https://doi.org/10.4081/qrmh.2018.7157

Waiting for the doctor to ask: influencers of lesbian, gay, and bisexual identity disclosure to healthcare providers

Vol. 2 No. 1 (2018)
Submitted: 11 November 2017
Accepted: 8 April 2018
Published: 30 May 2018
Communication, Medical, Disclosure, Decision-making, Gay, Lesbian, Bisexual, Patient-provider.
Abstract Views: 1293
PDF: 676
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Nicole C. Hudak
nh017915@ohio.edu
School of Communication Studies, Ohio University, Athens, OH, United States.
Heather J. Carmack
Department of Communication Studies, University of Alabama, Tuscaloosa, AL, United States.
Lesbian, gay, and bisexual (LGB) individuals encounter multiple barriers in healthcare, resulting in problematic care. Many LGB patients wrestle with whether to disclose their sexuality to healthcare providers. This article explored what influences LGB patients’ decision to disclose their sexuality to healthcare providers. Guided by Communication Privacy Management theory, the authors conducted in-depth interviews with 20 LGB patients. LGB patients heavily relied on boundary management when negotiating the disclosure of their sexuality. The findings suggest several factors influence LGB patients’ disclosure of sexuality: i) experience with family; ii) fear of gossip and connections; iii) concern for provider care refusal; iv) religion; v) age; and vi) level of trust with providers. Boundary turbulence can be created between patient and provider when there is uncertainty about if and when sexuality is considered private information. Additionally, a site of tension for LGB patients was their concern about providers sharing private information outside the clinic setting.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Healthy People 2020. Lesbian, gay, bisexual and transgender health [Internet]. United States Department of Health and Human Services. Washington, DC: USDHHS; 2013 [cited 2015 May 1]. Available from: http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=25
Mimiaga MJ, Goldhammer H, Belanoff C, et al. Men who have sex with men: perceptions about sexual risk, HIV and sexually transmitted disease testing, and provider communication. Sex Transm Dis 2007;34:113–119. DOI: https://doi.org/10.1097/01.olq.0000225327.13214.bf
Kuyper L, Vanwesenbeek I. Examining sexual health differences between lesbian, gay, bisexual, and heterosexual adults: the role of sociodemographics, sexual behavior characteristics, and minority stress. J Sex Res 2011;48:263–274. DOI: https://doi.org/10.1080/00224491003654473
McNair R. Outing lesbian health in medical education. Women Health 2003;4:89-103. DOI: https://doi.org/10.1300/J013v37n04_07
Hudak N. “Do you have to ask me one more time?”: communicating heterosexism in healthcare. Competitive paper presented at the NCA, Philadelphia, PA.
Goins ES, Pye D. Check the box that best describes you: reflexivity managing theory and praxis in LGBTQ health communication research. Health Commun 2012;28;397-407. DOI: https://doi.org/10.1080/10410236.2012.690505
Hudak N, Bates BR. In pursuit of “queer-friendly” healthcare: an interview study of how queer individuals select care providers. Health Commun 2018;1-7. DOI: https://doi.org/10.1080/10410236.2018.1437525
Utamsingh PD, Smart Richman L, Martin JL, et al. Heteronormativity and practitioner-patient interaction. Health Commun 2016;31:566-574. DOI: https://doi.org/10.1080/10410236.2014.979975
Venetis, MK, Meyerson, BE, Friley, BL, et al. Characterizing sexual orientation disclosure to heatlh care providers: lesbian, gay, and bisexual perspectives. Health Commun 2017;32;578-586. DOI: https://doi.org/10.1080/10410236.2016.1144147
Greene K, Magsamen-Conrad K, Venetis MK, et al. Assessing health diagnosis disclosure decisions in relationships: testing the disclosure decision-making model. Health Commun 2012;27:356–368. DOI: https://doi.org/10.1080/10410236.2011.586988
