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

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.