COMING OUT TO YOUR DOCTOR
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.
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.
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.
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)
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.
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.
organizations which serve the gay community may keep
information about glbt or glbt friendly health
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.
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!
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.
Kate, M.D., Lesbian Health and
Homophobia: Perspectives for the treating