Spring 2020 Healthy Minds Study. Descriptive statistics are reported for the level of distress due to the denial policies and likelihood to avoid identity disclosure. Over 90% of SGM students report distress knowing about denial policies (sexual minority: 6.95/10; gender minority: 8.05/10). Students also reported similarly high distress imagining that they had been denied care (sexual minority: 8.05/ 10; gender minority: 8.57/10). The majority of sexual (69.2%) and gender minority (82.2%) students agreed the policy would make them less likely to disclose their identity to a new provider. Experiencing, or even anticipating, discrimination in health care settings through denial policies has negative impacts on the health of SGM populations and has the potential to exacerbate existing mental health disparities for SGM young adults.