LAUSR

abstract This focus piece examines the findings of a qualitative study on the utilisation of health services among lesbian, gay, bisexual and transgender (LGBT) students in Durban. In-depth interviews with 12 LGBT-identifying students from the University of KwaZulu-Natal (UKZN) shed light on the factors influencing uptake of health services within and outside the university. The interviews show that factors inhibiting use outweighed the factors promoting use of health services among this group. LGBT students are often victims of structural violence, and they find themselves marginalised within the health system. Participants perceived health providers to be morally judgmental and lacking cultural sensitivity to meaningfully engage with same-sex activities and sexual health needs. They also perceived the South African health system to be neglectful and discriminating towards sexual minorities, as their health concerns are mostly addressed and met by foreign-funded health organisations. Social exclusion and non-inclusivity were clearly expressed. Students experienced health services to be heteronormative, saying that sexual and reproductive health resources and information exhibited in most health facilities did not adequately address the health issues confronted by sexual minorities. The consequences of structural violence on mental health and general wellbeing of students manifest through denials of sexual and reproductive health needs and delays in health seeking behaviours in the public health system, putting LGBT students at substantial risk of contracting sexually transmitted infections, and causing them to suffer physical and psychological harm. The findings point to the importance of making health services more inclusive of sexual minorities.