Hidden healthcare populations: using intersectionality to theorise the experiences of LGBT+ people in Nigeria, Africa

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Minority population groups are often excluded or marginalised within
health systems and in health research and policy. This article argues
that theories of intersectionality can help us to understand these issues
and develops the concept of ‘hidden healthcare populations’ – using
the case of people who identify as Lesbian, Gay, Bisexual, Transgender
Plus (LGBT+) in Nigeria, in sub-Saharan Africa. The findings present
original qualitative data from a seldom heard population group about
instances of abuse, rejection and marginalisation by healthcare
providers working in public and private healthcare facilities, and the
attempts of LGBT+ people to resist and survive in that context. We
extend theoretical understandings of intersectionality in global public
health and explore how the concept relates to the social determinants
of health. The article has significant implications for policy and
healthcare education and responds to a call from the World Health
Organisation to generate context-specific data to guide interventions
targeted at minority population groups. Additionally, our discussion has
wider significance because it highlights the Western-centric nature of
much theory in health policy – and offers analysis and reinterpretation
that incorporates queer, postcolonial, African perspectives.


Original languageEnglish
Pages (from-to)1-16
JournalGlobal Public Health
Early online date8 Dec 2020
Publication statusE-pub ahead of print - 8 Dec 2020


  • HIV/AIDS, LGBT+, decentred policy analysis, health inequalities, intersectionality, religion