Does Attachment Style Mediate Self-Acceptance and Self-Disclosure of Sexual Orientation in Lesbian, Gay, and Bisexual Adults?

Sexual orientation is a private matter that individuals can decide to disclose or conceal. Nevertheless, when interacting with others, people look for cues of sexual orientation. Hence, the person’s face, voice, or non-verbal behavior is taken as a cue revealing sexual orientation. As research on “gaydar” has shown, this detecting ability can sometimes be accurate or stereotype-based. Sometimes gay, lesbian, and bisexual people themselves intentionally communicate their sexual identity explicitly or through more subtle cues. Intentional or not, several cues are taken as communicating sexual orientation with the consequences of shaping interpersonal interactions. Identifying someone as gay or lesbian has several implications. On the one hand, it leads straight men and women to non-verbally behave differently than when interacting with other straight individuals (e.g., more physical distance, more self-touching). On the other hand, it also affects verbal communication (e.g., topics of conversation, questions, and statements). The harshest consequence is hate speech and homophobic language. Research has shown that being labeled as “faggot” or “dyke” not only negatively affects those who are the target of such verbal derogation but also negatively impacts on straight bystanders. Indeed, gay and lesbian targets of homophobic language report a lower level of well-being and self-acceptance, while being exposed to such language increases prejudice toward gay men and lesbians among straight people. In the case of straight men, the use of homophobic language is often associated with identity self-affirmation and self-presentation. Interestingly, a recent trend among gay people has been noticed: they use homophobic labels among them as a form of “reclaimed language,” meaning that these derogatory terms are used with a different intent and reframed in a more positive way. Moreover, communicating sexual orientation can increase self-acceptance, social support, and positive social comparison among gay men and lesbians and can also increase positive attitudes toward gay people, especially when it happens with friends and family members.

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Sexual Orientation and Gender Identity Disclosure in the Medical Context

Oxford Research Encyclopedia of Communication ◽

10.1093/acrefore/9780190228613.013.1187 ◽

2021 ◽

Author(s):

L. Brooke Friley ◽

Maria K. Venetis

Keyword(s):

Sexual Orientation ◽

Gender Identity ◽

Medical Care ◽

Impression Management ◽

Medical Provider ◽

Self Disclosure ◽

Medical Context ◽

Entry Points ◽

Disclosure Of Sexual Orientation ◽

And Gender

For individuals who identify as LGBTQ+, disclosing sexual orientation and/or gender identity can be a complex and risky conversation. However, in the medical context this conversation frequently becomes a central part of communication between patient and provider. Unfortunately, this conversation can also become a barrier that prevents patients from receiving or even accessing necessary medical care. LGBTQ+ individuals have reported experiencing significant discrimination in day-to-day life, and more specifically in patient–provider interactions. This discrimination leads LGBTQ+ individuals to avoid seeking necessary medical care and also frequently results in unsatisfactory care and poor health outcomes. This is of concern as LGBTQ+ individuals present with significantly higher rates of health issues and overall higher risks of cancer, chronic illnesses, and mental health concerns. Unfortunately, many medical providers are unequipped to properly care for LGBTQ+ patients and lack opportunities for education and training. This lack of experience leads many providers to operate medical offices that are unwelcoming or even inhospitable to LGBTQ+ patients, making it difficult for those patients to access inclusive care. This can be of particular concern when the patient’s sexual orientation or gender identity becomes relevant to their medical care, as they may feel uncomfortable sharing that information with a provider. Patient self-disclosure of sexual orientation or gender identity to a medical provider not only can contribute to a more positive relationship and improved quality of care but also can improve the psychological outlook of an LGBTQ+ individual. However, potential stigmatization can lead to the concealment of sexual orientation or gender identity information. These acts of concealment serve as intentional mechanisms of impression management within the patient–provider interaction. When LGBTQ+ patients do discuss their sexual orientation or gender identity with a provider, it is most often because the information is directly relevant to their health and disclosure, and therefore becomes essential and often forced. There are instances where LGBTQ+ patients are motivated to disclose to a provider who they believe will respond positively to information about their sexual orientation or gender identity. Disclosure of sexual orientation or gender identity may be direct in that it is clear and concrete. It may also be indirect in that individuals may use particular topics, such as talking about their partner, to broach the subject. Participants may also use specific entry points in the conversation, such as during taking a medical history about medications, to disclose. Some individuals plan and rehearse their disclosure conversations, whereas others disclose when they feel they have no other choice in the interaction. Increasing inclusivity on the part of providers and medical facilities is one way to promote comfortable disclosure of sexual orientation or gender identity. Additionally, updating the office environment and policies, as well as paperwork and confidentiality procedures, can also promote safe disclosure. Finally, improvements to training and education for healthcare professionals and office staff can dramatically improve interactions with LGBTQ+ patients. All of these efforts need to make integration of knowledge about how LGTBQ+ individuals can disclose comfortably and safely a central part of program design.

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