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Original Research: Lesbian Disclosure to Health Care Providers and Delay of Care

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Journal of the Gay and Lesbian Medical Association

Abstract

Purpose/Objective: 1) To identify if lesbians delay seeking health care because of sexual identity issues. 2) To examine the frequency of sexual identity disclosure for both lesbians and heterosexual women to health care provider (HCP). 3) To identify the methods used by HCPs, lesbians, and heterosexual women to disclose sexual identity. 4) To identify lesbians' perceptions of how disclosure of sexual identity could be made easier for them. Design: Descriptive study with convenience sample. Data gathered by survey. Setting: Thirty-three health care offices or clinics across the United States. Sample: The typical participant (n = 1161) was 40.14 years old (SD = 11.32, range = 15–92). Of this sample, 45.1% (n = 524) identified as lesbian and 54.9% (n = 637) identified as heterosexual. Most identified as white (83.6%) and educated, with variability in income levels. Measurement: Written survey was designed by expert clinicians and refined after two pilot studies. Results: Seventeen percent of HCPs inquired about client's sexual identity verbally; only 43% of HCPs (inclusive of this 17%) inquired about sexual identity in writing or in some other way. Lesbians reported that HCPs were less likely to know their sexual identity than heterosexual women. Lesbians were more likely to voluntarily report their sexual identity to HCPs than heterosexual women. Lesbians reported that ease of disclosure could be assisted by asking verbally, asking in writing, and by “improvement of HCP attitude.” Lesbians reported more delays in seeking health care because of sexuality issues, specifically, fear of discrimination against them because of their sexual identity compared to heterosexual women. Lesbians were more likely to conceal their lesbian identity from HCPs when they were less disclosed to family, co-workers, and friends. Conclusion: Most HCPs did not assess for sexual identity, even though related issues are important to discuss with clients. HCPs can ease disclosure by asking about sexual identity and by awareness of their expression of attitudes toward lesbianism. Delay of care related to discrimination can be considered a social risk factor for lesbian health and well-being.

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REFERENCES

  1. Morris J. Lesbian coming out as a multidimensional process. J Homosex. 1997;33(2):1–23.

    Google Scholar 

  2. O'Hanlan K. Lesbian health and homophobia: Perspectives for the treating obstetrician/gynecologist. Curr Probl Obstet, Gynecol Fertil 1995;July/August:100–33.

  3. Stevens PE. Lesbian health care research:Areview of the literature from 1970 to 1990. Health Care forWomen International 1992;13:91–120.

    Google Scholar 

  4. Herek GM. Psychological heterosexism in the United States. In: D'Augelli, A, Patterson C, editors. Lesbian, Gay, and Bisexual Identities Throughout the Lifespan: Psychological Perspectives. New York: Oxford University Press, 1995; 321–46.

    Google Scholar 

  5. Gartrell N. The lesbian as a “Single” woman. AmJ Psychother. 1981;35(4):502–09.

    Google Scholar 

  6. Eliason M. Lesbian and gay family issues. J Fami Nurs 1996;2(1):1–29.

    Google Scholar 

  7. Lyons TA. Lesbian mothers’ custody fears. Women and Therapy 1983; 2:231–40.

    Google Scholar 

  8. Steinhorn A. Lesbian mothers--The invisible minority: Role of the mental health worker. Women Ther 1983;1(4):35–48.

    Google Scholar 

  9. Jordan KM, Deluty RH. Coming out for lesbian women: Its relation to anxiety, positive affectivity, self-esteem, and social support. J Homosex 1998;35(2):41–63.

    PubMed  Google Scholar 

  10. Brown L. Lesbian identities: Concept and issues. In: D'Augelli A, Patterson C, editors. Lesbian, Gay and Bisexual Identities Over the Lifespan: Psychological Perspectives. New York: Oxford University Press, 1995:3–23.

    Google Scholar 

  11. D'Augelli, AR, Hershberger SL. Lesbian, gay and bisexual youth in community settings: Personal challenges and mental health problems. Am J Community Psychol 1993;21(4): 421–48.

    PubMed  Google Scholar 

  12. Gonsiorek J. Gay male identities: concepts and issue. In: D'Augelli A, Patteron C, editors. Lesbian, Gay and Bisexual Identities Over the Lifespan: Psychological Perspectives. New York: Oxford University Press, 1995:24–47.

    Google Scholar 

  13. Kurdek LA, Schmitt PJ. Perceived emotional support from family and friends in members of homosexual, married and heterosexual cohabitating couples. J Homosex 1987;14(3/4):57–68.

