Proportion of patients who disclose their sexual orientation to healthcare providers and its relationship to patient outcomes: A meta-analysis and review

Objective: Patient-centered care emphasizes the need to form a therapeutic and trusting relationship between patients and providers in which patients feel comfortable disclosing health-relevant and personal information. It is still unknown how many patients disclose their sexual orientation to providers, under what circumstances and what it is related to in terms of outcomes. Method: The present meta-analysis and review sought to identify the overall proportion of sexual orientation disclosure to healthcare providers, facilitators and barriers of disclosure, patient populations less likely to disclose, and the relationship between disclosure and outcomes. Thirty-five studies met the inclusion criteria yielding 38 independent proportions. Characteristics of patients, providers, location, and disclosure were extracted. Results: Sexual orientation disclosure proportions to healthcare providers ranged from .29 to .98. The random-effects pooled estimate was .63 (95% CI: .58, .68). Disclosure compared to nondisclosure was related to more positive direct and indirect health outcomes including higher satisfaction, more healthcare seeking and screenings and better self-reported health and psychological wellbeing. Conclusion: The overall proportion of disclosure to healthcare providers varied by patient, provider, location, and disclosure characteristics. Practice implications: These findings emphasize the need for future interventions directed at facilitating disclosure among populations identified as less likely to disclose. (C) 2018 Elsevier B.V. All rights reserved.