Exploring Sexual Orientation Disclosure to Health Care Providers among Sexual Minority Women.

sexual minority women"s health;Public Health;Health Sciences;Health Behavior and Health Education

Youatt, Emily J.Harper, Gary W ;

University of Michigan

关键词: sexual minority women";    s health;    Public Health;    Health Sciences;    Health Behavior and Health Education;   

Others  :  https://deepblue.lib.umich.edu/bitstream/handle/2027.42/120827/youatt_1.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

Sexual orientation disclosure (or, ;;coming out”) to one’s health care provider is championed by members of the medical and public health communities as a lynch pin to improving the health of sexual minority individuals. In this dissertation, I explore and critique this strategy in the context of young adult sexual minority women’s (YSMW’s) lives. Using data from the Michigan Smoking and Sexuality Survey (M-SASS), a web-based cross-sectional study of YSMW ages 18-24, I conducted two sets of analyses.First, I explored individual and interpersonal level factors associated with coming out to health care providers. These results suggest YSMW’s sexual identity and same-sex sexual experiences, along with how ;;out” they are to others and their experience of internalized homophobia, influence whether or not women in this sample had disclosed their sexual orientation to their health care provider. Second, I examined the relationship between clinical disclosure and discussions about, recommendations for, and receipt of sexual and reproductive health care services. My results suggest that YSMW who had come out to their providers were equally or more likely than those who had not disclosed their sexual orientation to have discussed, been recommended, or receivedthese services. This analysis also showed important differences in receipt of sexual health services based on race, ethnicity, geography, and sexual identity, highlighting the importance of examining the experiences of a diverse sample of YSMW. For my final empirical chapter, I conducted a literature review assessing how sexual orientation disclosure is being measured in the current health science literature. This review also documented the extent to which studies focusing on disclosure attempt to link this health behavior to health outcomes or health care utilization. My review found a great deal of variability in the items researchers employ to measure sexual orientation disclosure to health care providers, and few attempts to explore relationships between disclosure and health or health care utilization. Overall, this dissertation critiques the current state of the science on coming out to providers, seeks to address existing gaps in the disclosure literature, and offers directions for health promotion and future research focused on YSMW’s clinical disclosure experiences.