Sexual orientation disclosure in healthcare: systematic review

Brooks, Hannah, Llewellyn, Carrie D, Nadarzynski, Tom, Castilho Pelloso, Fernando Castilho, De Souza Guilherme, Felipe, Pollard, Alex and Jones, Christina J (2018) Sexual orientation disclosure in healthcare: systematic review. British Journal of General Practice. pp. 1-10. ISSN 0960-1643

[img] PDF - Accepted Version
Restricted to SRO admin only until 30 January 2019.

Download (588kB)


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.

Item Type: Article
Keywords: General practice; sexual orientation (SO); disclosure; LGBT; review
Schools and Departments: Brighton and Sussex Medical School > Primary Care and Public Health
Subjects: R Medicine > R Medicine (General) > R727 Medical personnel and the public. Physician and the public
Depositing User: Alexander Pollard
Date Deposited: 13 Jul 2017 08:05
Last Modified: 28 Mar 2018 11:39

View download statistics for this item

📧 Request an update