Increasing LGBTQ Patient Disclosure and Health Outcomes
By Leslie M. Price, MSN, RN, WHNP-BC (she/her/hers)

Many health care providers may underestimate their ability to make an impact on the care of lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients. Each healthcare encounter is an opportunity to provide individualized preventive care that takes all relevant health risks into consideration. When sexual orientation and gender identity status is ignored, so too are the unique risk factors and preventive health measures that the provider may address. Cultural competence extends beyond racial and ethnic borders. Researching the unique health needs of these populations can increase adherence to care, decrease morbidity and mortality common to these populations, and contribute to better health outcomes for LGBTQ and gender non-conforming (GNC) patients. 

Primary care providers can directly impact LGBTQ health through their knowledge of potential barriers to disclosure, the benefits of obtaining disclosure information, and by applying this information to individualized patient care. 

Barriers to disclosure affect health risks and they include the following 

  • A perceived, or actual, discrimination against LGBTQ individuals by office staff or providers
  • Never being asked to identify sexual orientation
  • Heterosexual assumptions by providers
  • Lack of provider knowledge about how LGBTQ status. 

By consulting research on the topic of identity disclosure, providers can implement a number of evidence-based practice changes:

  1. Develop more LGBTQ-inclusive intake forms
  2. Adding LGBTQ non-discrimination statements in their practices
  3. Spend the time to include questions about sexual orientation when taking patient history. 

By decreasing fear of discrimination and offering multiple opportunities for self-disclosure, providers can increase rates of identifying LGBTQ patients and provide more culturally appropriate care. Patient preferences can also be impacted by implementation of LGBTQ screening tools. By taking time to elicit patient preferences and values, providers can include the patient in their own health care choices, learn what guiding principles can be illuminated in the patient’s plan of care, and identify individual needs that can be reflected back to the patient. 

Disclosure of LGBTQ status is a complicated issue often influenced by fear of discrimination, the amount of importance that an individual places on their LGBTQ identity, opportunities to disclose in the healthcare setting, assumptions of providers, and the perceived level of importance of LGBTQ health risks by both patient and provider. Studies indicate that many patients are never screened for sexual orientation, and many do not self-disclose without being prompted. By providing a supportive atmosphere and eliminating heteronormative screening assumptions, patients are given more opportunities to present information that will let providers more adequately assess health risks.

Leslie Price is a guest writer for InCrowd. 

You can learn more about her on LinkedIn.

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