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Llewellyn_2017_SO disclosure BJGP - FINAL.pdf (575.09 kB)

Sexual orientation disclosure in healthcare: systematic review

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posted on 2023-06-09, 07:09 authored by Hannah Brooks, Carrie LlewellynCarrie Llewellyn, Tom Nadarzynski, Fernando Castilho Castilho Pelloso, Felipe De Souza Guilherme, Alex Pollard, Christina J Jones
Background: Significant health disparities between sexual minority individuals (i.e. lesbian, gay, bisexual or transgender (LGBT)) and heterosexual individuals have been demonstrated. Aim: To understand the barriers and facilitators to sexual orientation (SO) disclosure experienced by lesbian, gay, bisexual and transgender (LGBT) adults in healthcare settings. Design and setting: Mixed methods systematic review, including qualitative, quantitative and mixed methods papers following PRISMA guidelines. Method: Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT) and then underwent a qualitative synthesis. Studies were included if their participants were =18 years who either identified as LGBT, had a same-sex sexual relationship or were attracted to a member of the same-sex. Results: The review included 31 studies representing 2442 participants. Four overarching themes were identified as barriers or facilitators to SO disclosure, the moment of disclosure, the expected outcome of disclosure, the HCP, and the environment or setting of disclosure. The most prominent themes were the perceived relevance of SO to care, the communication skills and language used by HCPs and the fear of poor treatment or reaction to disclosure. Conclusion: The facilitators and barriers to SO disclosure by LGBT individuals are widespread but most were modifiable and could therefore be targeted to improve HCP awareness of their patient’s SO. HCPs should be aware of the broad range of factors that influence SO disclosure and the potential disadvantageous effects of non-disclosure on care. The environment in which patients are seen should be welcoming of different SOs as well as ensuring HCP communication skills, both verbal and non-verbal, are accepting and inclusive.

History

Publication status

  • Published

File Version

  • Accepted version

Journal

British Journal of General Practice

ISSN

0960-1643

Publisher

Royal College of General Practitioners

Issue

6888

Volume

68

Article number

e187-e196

Department affiliated with

  • Primary Care and Public Health Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2017-07-13

First Open Access (FOA) Date

2019-01-30

First Compliant Deposit (FCD) Date

2017-07-12

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