Why You Should (& How To) Come Out as LGBTQ+ to Your Doctors

Everyone can feel uncomfortable revealing personal information about themselves to a doctor, even to a primary care physician or other provider they have a professional relationship with. And LGBTQ+ patients can feel even more vulnerable because the information we share sometimes reveals details about our gender and sexual identity – basically, the process requires that we “come out” to our healthcare professional.

Coming out is defined as the process a person goes through when they first acknowledge, accept and appreciate their gender identity or sexual orientation, and begins to share their story with others. While it may be a stressful discussion to initiate with your doctor (& you’ll likely have to have that discussion more than once), there are important long-term benefits to coming out as LGBTQ+ to your doctors. Your doctors have an obligation to maintain patient confidentiality, so being open about your life and being an active advocate for your own health are the best ways to manage your care. Below are some important reasons why.

Reasons Why Coming Out to your Doctors is Important

• Coming out helps your doctors understand the “full you”. Doctors can better treat their patients when they know more about them. Creating open communication and trust helps them look at and treat your health more holistically.
• Members of LGBTQ+ communities are at increased risk for certain health conditions including cancer, HPV, HIV, heart disease, cardiovascular disease and mental health issues. Coming out helps your doctors ask relevant questions, and provide appropriate care and education.
• Intake questions don’t always include sexual orientation and gender identity, and this means important health factors and opportunities for open communication might be missed.
• Sharing medical proxy & directives – you’ll need to be out with your doctors in order to share your healthcare proxy & directives with them, which is extremely important to protect yourself and your spouse / partner and children in the event of catastrophic illness or injury.
• Your medical team involves more than just the doctors you see face-to-face. Coming out to your doctors help inform all the healthcare professionals on your team – including those you may never meet. This can be important for ensuring you get the diagnoses, screenings and treatment you need.
• Being out as LGBTQ+ with your doctors can help them connect you with the right resources. For example, doctors can connect patients with challenges around discrimination, food or housing security, access to health insurance, assistance with medications, etc. with a social worker, or additional provider or program to help, but only if they know what the patient is dealing with.

The Impact of Bias and Discrimination on Coming Out to your Doctor

Some LGBTQ+ patients haven’t come out to their doctors because of a fear of discrimination, or due to previous negative experiences in healthcare environments. Unfortunately, not all doctors and medical offices are welcoming and inclusive. There are real instances of LGBTQ+ patients experiencing moral judgments, biased assumptions – even inadequate, unethical or outright refusal of care due to their gender or sexual identity. It can also be a challenge to find quality affirming healthcare outside of some major metropolitan areas. Thankfully, there are legal protections in place to remedy that, and attitudes and medical training are more inclusive now. As newly-trained practitioners join the medical field, these offensive scenarios will become less frequent.

Coming out to your doctors needs to be an intentional and mindful decision. Here’s our best advice for LGBTQ+ individuals who aren’t out to their medical doctors:

• If you’re already working with the practitioner & plan to continue, spend time thinking about the doctor’s / medical practice’s attitudes, policies, other clients, forms, etc. How would it feel to have that discussion with them? If you need more information to answer that, ask them about their experience with LGBTQ+ clients, cultural competency training for their staff, their non-discrimination policies etc. You can do while you’re in the office, or call / text / email when you’re somewhere private and comfortable. If the only issues keeping you from coming out to that doctor are your own anxieties, consider taking the step if it feels safe. If you don’t feel ready, working with an affirming psychotherapist (even short-term) can provide you with support and help you with these decisions.
• If you’re looking for a new affirming provider / practice, do it – now! Conduct online research, ask trusted friends, reach out to the local LGBTQ+ community center and other resource groups, contact medical providers you know and trust for a referral. When you find a practice you want to learn more about, you can call without giving your name to ask screening questions – including whether they have experience with LGBTQ+ patients; if they conduct LGBTQ+ cultural competency training for their staff; if they have an LGBTQ+-affirming or nondiscrimination policy in place.

Tips for Coming Out to Your Doctors
Here’s some advice that can help you prepare for your appointment, and stay confident during the process:

• Consider in advance what you want to share. This might include gender identity, sexual orientation, health history, if you are partnered, if you have multiple partners, what types of sex you’re having, etc. Think ahead of time about what you’re comfortable sharing, how you would answer those questions.
• Bring it up when you feel most comfortable. For example, you might want a few minutes with the doctor before you’re in the exam room, or in the privacy of the exam room but while you’re still fully clothed (if disrobing is required for the appointment). You could also decide to just work it in to the usual exam conversation. Whatever you decide, make a plan so it’s sure to happen. If you need the help of the doctor’s medical support staff to set it up, ask them – it’s your right.
• Be patient. New questions can come up when you’re presenting your doctor with new information. Stay open to answering well-intended follow-up questions that could benefit your treatment and comfort long-term, and recognize that this might take some time and involve more staff members than just your doctor.
• Request to have your accurate name and pronouns noted in your chart so that everyone in the office can see and use them during your visits.
• Remember there are laws to protect you from discrimination and privacy violations. Coming-out confidentiality is protected in most cases under HIPAA, and by Section 1557 of the Affordable Care Act which prohibits discrimination in healthcare based on sexual orientation, sex, or gender identity. If you feel a provider has discriminated against you after you came out to them, you may report them to the US Department of Health and Human Services Office of Civil Rights.
• Bring a friend with you. If you’re uneasy about having this discussion with your healthcare provider, consider asking a trusted friend to come with you. It’s a good idea to discuss your priorities and concerns with them in advance of the appointment so they can help advocate for you.

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IntraSpectrum Counseling is Chicago’s leading psychotherapy practice dedicated to the LGBTQ+ community, and we strive to provide the highest quality mental health care for multicultural, identity, kink, polyamorous, and intersectional issues. For anyone needing affirming and validating support, please click here or contact us at help@intraspectrum-chicago.com.