Disclosure of Sexual Orientation Among Women Who Have Sex With Women During Gynecological Care: A Qualitative Study In Brazil

Abstract

BackgroundEvidence shows that women who have sex with women (WSW) face disparities in access to health care when compared to heterosexual women in several countries. AimTo investigate the experiences WSW have after disclosure of sexual orientation during gynecological care in Brazil. MethodsWe performed a qualitative study using content analysis. We recorded and transcribed interviews with 34 WSW from the 5 regions in Brazil. Data were analyzed using descriptive content analysis. OutcomesThe main categories of analysis were decision-making process to disclose and attitude of gynecologists after disclosure. ResultsWSW disclosed their sexual orientation in an un-favorable environment. Gynecologists rarely asked about patients’ sexual orientation and used a script for hetero-normative anamnesis. The reactions of gynecologists were discriminatory, resulting in abbreviated consultations and un-comfortable gynecological exams. They missed a window of opportunity for prevention, diagnosis, and treatment of various diseases. The experiences Brazilian WSW had during gynecological care demonstrated the dominant hetero-normativity in the health care scenario. The attitudes of the gynecologists precarized the existence of WSW in health service. Clinical ImplicationsThis study suggests that gynecologists missed an opportunity to use WSW's sexual orientation disclosure to offer specific care to them. Strengths & LimitationsThis is the first qualitative study about WSW’s experiences during gynecological care in Brazil. Future studies should be developed from a wider sampling, especially among lower-class WSW. ConclusionThe results point out the need for a change in medical training and guidelines to assist WSW in the country.Rufino AC, Madeiro A, Trinidad AS, et al. Disclosure of Sexual Orientation Among Women Who Have Sex With Women During Gynecological Care: A Qualitative Study In Brazil. J Sex Med 2018;15:966–973.