Community fear or dislike of LGBTQ+ people Lack of public information about LGBTQ+ competent medical or service providers in my area Long distances to LGBTQ+ culturally competent medical facilities Not enough support groups (clinical or peer) for LGBTQ+ people Not enough health professionals who are adequately trained and competent to deliver health care to LGBTQ+ people Doctors and other health care workers who refuse to provide services to LGBTQ+ people