Deciding to disclose: Predictors of coming out to health care providers among young sexual minority women

Background: Medical and public health professionals argue sexual identity disclosure (“coming out”) to one’s health care provider is critical for obtaining optimal care and  reducing health disparities between heterosexuals and sexual minorities (those who identify their sexuality as lesbian, gay, bisexual, or something other than heterosexual). Yet, factors predicting sexual minorities’ disclosure decisions are poorly understood. Methods: Using data from a cross-sectional web-survey of young sexual minority women (YSMW; N=386; ages 18-24), we examined factors predicting disclosure among YSMW. Using multivariate logistic regression with disclosure to medical providers as the dependent variable, we assessed the influence of YSMW’s sociodemographic characteristics, social relationships with other YSMW, health and health care variables, psychosocial resources, and sexuality-specific stressors on disclosure. Results: Women identifying as bisexual (OR=0.40) or “other” non-heterosexual (OR=0.22) were less likely to come out to their doctor than women identifying as lesbian. Women reporting recent same-sex sexual experiences were more likely to disclose than those without such encounters (OR=2.17). Women reporting greater internalized homophobia were less likely to be out to their doctors (OR=0.45), while women who were out to others (i.e., parents, friends, coworkers) were more likely to be out to their doctor (OR=6.30). No other significant associations were found. Discussion: These findings underscore the importance of sexual identity and social relationships with other same-sex attracted women on YSMW’s disclosure behavior. The implications of promoting coming out to medical providers based solely on sexual identity categories will be discussed.