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LBTI Health Care Concerns

Coming Out to Our Health Care Providers

Coming out to our health care providers allows us to receive care specific to our needs as individuals, not just as lesbian, bisexual, transgender, and intersex (LBTI) people. When we can be fully honest about our lives, our concerns, and our health risks and behaviors, our providers are in a better position to care for us, in part because we are more comfortable asking questions, discussing sensitive information that may be critical for diagnosis of a problem, and seeking help when we need it.

It can be difficult to decide whether to come out to a health care provider. It may depend on how out we are to family, friends, colleagues, and acquaintances, or it may be an opportunity to come out for the first time. It may depend on the types of questions the provider asks and whether they provide an opportunity to share this information, as a 39-year-old post-operative transsexual woman explains.

I have been out to the majority of physicians as a matter of giving honest answers to history and physical questions. However, on the rare occasion when I was not asked what medications I was taking or surgery I'd had in the last few years, along with a self-perceived degree of relevance to my visit, there were times when I didn't share much information about my past.

We may wonder how important it is to disclose this information about ourselves to a provider, but according to many studies, we receive better care and are more likely to follow through on a treatment plan when we can establish a trusting bond.

For many of us, coming out to a new provider is the first order of business, so we can determine right away if she or he is a good fit for us.

I am out to my primary care physician. I believe that my sexuality is directly connected to my physical health, and regardless of how I feel about coming out to them, I need to explain my sexuality for my own health's sake.

I make my orientation known right away. If I sense any homophobia at all I do not see that provider again, and I tell them why.

I am a 43-year-old Caucasian gay FTM...My long-term GP didn't look too surprised and went on with business as usual. My OB/GYN found it utterly interesting. He does not have experience with transmen. I came out to my doctors because a) they were easy people to come out to and b) I wanted places where I could just be who I am.

My partner and I have children so we have to be out to doctors in order for them to understand that we both have rights to seek medical attention for our children.

I am a 26-year-old, urban, Asian-American lesbian. I am out to my HCP because I want her to address any health issues specific to women of my sexual orientation. As a medical student, I do not want to be a hypocrite and advise patients to do certain things I do not do myself.

I am most definitely out to my health care provider, not only about being queer/bi, but also about being polyamorous--that I have a primary and secondary partner and that my boyfriend is transgendered. If I want the best care possible then I need to be honest on all fronts so my health care practitioner can make the best informed decisions about my well-being. In some cases that means good doctors are made and not found!

I have a practitioner that I am out to because I have never been "in" to anyone. My partner and I of ten years use the same male doctor. I have trained this doctor for over ten years.

Some of us take time to build trust before we decide to come out, as a self-identified 35-year-old, urban, white lesbian explains.

I am out, but it was a process for me. I did not tell her right away, but I did tell her once I felt comfortable (two to three years later). I do get regular check-ups now, but I did not for my first 22 years of life...Now I go every year. I did not go in the past because of shame, fear, and denial. I was ashamed of who I was, I feared having an illness and I was in denial that I needed check-ups.

As patients we are more vulnerable if we do not fit someone's idea of "normal." Each of us must decide when and where to come out in our encounters with the health care system.

Some of us share only the information that we think is necessary or appropriate, rather than focusing on our sexual orientation or gender identity. Even if we are not ready to come out to a provider, it is essential that providers know our risk behaviors, so they can consider all of the information in order to properly care for us.

I practice in advance how to maintain my privacy and still get the care I need--ways of refusing to answer offensive or unnecessary inquiries, and of asking direct, specific questions about what I need to know.

Even those of us who work in the LGBTI health community can feel vulnerable at times, including a 40-year-old African-American femme lesbian who has a lesbian health care practitioner:

Having to come out to new doctors, like I had to do recently, is still scary. All the what-ifs...particularly while I'm naked. It's just not a time when it's easy to self-advocate...I feel like I am always on guard, always deciding do I come out, do I educate this provider? It's way more stressful than it should be.

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