The L-Health project, funded by the European Union, is the first study on the health of LesBianes* at the European level. It combines quantitative and qualitative methodologies to address inequalities in primary care for this community in Catalonia.

On Friday, February 21, at 11:00 a.m., the official presentation of the L-Health project took place at the headquarters of the atalan Health Institute. This pioneering and necessary research is being conducted due to the lack of existing data, not only in Catalonia but also at the national and international levels. The objective is to design training for healthcare professionals to improve the clinical practice received by LesBianes* in primary care services. Likewise, the initiative aims to identify health and primary care inequalities affecting lesbians, bisexuals, pansexuals, and heterosexual women who have affective-sexual relationships with other women.

IDIBGI is participating in this project, led by Institut d’Investigació en Atenció Primària Jordi Gol i Gurina (IDIAPJGol), and also includes the participation of the Agència de Salut Pública de Barcelona (ASPB), Sida Studi, and the EuroCentralAsian Lesbian* Community (EL*C). Its main objectives are:

• Understanding the needs and discrimination experienced by LesBianes* concerning their health and primary care and analyzing health inequalities.
• Exploring the needs, knowledge gaps, and attitudes of primary healthcare professionals towards LesBianes*.
• Designing and evaluating training for healthcare professionals to improve clinical practice for LesBianes*.

Through these objectives, L-Health aims to promote excellence in the clinical care of this community within primary healthcare services.

Project Methodologies
During the presentation, the project’s principal researchers explained the three fundamental lines of this study:

1. Quantitative study using an online chain methodology. A questionnaire will be distributed to LesBianes*, which they must complete. Each participant will invite three more LesBianes* they know. The first participant in the chain, known as the “seed,” plays a key role in disseminating the study and extending the chain. Anna Ponjoan, principal investigator of L-Health, highlighted: “If we achieve long participation chains, this methodology will allow us to obtain a representative sample of the diversity within the LesBianes* community in Catalonia.” Additionally, a large clinical database of seven million medical records from primary care patients in Catalonia, called SIDIAP, will be used to identify health inequalities and compare the health status of the representative sample of LesBianes* with a random sample of women from the general population.
2. Qualitative study through group interviews with LesBianes* and primary care professionals. Parallel to this, group discussions will be organized in which participants will reflect on their health needs, the barriers they face in primary care, and possible improvement proposals. Additionally, groups will be formed with primary care professionals to understand their experiences, attitudes, and needs with the aim of improving knowledge and clinical practice towards this community. Constanza Jacques, also a principal investigator of the project, emphasized: “It is essential that LesBianes* are not only the subject of study but also active protagonists in building a more equitable healthcare system.”
3. Study using participatory methodologies. This project adopts a feminist and intersectional perspective, making it crucial to promote participatory strategies involving a diverse range of LesBianes*. A Steering Group, coordinated by ASPB, has been created to advise on the different phases of the project and respond to the needs of the community.

Pilot Training
Based on these research lines, the NGO Sida Studi will design a participatory pilot training program for healthcare professionals. In line with the project’s feminist and intersectional perspective, the training will use methodologies related to reflexivity and situated knowledge, aiming to promote community health for LesBianes* within primary care services.

The Perspective of Participants
One of the most significant moments of the press conference was the testimony of the person who initiated the participation chain. Speaking anonymously, they shared their personal experience: “We know that the lack of information about our health is not a coincidence. If we are not in the studies, if we are not part of the research, it is as if we do not exist.”

A Transformative Impact
L-Health, which will be conducted between 2024 and 2026, seeks not only to collect data but also to transform the results into practical tools. These tools will include educational materials to raise awareness among healthcare personnel and improve their clinical practice, with the ultimate goal of fostering more inclusive primary care.
The project is based on feminist and intersectional values, recognizing the diversity and structural inequalities affecting this community.

Organization and Collaboration
L-Health is the result of an interdisciplinary collaboration between the Fundació Institut Universitari per a la Recerca en Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), the EuroCentralAsian Lesbian* Community (EL*C), Agència de Salut Pública de Barcelona (ASPB), the NGO Sida Studi, and the Girona Biomedical Research Institute (IDIBGI). These entities join forces to combine academic research, international community activism, and political advocacy in the field of public health.

(*) NOTE: The L-Health project uses the term LesBianes* as an inclusive concept encompassing lesbians, bisexuals, pansexuals (both cisgender women and other gender-diverse identities), as well as heterosexual women who have sex with or are attracted to other women. This approach acknowledges the diversity of identities and experiences within the community, ensuring that all are represented in the study.