Patterns and Predictors of Disclosure of Sexual Orientation to Healthcare Providers Among Lesbians, Gay Men, and Bisexuals
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The present study sought to identify patterns and predictors of disclosure of sexual orientation to healthcare providers among lesbian, gay, and bisexual (LGB) adults. Respondents were 396 self-identified LGB individuals ages 18–59, recruited from diverse community venues in New York City, with equal numbers of men and women and Whites, Blacks, and Latinos. Respondents were interviewed at baseline and 1-year follow-up. We assessed the relationships among disclosure of sexual orientation, demographic characteristics, health, and minority stress. Rates of nondisclosure to healthcare providers were significantly higher among bisexual men (39.3 %) and bisexual women (32.6 %) compared with gay men (10 %) and lesbians (12.9 %). Bivariate and multivariate logistic regression models predicting disclosure of sexual orientation indicated that patient age, level of education, immigration status, medical history, level of internalized homophobia, and degree of connectedness to the LGBT community were significant factors, along with sexual identity. Nondisclosure of sexual orientation was related to poorer psychological well-being at 1 year follow-up. Our findings suggest that interventions targeting sexual minorities ought to carefully tailor messages to subpopulations. In particular, interventionists and clinicians ought to be mindful of differences between bisexually and gay/lesbian-identified individuals.
KeywordsHealthcare Doctor–patient communications Lesbians Gay men Bisexuals
- Bernstein, K. T., Liu, K., Begier, E. M., Koblin, B., Karpati, A., & Murrill, C. (2008). Same-sex attraction disclosure to health care providers among New York City men who have sex with men: Implications for HIV testing approaches. Archives of Internal Medicine, 168, 1458–1464.PubMedCrossRefGoogle Scholar
- Frost, D. M., Lehavot, K., & Meyer, I. H. (2011, August). Minority stress and physical health among sexual minorities. Poster presented at the 119th Annual Convention of the American Psychological Association, Washington, DCGoogle Scholar
- Gates, G. J. (2011). How many people are lesbian, gay, bisexual, and transgender? Retrieved from The Williams Institute website: http://williamsinstitute.law.ucla.edu/wp-content/uploads/Gates-How-Many-People-LGBT-Apr-2011.pdf. Accessed 26 July 2012.
- Herek, G. M., & Glunt, E. K. (1995). Identity and community among gay and bisexual men in the AIDS era: Preliminary findings from the Sacramento Men’s Health Study. In G. M. Herek & B. Greene (Eds.), AIDS, identity, and community: The HIV epidemic and lesbians and gay men (pp. 55–84). Thousand Oaks, CA: Sage.Google Scholar
- Institute of Medicine. (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. Washington, DC: The National Academies Press.Google Scholar
- Martin, J. L., & Dean, L. (1987). Summary of measures: mental health effects of AIDS on at-risk homosexual men. Unpublished manuscript.Google Scholar
- The Fenway Institute (2012). How to gather data about sexual orientation and gender identity in clinical settings. Retrieved from The Fenway Institute website: http://www.fenwayhealth.org/site/DocServer/Policy_Brief_HowtoGather..._v3_01.09.12.pdf?docID=9142
- The Joint Commission (2011). Advancing effective communication, cultural competence, and patient- and family- centered care for the lesbian, gay, bisexual, and transgender (LGBT) community: a field guide. Oak Brook, IL.Google Scholar
- U.S. Department of Health and Human Services, Health Resources and Services Administration. (2011). Women’s health USA 2011. Rockville, Maryland: U.S. Department of Health and Human Services.Google Scholar
- Ware, J. E., Kosinski, M., Turner-Bowker, D. M., & Gandek, B. (2002). Introduction. In How to score version 2 of the SF-12 Health Survey; pp. 3-8. Lincoln, RI, & Boston, MA: QualityMetric Inc., & Health Assessment Lab.Google Scholar
- Williams, D. R., Spencer, M. S., & Jackson, J. S. (1999). Race, stress, and physical health. In R. J. Contrada & R. D. Ashmore (Eds.), Self, social identity, and physical health (pp. 71–100). NY: Oxford University Press.Google Scholar