Lesbian disclosure and health care seeking in the United States: A replication study

Abstract

The current study explored factors associated with lesbian disclosure to health care providers (HCPs) and engagement in preventative health behaviors by replicating and extending a Canadian path analysis study with a sample of U.S. lesbians. Both patient (education, feminism, global outness, and internalized homophobia) and HCP-related (lesbian-friendly HCPs and patient comfort) factors were either directly or indirectly associated with disclosure and engagement in preventative health behaviors, including avoidance of health-compromising behaviors (e.g., smoking) and health care seeking. Importantly, findings suggest that HCPs-particularly those who are inclusive of lesbian patients-may play a role in assuaging their patients' experiences of minority stress. Overall, the findings were similar to those originally reported in the Canadian study, with the exception of internalized homophobia playing a more visible role in the current study.

Nonadherence to breast and cervical cancer screening among sexual minority women: Do stigma-related psychological barriers play a role?

“…As noted by Katz (2009), studies have documented the reluctance of patients to disclose sexual orientation to avoid negative reaction or vulnerability (e.g., Law, Mathai, Veinot, Webster, & Mylopoulos, 2015), even though disclosure can improve health (St. Pierre, 2013).…”

“…Another potential relevant psychological process is internalized homophobia (IH), the integration of negative societal views about homosexuality into a person’s self-concept (Hatzenbuehler, 2009). Internalized homophobia can diminish a woman’s willingness to disclose her sexual orientation and to seek health care services (St. Pierre, 2013).…”

“…Conversely, SMW who disclose their sexual identity to HCPs appear to have better self-reported health outcomes than those who do not disclose (Kamen, Smith-Stoner, Heckler, Flannery, & Margolies, 2015). Studies have indicated that disclosure of lesbian identity to HCPs predicted increased rates, for example, of Pap test, clinical breast exam, and mammography, thereby enabling more comprehensive services (St. Pierre, 2013).…”

Fatores Associados à Prevenção Sexual e Reprodutiva de Mulheres Lésbicas

“…Dentro do contexto de atendimento, a postura do profissional de saúde no tratamento de mulheres lésbicas é de suma importância para que elas falem sobre sua orientação sexual abertamente, garantindo um bom atendimento e possibilitando maior adesão ao tratamento e a práticas de saúde (Tabaac, Perrin, & Trujillo, 2015). Para clínicos que se preocupam em incorporar determinantes sociais em sua abordagem para cuidados com a saúde, saber sobre a orientação sexual de suas pacientes tem o potencial de prover um atendimento mais humanizado, coerente e com maior compreensão sobre o todo (Pierre, 2017).…”

“…No que diz respeito à raça, mulheres lésbicas negras em geral são menos abertas sobre sua orientação sexual do que mulheres lésbicas brancas (Meyer, 2003;Morris et al, 2001). A abertura também costuma aparecer de diferentes maneiras em mulheres, a depender do contexto social e econômico em que elas se encontram, geralmente sendo mais presente em mulheres com maior renda e nível de escolaridade mais alto (Pierre, 2017).…”