“It’s Not Safe; They Think Being Gay is a Disease”: Lesbian, Gay and Bisexual Peoples’ Experiences of Navigating Healthcare in St. Lucia

Lesbian, gay, and bisexual (LGB) individuals face significant healthcare disparities, yet research remains concentrated in Western, anglophone nations with established LGBTQ+ rights frameworks. The Caribbean is critically underrepresented in this literature, and St. Lucia, a small island nation shaped by Kwéyòl cultural heritage, Catholic-majority religiosity, and incomplete legal protections, has received limited empirical attention. This qualitative study examined how LGB individuals navigate the healthcare system in St. Lucia. Fourteen semi-structured interviews were analyzed using reflexive thematic analysis, guided by the Health Stigma and Discrimination Framework, Minority Stress Theory, and Queer Theory. Four themes were identified: persistent pathologization of same-sex attraction; systemic discrimination ranging from outright care refusal to pervasive clinical coldness; a hidden geography of affirming care existing only through covert informal networks; and strategic concealment of sexual identity, a protective strategy that was psychologically costly and sometimes directly compromised care quality. Findings illuminate how legal, religious, cultural, and structural forces converge in this small, post-colonial, collectivist context to make healthcare a site of risk as much as care.