Understanding (non)disclosure of sexual orientation and gender identity in Slovenian primary healthcare: Perspectives from LGBT+ individuals and general practitioners

Abstract

Background: Disclosure ('coming out') is an ongoing process for LGBT+ individuals, impacting various aspects of their lives. While research underscores the importance of disclosure for the health and well-being of LGBT+ people, concerns about stigma and discrimination often lead to non-disclosure, affecting healthcare access and outcomes. In Slovenia, where general practitioners (GPs) play a pivotal role in healthcare, understanding the dynamics of disclosure within primary healthcare settings is crucial.

Methods: This qualitative study utilised an online survey with open-ended questions to explore the experiences and expectations of both LGBT+ individuals and GPs regarding disclosure. Thematic analysis was employed to identify key themes and subthemes from the data collected between October and December 2021.

Results: Among 214 LGBT+ participants and 28 GPs, four main themes emerged: the necessity and relevance of disclosure; fear, insecurity, or neutrality towards non-disclosure; characteristics and actions of GPs helpful for disclosure; and GPs' self-evaluation of reactions to disclosure. Some participants viewed disclosure as essential for quality healthcare, disclosing their sexual orientation when necessary for medical treatment or to establish a trusting relationship with their GP, but others feared discrimination and preferred non-disclosure. GPs' characteristics and actions, such as creating a safe environment and using inclusive language, were crucial for facilitating disclosure.

Conclusions: Our findings reinforce the significance of GP engagement in fostering safe and supportive environments for disclosure, ultimately improving healthcare access and outcomes for LGBT+ individuals in Slovenia.

Keywords: LGBT+ disclosure; general practice; health disparities; healthcare access; stigma and discrimination.