Fourth Tuesday (LGBT) – Coming Out to Your Physician

Wikipedia-LGBTSecrets

Members of the LGBT community all have unique aspects of their lives that can affect both the health issues they face and the type of health care they require. Health care providers need to be informed about their patients’ sexual orientation and gender identity in order to offer the best possible care. But surveys consistently report that many LGBT persons do not share their orientation with health care providers. It is also difficult for transgender persons to access providers who are knowledgeable about their needs. It is important for LGBT persons to find providers they trust and feel comfortable with, and it’s important for them to be open with their providers about their orientation and gender identity.

Assumptions

Because the LGBT community is a minority group, many health care providers unfortunately will assume patients are heterosexual and cis-gendered unless explicitly told otherwise. The assumptions can become apparent early in a visit: often one of the first questions female patients are asked is what kind of birth control they are on. If the patient is lesbian, this can create an uncomfortable space for them. That discomfort can then make the entire visit uncomfortable for the patient, making it harder for her to discuss her health issues.

Because of these assumptions, the responsibility to inform the provider often falls on the patient. Coming out to a health care provider, especially during a first visit, can be intimidating. There are a number of steps LGBT patients can take to ensure they can do so in a safe manner.

Gay and Lesbian Medical Association

First, patients can ask LGBT friends or family members for a referral. They can also ask health care providers they trust to recommend LGBT-friendly providers. They can use the Gay and Lesbian Medical Association’s provider directory for LGBT patients. This directory lists providers who have affirmed their commitment to welcoming LGBT patients to their practices. Some LGBT-friendly providers advertise in LGBT publications as well.

Patients can investigate providers to find out their level of LGBT friendliness. They can call providers to ask about their nondiscrimination policy, or look online to see if providers display an LGBT pride symbol on their website.

On the initial visit, an LGBT patient can bring a trusted friend or partner with them. The friend can come along for the visit and be there after, can be present when the patient is discussing her orientation or gender identity with the provider, or can even be in the exam room with the patient.

Set Your Own Agenda With Your Doctor

The patient should discuss their sexual orientation and gender identity with the provider before the exam commences. The patient can ask the provider to take a few minutes before the exam to discuss health care issues that are important to them. The patient should have this discussion while still fully clothed and before they are in the exam room. The patient can discuss health care issues that specifically affect the LGBT community, and ask the health care provider what information they can provide about their health history that will help to improve their health care experience. While the patient does not have to tell the provider anything they is uncomfortable disclosing, the more information the provider has, the better she will be able to care for the patient. This underscores the importance of finding a provider who has created a safe environment and whom the patient trusts. It is likewise important for health care providers to become culturally sensitive to the health issues faced by LGBT patients so that they can create a safe space in which patients are able to come out.

Being able to discuss your sexual orientation and gender identity with your doctor is very important, and can greatly affect the quality of health care you receive. Out For Health is a project that provides resources for patients and health care providers on the benefits and importance of coming out to your doctor.