title: Sexual orientation disclosure to health care providers among urban and non-urban southern lesbians.
abstract: Concerns regarding sexual orientation disclosure to health care providers have been suggested as a barrier to care which may account for documented differences in the health care utilization of lesbians relative to heterosexual women. This study explored the correlates of sexual orientation disclosure to health care providers among 934 lesbian women living in urban and non-urban areas of the South. Psychosocial resources, such as self-esteem, social support, and mastery, along with several lesbian-specific experiences (proportion of lesbian, gay, bisexual, or transgender friends, access to the lesbian, gay, bisexual, or transgender community, degree of being "out"), were all independently associated with greater likelihood of having disclosed to a health care provider. Internalized homophobia and lesbian-related stigma decreased the likelihood of disclosure. Lesbians living in non-urban areas were significantly less likely to have disclosed than women in urban areas, suggesting that disclosure may present a special concern for populations in non-urban areas.
authors: Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL 35294, USA. elaustin@uab.edu
authors: Erika Laine
authors: EL
authors: Austin
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006306:Health Surveys; D018452:Homosexuality, Female / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D011320:Primary Health Care; D011369:Professional-Patient Relations; D012424:Rural Population / Q000706:statistics & numerical data; D012649:Self Concept; D012650:Self Disclosure; D057545:Social Stigma; D012944:Social Support; D011795:Surveys and Questionnaires; D014481:United States; D014505:Urban Population / Q000706:statistics & numerical data