From Cueless to Cue-Full: Understanding Health Care Cues' Impact on Sexual Orientation and Gender Identity Disclosure.

Abstract

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals face health care disparities, highlighting the need for inclusive and affirming health care environments. Critical to this issue is the willingness to disclose sexual orientation and gender identity (SOGI) in health care settings, as it can significantly influence the quality of care. Despite prior literature emphasizing affirming spaces, the link between the physical health care office environment and SOGI disclosure remains underexplored. This study investigates the impact of health care office environments on the disclosure of SOGI in a diverse sample of N = 399 participants (LGBTQ+ n = 196; cisgender and heterosexual: cishet n = 203). Findings reveal that affirming health care settings enhance willingness to disclose SOGI status, particularly among sexual minorities who identify as cisgender (LGBQ) individuals, while transgender and gender diverse individuals exhibit less willingness to disclose compared to LGBQ and cishet individuals. Individual factors (e.g., outness, internalized stigma) significantly influence willingness to disclose SOGI status. Affirming health care environments mitigated the negative impact of internalized LGBTQ+ stigma on willingness to disclose. These results highlight the need for affirming spaces, addressing both external discrimination and internalized LGBTQ+ stigma to mitigate LGBTQ+ health disparities.