Deaf LGBTQ Patients' Disclosure of Sexual Orientation and Gender Identity to Health Care Providers

• Published in: Psychology of sexual orientation and gender diversity 2019-06, Vol.6 (2), p.194-203
• Main Authors: Miller, Cara A., Biskupiak, Andrew, Kushalnagar, Poorna
• Format: Article
• Language: English
• Subjects: Bisexuality; Client Attitudes; Deafness; Female; Gender Identity; Health Care Services; Homosexuality; Human; Lesbianism; Male; Male Homosexuality; Psychotherapeutic Processes; Self-Disclosure; Sexual Orientation; Sign Language; Stigma; Test Construction
• ISSN: 2329-0382; 2329-0390
• DOI: 10.1037/sgd0000319

Even with accessible communication, Deaf patients who self-identify as lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ) might or might not feel comfortable disclosing their sexual orientation or gender identity to a health care provider based on social stigma concerns and previous negative experiences with health care providers. The current study examined whether Deaf LGBTQ individuals' the patient-centered communication and Deaf LGBTQ individuals' level of comfort in sharing with health information in the presence of an interpreter contributed to coming out to providers. Using an online health survey in American Sign Language (ASL) and English, data were gathered from 313 (32% persons of color) self-identified LGBTQ Deaf adults across diverse cities in the United States. Binary logistic regression was used to examine the relationships between sexual orientation, gender identity, patient centered communication, and sharing health information with healthcare providers in front of an interpreter, and disclosing orientation or identity to healthcare providers. After controlling for sociodemographic and patient-related variables, cisgender women were significantly less likely to disclose their LGBTQ identities to health care providers compared with cisgender men. Being accepted as LGBTQ by loved ones and high perceived patient-centered communication significantly increased the likelihood of coming out to providers. The presence of an ASL interpreter did not prevent or promote the Deaf LGBTQ patients' decision to share health information with their health care provider. Implications for future research and recommendations for providers seeking to develop greater intersectional cultural competencies are discussed, with emphasis on the need for providers to be familiar with health access challenges and inequities facing Deaf bisexual and queer women. Public Significance Statement This study highlights that those who are female, both cisgender and transgender, and identify as bisexual or queer are less likely to disclose their sexual orientation and gender identities to health care providers, compared with their male and gay−lesbian counterparts. In addition, it presents an emphasis on the important need for providers to develop greater intersectional cultural competencies and to be knowledgeable about the challenges and inequities that Deaf bisexual and queer women face in accessing health care.