PhD Student Rutgers University New Brunswick, New Jersey
Objectives: “Coming out” is the process whereby an LGBTQ+ person discloses their sexual or gender identity. The purpose of this study is to examine how coming out is addressed in LGBTQ+ competency courses and workshops by medical professionals and researchers and geared towards medical professionals and staff. Whether and how LGBTQ+ people are given agency with regards to disclosure within these workshops is also addressed.
Methods: The materials of 3 workshops for medical professionals that included case studies or panels were reviewed for how they discuss when a patient comes out, including how to navigate the situation, how to discuss health information and concerns, and how to show that patients are supported while building the patient-provider relationship. The 3 workshops were selected from a scoping literature review LGBTQ+ workshops, no more than a decade old, and contained modules that focused on the social aspects of medical interaction and not just LGBTQ+ statistics. Materials that were available online through MedEdPortal and Zenodo were reviewed include Powerpoints presentations, scenario questions, and assessment tests.
Results: The workshops framed patients coming out as a sensitive topic. The suggestion of sharing resources with patients was mentioned in one of the three workshops. Medical transition options for transgender people were mentioned in two of the three workshops. No workshop focused on how to navigate when a transgender person comes out to their provider in search of either social support or transition treatments. Providers were taught to stress the importance of collecting SOGI information to their patients. Only one workshop mentioned disclosing a patient’s identity to a referral, but did not stress the potential impact of outing a patient.
Conclusions: LGBTQ+ competency workshop scenarios that discuss coming out focus on LGBTQ+ people coming out when discussing relevant health information and transgender people who have already begun medically transitioning. They should include scenarios and materials for providers on how to navigate when a transgender patient comes out to them in order to seek resources, support, and potential medical transition care. Similarly, they should highlight the importance of sharing resources to patients. Workshops must stress patient agency when the potential for disclosing to another medical professional is involved and should address the impact of outing patients through referrals. This is an example of as situation where explicit consent outside of HIPPAA is necessary to obtain.
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