Original Research: Does “Don't Ask Don't Tell” Apply to Health Care? Lesbian, Gay, and Bisexual People's Disclosure to Health Care Providers

Abstract

Lesbian, gay, and bisexual people are often hesitant to reveal their sexual identities to health care providers for fear of poor care. This study begins to explore some of the factors related to disclosure, including the prevalence of different kinds of disclosure/nondisclosure and the frequency of protective strategies in health care settings. Eighty-eight LGB people (38 lesbians, 37 gay men, and 13 bisexuals) responded to a questionnaire about their most recent experiences with health care as well their overall experiences. More respondents reported avoiding questions about sexuality (38%) than actively disclosed to their health care provider (37%). These respondents reported a wide range of protective strategies in health care settings, with women reporting use of more strategies in past health care experiences than men. Women were also more likely to have a regular physician and to disclose sexual identity to a health care provider than were men. Many respondents gave examples of unpleasant interactions with health care providers or reported that health care providers made heterosexist assumptions. Rates of disclosure to health care providers remain low because lesbian, gay, and bisexual people still perceive health care settings and providers as threatening.