    PubMed  Google Scholar 

  14. Stevens PE, Hall JM. Stigma, health beliefs and experiences with health care in lesbian women. Image J Nurs Sch 1988;20(2):69–73.

    PubMed  Google Scholar 

  15. Bradford J, Ryan C, Rothblum E. National lesbian health care survey: Implications for mental health. J Consult Clin Psychol 1994;62(2):228–42.

    PubMed  Google Scholar 

  16. Eliason M, Randall CE. Lesbian phobia in nursing students. West J Nurs Res 1991;13(3):363–74.

    PubMed  Google Scholar 

  17. Gentry SE. Caring for lesbians in a homophobic society. Health Care Women Int 1992;13:173–80.

    PubMed  Google Scholar 

  18. Anderson MK, Mavis BE. Sources for coming out self-efficacy for lesbians. J Homosex 1996;32(2):37–52.

    PubMed  Google Scholar 

  19. Lucas V. An investigation of the health care preferences of the lesbian population. Health Care Women Int 1992;13:221–8.

    PubMed  Google Scholar 

  20. Stevens PE. Protective strategies of lesbian clients in health care environments. Res Nurs Health 1994;17:217–29.

    PubMed  Google Scholar 

  21. Hitchcock JM, Wilson HS. Personal risking: Lesbian selfdisclosure of sexual orientation to professional health care providers. Nurs Res 1992;41(3):178–83.

    PubMed  Google Scholar 

  22. PerrinEC, Kulkin H. Pediatric care for children whose parents are gay or lesbian. Pediatrics 1996;97(5):629–35.

    PubMed  Google Scholar 

  23. Institute of Medicine. Lesbian Health: Current Assessment and Directions for the Future.Washington, DC: National Academy Press, 1999.

    Google Scholar 

  24. Erlichman KL. Lesbian mothers: Ethical issues in social work practice. Women Ther 1989;8(3):207–24.

    Google Scholar 

  25. Falk PJ. Lesbian mother: Psychosocial assumptions in family law. Am Psychol 1989;44(6):941–7.

    Google Scholar 

  26. Rand C, Graham DLR, Rawlings EI. Psychological health and factors the courts seek to control in lesbian mothers custody trials. J Homosex 1982;8(1):27–39.

    PubMed  Google Scholar 

  27. White JC, Levinson W. Lesbian health care: What a primary care physician needs to know. West J Med 1995;162:463–6.

    PubMed  Google Scholar 

  28. Slater S, Mencher J. The lesbian family life cycle:Acontextual approach. Am J Orthopsychiatry 1991;61(3):372–82.

    PubMed  Google Scholar 

  29. Krieger N, Rowley D, Herman A, AveryB, Phillips M. Racism, sexism and social class: Implications for studies of health, disease and well-being. Am J Prev Med 1993;9(6 suppl): 82–122.

    PubMed  Google Scholar 

  30. White JC, Levinson W. Primary care of lesbian patients. J Gen Intern Med 1993;8:41–7.

    Google Scholar 

  31. White JC, Dull VT. Health risk factors and health-seeking behavior in lesbians. J Women's Health 1997;6(1):103–12.

    Google Scholar 

  32. Roberts SA, Dibble SL, Scanlon JL, Paul SM, Davids H. Differences in risk factors for breast cancer: Lesbian and heterosexual women. JGay Lesbian Med Assoc 1998;2(3):93–101.

    Google Scholar 

  33. Matthews WC, Booth MW, Turner JD, Kessler, L. Physician's attitudes toward homosexuality--Survey of the California County Medical Society. West J Med 1986;144:106.

    PubMed  Google Scholar 

  34. Wallick M, Cambre K, Townsend M. How the Topic of Homosexuality is Taught at U.S. Medical Schools. Acad Med 1992; 67(9):601–63.

    PubMed  Google Scholar 

  35. Gonsiorek JC. Mental health issues of gay and lesbian adolescents. J Adolesc Health Care 1988;9:114–22.

    PubMed  Google Scholar 

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van Dam, M.A.A., Koh, A.S. & Dibble, S.L. Original Research: Lesbian Disclosure to Health Care Providers and Delay of Care. Journal of the Gay and Lesbian Medical Association 5, 11–19 (2001). https://doi.org/10.1023/A:1009534015823

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  • DOI: https://doi.org/10.1023/A:1009534015823

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