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Coming Out

"A heterosexual woman doesn’t go in afraid to say, ’This is my partner.’ She will not have to think about whether or not this doctor in an emergency will hate her if she discloses that she is in this relationship, or if he will treat her differently."[4]

Many lesbians fear stigmatization and discrimination by health care providers based on their sexual orientation and fear coming out to their health care provider[5] [6] [7]. There is some literature showing there is a correlation between the sex of the health care provider and their reaction to a patient coming out, with male physicians more likely to respond negatively[6].

"All of the women in our study who made unplanned disclosures of their sexual orientation to female physicians received positive reactions. However, the responses from male physicians were uniformly negative."[6]

The health care system can be especially intimidating for lesbian women of colour who experience prejudice based on, not only sexual orientation, but race, class, and gender as well. Many fear that these assumptions and prejudices will result in substandard quality of care[8].

"The whole system is inaccessible to me and people like me because of the homophobia, and the racism, and the sexism, to say nothing of inability to pay. But a totally new system of health care is the bottom line. The system of education for nurses and doctors and the system of health care delivery have to stop imbuing, tolerating and reinforcing prejudice."[8]

Coming out to a health care provider has positive implications for health. In one survey of 324 lesbians in Portland, Oregon, those respondents who were ’out’ to their primary care provider were more likely to have ever had a Pap smear and to currently be a non-smoker[9].

One factor influencing whether a patient comes out to her physician or care provider is the perception of acceptance and understanding on the part of the provider[10]. Decisions to disclose are multifactorial and depend on past experiences in the health care system[3].

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3. Mathieson CM, Bailey N, Gurevich M. Health care services for lesbian and bisexual women: some Canadian data. Health Care for Women International. 2002;23:185-196.

4. Anderson L, Healy T, Herringer B, Issac B, Perry T. Out in the Cold: The Contradictory Context of Health and Wellness for Lesbians in Northern Communities. 2001. BC Centre of Excellence for Women's Health. Vancouver, BC. As quoted in: Hudspith M. Caring for Lesbian Health: A Resource for Canadian Health Care Providers, Policy Makers and Planners, Revised Edition. 2001. Health Canada. http://www.hc-sc.gc.ca/english/women/facts_issues/lesbian_health.htm. Accessed on October 24, 2003.

5. Peterkin A, Risdon C. Caring for Lesbian and Gay People: A Clinical Guide. 2003. University of Toronto Press Incorporated. Toronto, Ontario.

6. Tiemann AK, Kennedy SA, Haga MP. Rural Lesbians' Strategies for Coming Out to Health Care Professionals. In Ponticelli CM, Ed. Gateways to Improving Lesbian Health and Health Care: Opening Doors. pp. 61-75. Binghamton, NY. The Haworth Press, Inc.; 1998.

7. Rosenfeld, JA, Ed. Handbook of Women's Health. New York, NY. Cambridge University Press; 2001.

8. Stevens PE. The Experiences of Lesbians of Color in Health Care Encounters: Narrative Insights for Improving Access and Quality. In Ponticelli CM, Ed. Gateways to Improving Lesbian Health and Health Care: Opening Doors. 1998. The Haworth Press, Inc. Binghamton, NY. pp. 77-94.

9. White JC, Dull VT. Room for Improvement: Communication between Lesbians and Primary Care Providers. In Ponticelli CM, Ed. Gateways to Improving Lesbian Health and Health Care: Opening Doors. 1998. The Haworth Press, Inc. Binghamton, NY. pp. 95-110.

10. Barbara AM, Quandt SA, Anderson RT. Experiences of lesbians in the health care environment. Women & Health. 2001;34(1):45-62.

All references for this section