“Do I feel safe revealing this information to you?”: Patient perspectives on disclosing sexual orientation and gender identity in healthcare

Abstract

Objective: To examine university student perspectives on, and experiences with, disclosing sexual orientation and gender identity (SO/GI) in healthcare. Participants: Thirty-four graduate and undergraduate students from a large mid-Atlantic city in the United States participated in 1 of 6 focus groups held from October 2017 to February 2018. Methods: Focus groups were audio-recorded and transcribed verbatim. Transcripts were analyzed using thematic analysis and principles of grounded theory to identify emerging themes. Results: Patient considerations around disclosing SO/GI fell within three thematic categories: the relevancy of SO/GI information to the clinical encounter, the patient–provider relationship, and concerns about negative provider reactions to disclosure. Conclusions: Findings highlight the need for provider understanding of SO/GI diversity and establishing safe and comfortable environments to facilitate disclosure for young adult patients. Lack of sensitivity to patients’ experiences may exacerbate health disparities among sexual and gender minorities by failing to collect accurate epidemiological data and discouraging seeking care.

Keywords:

• gender identity
• health disparities
• patient–provider communication
• qualitative research
• sexual orientation

Acknowledgments

The authors thank Lauren Nadler and Nicky Knepp for their contributions to the data collection and coding.

Author note

The views expressed in this article do not necessarily represent those of the U.S. Department of Veterans Affairs or the US Government.

Conflict of interest disclosure

The authors have no conflicts of interest to report. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of United States and received approval from the Institutional Review Board of University of Pennsylvania.