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失聪的 LGBTQ 患者向医疗服务提供者披露性取向和性别认同的情况。

Deaf LGBTQ Patients' Disclosure of Sexual Orientation and Gender Identity to Health Care Providers.

作者信息

Miller Cara A, Biskupiak Andrew, Kushalnagar Poorna

机构信息

LGTBQA Resource Center.

Deaf Health Communication and Quality of Life Center.

出版信息

Psychol Sex Orientat Gend Divers. 2019 Jun;62(2):194-203. doi: 10.1037/sgd0000319. Epub 2018 Nov 29.

Abstract

INTRODUCTION

Even with accessible communication, deaf patients who self-identify as LGBTQ might or might not feel comfortable disclosing their sexual orientation/gender identity to a health care provider based on social stigma concerns and previous negative experiences with healthcare providers. The current study examined whether deaf LGBTQ individuals' patient centered communication and level of comfort in sharing health information in the presence of an interpreter contributed to coming out to providers.

METHODS

Using an online health survey in American Sign Language (ASL) and English, data was gathered from 313 (32% persons of color) self-identified LGBTQ deaf adults across diverse cities in the U.S.A. Binary logistic regression was used to examine the relationships between sexual orientation, gender identity, patient centered communication, and sharing health information with healthcare providers in front of an interpreter, and disclosing orientation/identity to healthcare providers.

RESULTS

After controlling for sociodemographic and patient-related variables, cisgender women were significantly less likely to disclose their LGBTQ identities to healthcare providers compared with cisgender men. Being accepted as LGBTQ by loved ones and high perceived patient centered communication significantly increased the likelihood of coming out to providers. The presence of an ASL interpreter did not prevent or promote the deaf LGBTQ patients' decision to share health information with their healthcare provider.

CONCLUSION

Implications for future research and recommendations for providers seeking to develop greater intersectional cultural competencies are discussed, with emphasis on the need for providers to be familiar with health access challenges and inequities facing deaf bisexual and queer women.

摘要

引言

即使沟通无障碍,自我认定为 LGBTQ 的聋人患者可能会因社会污名化担忧以及之前与医疗服务提供者的负面经历,而不确定是否愿意向医疗服务提供者透露自己的性取向/性别认同。本研究调查了聋人 LGBTQ 群体以患者为中心的沟通方式,以及在有口译员在场的情况下分享健康信息时的舒适程度,是否有助于向医疗服务提供者坦诚身份。

方法

通过一项使用美国手语(ASL)和英语的在线健康调查,收集了来自美国不同城市的 313 名自我认定为 LGBTQ 的成年聋人(32% 为有色人种)的数据。采用二元逻辑回归分析来研究性取向、性别认同、以患者为中心的沟通方式、在口译员面前与医疗服务提供者分享健康信息,以及向医疗服务提供者披露性取向/性别认同之间的关系。

结果

在控制了社会人口统计学和患者相关变量后,与顺性别男性相比,顺性别女性向医疗服务提供者披露其 LGBTQ 身份的可能性显著降低。被亲人接纳为 LGBTQ 群体以及高度认可以患者为中心的沟通方式,显著增加了向医疗服务提供者坦诚身份的可能性。美国手语口译员的在场并未阻止或促进聋人 LGBTQ 患者与医疗服务提供者分享健康信息的决定。

结论

讨论了对未来研究的启示以及对寻求发展更强交叉文化能力的医疗服务提供者的建议,强调医疗服务提供者需要熟悉聋人双性恋和酷儿女性所面临的医疗获取挑战和不平等问题。

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