Neville Miller A, Rubin DL. Factors leading to self-disclosure of a positive HIV diagnosis in Nairobi, Kenya. Qual Health Res 2007;17:586-598. DOI: https://doi.org/10.1177/1049732307301498
Smith RA, Hernandez R, Catona D. Investigating initial disclosures and reactions to unexpected, positive HPV diagnosis. West J Commun 2014;78:426–440. DOI: https://doi.org/10.1080/10570314.2013.786120
Broekema K, Weber KM. Disclosures of cystic fibrosis-related information to romantic partners. Qual Health Res 2017;27:1575-1585. DOI: https://doi.org/10.1177/1049732317697675
Qiao S, Li X, Staunton B. Practice and perception of parental HIV disclosure to children in Beijing, China. Qual Health Res 2014;24:1276-1286. DOI: https://doi.org/10.1177/1049732314544967
Carmack HJ. “What happens on the van, stays on the van”: the (re)structuring of privacy and disclosure scripts on an Appalachian mobile health clinic. Qual Health Res 2010;20:1393-1405. DOI: https://doi.org/10.1177/1049732310372618
Petronio S. Boundaries of privacy: dialectics of disclosure. Albany, NY: State University of New York Press; 2002.
Bjorkman M, Malterud K. Being lesbian – does the doctor need to know?: a qualitative study about the significance of disclosure in general practice. Scand J Prim Health Care 2007;25:58–62. DOI: https://doi.org/10.1080/02813430601086178
Austin EL. Sexual orientation disclosure to health care providers among urban and non-urban southern lesbians. Women Health 2013;53:41–55. DOI: https://doi.org/10.1080/03630242.2012.743497
Kitts RL. Barriers to optimal care between physicians and lesbian, gay, bisexual, transgender, and questioning adolescent patients. J Homosex 2010:57:730–747. DOI: https://doi.org/10.1080/00918369.2010.485872
Labig CE, Peterson TO. Sexual minorities and selection of a primary care physician in a Midwestern U.S. city. J Homosex 2006;51:1–5.
Fish J. Heterosexism in health and social care. New York, NY: Palgrave Macmillan; 2006. DOI: https://doi.org/10.1057/9780230800731
Mayer KH, Bradford JB, Stall R, et al. Sexual and gender minority health: what we know and what needs to be done. Am J Public Health 2008;98:989–995. DOI: https://doi.org/10.2105/AJPH.2007.127811
Petronio S, Sargent J. Disclosure predicaments arising during the course of patient care: nurses’ privacy management. Health Commun 2011;26:255–266. DOI: https://doi.org/10.1080/10410236.2010.549812
Parkhill AL, Mathews JL, Fearing S, Gainsburg J. A transgender health care panel discussion in a required diversity course. Am J Pharm Educ 2014;78:1–7. DOI: https://doi.org/10.5688/ajpe78481
Lindlof TR, Taylor BC. Qualitative communication research methods. 3rd ed. Thousand Oaks, CA: Sage Publications; 2011.
Keyton J. Communication research: asking questions, finding answers. 2nd ed. New York, NY: McGraw-Hill; 2006.
Johnson JM. In-depth interviewing. In: Gubrium JF, Holstein JA, editors. Handbook of interview research: context and method. Thousand Oaks, CA: Sage; 2002. p. 103-119.
Creswell JW. Research designs: qualitative, quantitative, and mixed methods approaches. 4th ed. Thousand Oaks, CA: Sage Publications; 2014.
Tracy SJ. Qualitative quality: eight “big-tent” criteria for excellent qualitative research. Qual Inq 2010;16:837-851. Retrieved from http://qix.sagepub.com/ DOI: https://doi.org/10.1177/1077800410383121
Owen WF. Interpretive themes in relational communication. Q J Speech 1984;70:274–287. DOI: https://doi.org/10.1080/00335638409383697
Sankar P, Mora S, Merz JF, Jones NL. Patient perspectives of medical confidentiality: a review of literature. J Gen Intern Med 2003;18:659-669. DOI: https://doi.org/10.1046/j.1525-1497.2003.20823.x

How to Cite

Hudak, Nicole C., and Heather J. Carmack. 2018. “Waiting for the Doctor to Ask: Influencers of Lesbian, Gay, and Bisexual Identity Disclosure to Healthcare Providers”. Qualitative Research in Medicine and Healthcare 2 (1). https://doi.org/10.4081/qrmh.2018.7157.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.