COMING OUT TO YOUR DOCTOR

If you have not already done so take a look at the fact sheet on Lesbian Health.  While being a lesbian or bisexual woman is not a disease or risk factor, there are a variety of health challenges and conditions which lesbians and their health practitioners need to monitor carefully.  As well, practitioners need to be able to help lesbian patients cope with the impacts of homophobia on their life and health. Clearly it is critical that lesbian and bisexual women have easy access to safe, culturally competent health and mental care.  As the lesbian health fact sheet states, by far the largest impact on lesbian health comes from the tendency for lesbian or bisexual women to avoid regular health care or fail or delay returning for follow-up care. It is important to your health and wellness that you be able to “come out” to your doctor.

Women who are not able to be open about their sexual identity can miss all of the benefits of being your true self.  Being “closeted”, or hiding your lesbian or bisexual identity, can mean living in fear.  This can be stressful and can lead to behavioral and health outcomes such as depression, substance abuse, eating disorders, anxiety and others.  Being closeted from your doctor will mean that your doctor will not know all that she/he needs to know to take care of your health.

The excellent paper on lesbian health written by Kate O’Hanlan, M.D. sites a variety of studies, which find homophobia among nurses, doctors and medical students.  The percentages of homophobic beliefs and behaviors range from 8% to over 50%.  The good news here is that not all health practitioners hold these beliefs.  On the other hand a surprising number do.  Studies have also found that as many as 96% of lesbian women anticipated negative reactions from practitioners if they were open about their sexuality.  These statistics are beginning to change.

Dr. O’Hanlan’s work is aimed at providing information to medical practitioners about lesbian health and educating them to the needs of lesbian patients.  This work and the work of organizations such as the Gay and Lesbian Medical Association are beginning to make inroads in helping doctors overcome homophobia and learn to treat their gay, lesbian, bisexual and transgender (glbt) patients.

Culturally competent health practitioners are practitioners who are open and welcoming to glbt patients.  They do not make assumptions about the sexuality of any patient without asking appropriate questions.  They take histories and do examinations that are appropriate to the needs of the glbt patient.  They are knowledgeable about and open to discussing a variety of types of families and include all caregivers and partners in health discussions as necessary.  If they make mistakes in understanding they apologize and are open to learning.  There is an excellent discussion of cultural competence for health practitioners at http://www.metrokc.gov/health/glbt/providers.htm.  Reading this can help you know what a practitioner should know and what you have a right to expect.

Finding culturally competent doctors can be difficult, but it is far from impossible.  Word of mouth is a great place to start.  Ask your lesbian friends about their doctor, if they are out to their doctor and how they feel about the doctor’s care.  They may even know doctors who are lesbian or bisexual.  Ask about their patient care as well.

Community organizations which serve the gay community may keep information about glbt or glbt friendly health practitioners.  Some organizations that serve women, particularly feminist organizations or women’s centers on University campuses or organizations that disseminate health information may have information on lesbian-friendly doctors as well.

Finally, when shopping around ask up front if there are doctors in the practice who are friendly to lesbian patients.  You can typically tell, by the type of answer you get, where the office stands on the issue.  If you don’t like the answer, move on.  If you get a pleasant or thoughtful ‘yes’ then you may have found your doctor!

Some women who identify as lesbian or bisexual are able to be out everywhere all the time.  Others find this difficult and have to pick and choose the spaces they can be out in.  In either case the necessity of having to come out in order to be fully known is an unfortunate reality of homosexual life. Wherever you are on that continuum try to find spaces in your life where you can be out, where you can be all of the things that you are, intellectual, spiritual, social, sexual, physical, all of it. Being who you are is a gift, so open it, take care of it, and enjoy it.

References:

http://www.metrokc.gov/health/glbt/lbwomen.htm

http://www.metrokc.gov/health/glbt/providers.htm.