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Title Openness About LGBT Patients’ Orientation To Their Healthcare Provider May Affect Health Outcomes
Clinical Question Does provider knowledge about a patient’s sexual orientation promote a better health care experience than those individuals who do not share their sexual orientation?
Clinical Bottom Line Patients who disclose their sexual orientation tend to report better health care experiences; however, factors such as provider bias and SES can negatively affect patients’ health outcomes.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 7396288Dardick/1980622 “homosexual men and women” from BostonQuestionnaire
Key resultsThe patients who openly reported their sexual orientation to the healthcare providers were more satisfied with their experience and viewed their provider as more competent. For the men in the study, they were even offered more comprehensive health care in terms of STI screenings. 49% explicitly shared their orientation, 11% assumed provider already knew, and 7% would not share their orientation under any circumstances.
#2) 24307473McGarrity /2014406 gay or bisexual men in ArizonaSurvey
Key resultsMen with higher SES were predicted to have better health benefits with being open about their sexual orientation; however, men with lower SES were predicted to have health problems.
#3) 26731405Whitehead/2016477 cisgender men, 368 cisgender women, and 169 from transgender & non-binary individuals who clicked on Facebook adsSurvey
Key resultsThe researchers indicate that stigma negatively shapes the health care of rural LGBT populations to the point that intervention to decrease this stigma in health care settings is necessary.
Evidence Search orientation outness, LGBT openness, LGBT outness
Comments on
The Evidence
Validity: All three studies had adequate sample sizes and used appropriate analysis of the questionnaires/surveys that they used to gain information from participants. However, as with many questionnaires and studies of this type, the populations sampled were limited by location and choice to participate (selection bias). These studies may not have been representative of the LGBT community and may have excluded a portion of the LGBT population. The populations between these studies were not the same. The 1980 study classified participants as “homosexual males or females,” the 2014 study only looked at gay or bisexual men, while the last study incorporated the extent of the LGBT spectrum, but only looked at rural populations. Perspective: Anecdotally and culturally speaking, it is clear that bias could exist in a healthcare setting towards patients who identify as LGBT. The research could be more extensive into how much bias exists and how fully it affects LGBT patients, especially in the field of dentistry.
Applicability There is a substantial lack of literature about the LGBT patient and oral health care. These articles broadly apply to health care providers in general, but there is a paucity in the research regarding dentistry. Even though there is not information directly related to dentistry, these articles illustrate the overall importance about being out and open to all health care providers, including dentists. However, the lack of emphasis in the dental school curriculum does little to alleviate the stigma or improve comfort in discussing LGBT issues. From the clinicians’ perspective, knowing this information about your patient could lead you to ask certain questions or refer to other providers that could impact the patients’ overall health. From the patient’s side, the ability to trust and feel comfortable with a competent provider could lead to better health outcomes.
Specialty/Discipline (Public Health)
Keywords LGBT, homosexual, openness, sexual orientation, stigma, bias, providers, health outcomes
ID# 3221
Date of submission: 04/11/2017spacer
E-mail Khairallah@livemail.uthscsa.edu
Author Michael Khairallah
Co-author(s) e-mail
Faculty mentor/Co-author David Cappelli, DMD, MPH, PhD
Faculty mentor/Co-author e-mail Cappelli@uthscsa.edu
Basic Science Rationale
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