Under What Conditions do Lesbians Disclose Their Sexual Orientation to Primary Healthcare Providers? A Review of the Literature

Pierre, Melissa St.

doi:10.1080/10894160.2011.604837

Cited by 59 publications

(52 citation statements)

References 45 publications

(37 reference statements)

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“…Numerous studies have explored disclosure of sexual orientation in the context of a patient-provider relationship, finding that disclosure depends on the patient-provider relationship, the perceived risk of disclosing, and the patient's internal attributes (Durso & Meyer, 2013;McNair, Hegarty, & Taft, 2012;St. Pierre, 2012).…”

Section: Discussionmentioning

confidence: 99%

Addressing Health Disparities of Lesbian and Bisexual Women: A Grounded Theory Study

Johnson

Nemeth

2014

Women's Health Issues

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Section: Discussionmentioning

confidence: 99%

Addressing Health Disparities of Lesbian and Bisexual Women: A Grounded Theory Study

Johnson

Nemeth

2014

Women's Health Issues

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“…However, we speculate that in the medical context, participants may have taken their disclosure cues from other features such as the office environment rather than from the disclosure recipient. If the office environment communicated that the provider would be open and receptive, patients may have been more comfortable in disclosing (Hitchcock & Wilson, 1992;St. Pierre, 2012).…”

Section: Theoretical Implicationsmentioning

confidence: 97%

Characterizing Sexual Orientation Disclosure to Health Care Providers: Lesbian, Gay, and Bisexual Perspectives

Venetis

Meyerson

Friley

et al. 2016

Health Communication

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This study examines lesbian, gay, and bisexual patients' disclosure patterns of sexual orientation to health care providers. Using a semistructured interview format, researchers conducted interviews with 24 lesbian, gay, bisexual, and queer (LGBQ) adults about sexual orientation disclosure strategies. All interviews were transcribed and independently coded using thematic analysis. Results suggest that patient sexual orientation disclosure may be patient initiated and may occur to clarify or correct provider misinformation. Participants disclosed their orientation early in the medical visit during introductions, during small talk with the provider, and during the history-taking phase of the visit. Participants characterized sexual orientation disclosures as presented with minimal information, casually, and often indirectly. Practical and theoretical implications are discussed.

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“…[9][10][11][12] Racial and ethnic minority populations that are also LGBT are at especially high risk for poor SDM. 13,14 Clinicians often lack the training to encourage disclosure of sexual orientation, [15][16][17] resulting in inadequate communication and SDM. 18 Moreover, generic patient engagement approaches geared toward predominantly white LGBT populations may not be appropriate for patients with multiple minority identities.…”

Section: Introductionmentioning

confidence: 99%

A Model of Organizational Context and Shared Decision Making: Application to LGBT Racial and Ethnic Minority Patients

et al. 2016

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Shared decision making (SDM) occurs when patients and clinicians work together to reach care decisions that are both medically sound and responsive to patients' preferences and values. SDM is an important tenet of patient-centered care that can improve patient outcomes. Patients with multiple minority identities, such as sexual orientation and race/ethnicity, are at particular risk for poor SDM. Among these dualminority patients, added challenges to clear and open communication include cultural barriers, distrust, and a health care provider's lack of awareness of the patient's minority sexual orientation or gender identity. However, organizational factors like a culture of inclusion and private space throughout the visit can improve SDM with lesbian, gay, bisexual, and transgender (BLGBT^) racial/ethnic minority patients who have faced stigma and discrimination. Most models of shared decision making focus on the patient-provider interaction, but the health care organization's context is also critical. Context-an organization's structure and operations-can strongly influence the ability and willingness of patients and clinicians to engage in shared decision making. SDM is most likely to be optimal if organizations transform their contexts and patients and providers improve their communication. Thus, we propose a conceptual model that suggests ways in which organizations can shape their contextual structure and operations to support SDM. The model contains six drivers: workflows, health information technology, organizational structure and culture, resources and clinic environment, training and education, and incentives and disincentives. These drivers work through four mechanisms to impact care: continuity and coordination, the ease of SDM, knowledge and skills, and attitudes and beliefs. These mechanisms can activate clinicians and patients to engage in high-quality SDM. We provide examples of how specific contextual changes could make SDM more effective for LGBT racial/ethnic minority populations, focusing especially on transformations that would establish a safe environment, build trust, and decrease stigma.

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Under What Conditions do Lesbians Disclose Their Sexual Orientation to Primary Healthcare Providers? A Review of the Literature

Cited by 59 publications

References 45 publications

Addressing Health Disparities of Lesbian and Bisexual Women: A Grounded Theory Study

Addressing Health Disparities of Lesbian and Bisexual Women: A Grounded Theory Study

Characterizing Sexual Orientation Disclosure to Health Care Providers: Lesbian, Gay, and Bisexual Perspectives

A Model of Organizational Context and Shared Decision Making: Application to LGBT Racial and Ethnic Minority Patients

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