5 Tips for Coming Out to Your Doctor

Doctors can better treat their patients, generally, when they know more about the patient, like if the patient is a smoker, has a family history of cancer, or may be pregnant.

Intake questions don’t always include sexual orientation and gender identity, and this means important health factors might be missed that could give doctors clues to additional screening, or facilitate more open and honest patient-doctor communication.

LGBTQ+ People Have Specific Health Needs

Members of LGBTQ+ communities are at increased risk for certain health conditions, so when a doctor knows the patient is LGBTQ+, they can know to ask relevant questions and provide appropriate education.

Some health needs and conditions that affect people who are LGBTQ+ in unique ways include:

• Cancer Queer women may be at increased risk for breast, cervical, and ovarian cancer, according to the American Cancer Society. This is possibly due to lower rates of preventive screening, according to the National LGBT Cancer Network. A study published in 2018 in the American Journal of Preventive Medicine showed that transgender and gender-nonconforming adults are more likely to avoid preventive screenings for these cancers due to discomfort with medical professionals. Smoking, HPV, HIV, and obesity — all more prevalent in LGBTQ+ communities, according to the National LGBT Cancer Network — increase the risk of cancer.
• Heart disease Queer women and men are more likely to have cardiovascular disease due to tobacco, drug, and alcohol use; increased BMI; and mental health issues like stress, research shows.
• HIV and STIs Queer men in the United States have an estimated 1 in 6 lifetime risk of HIV infection, compared with 1 in 524 for straight men and 1 in 253 for straight women, according to the Centers for Disease Control and Prevention (CDC).
• Obesity Lesbians and bisexual women are nearly twice as likely as straight women to have obesity, research shows.
• Mental health LGBTQ+ people are at increased risk for depression and suicide, research shows.
• Sexual violence Forty-six percent of bisexual women and 47 percent of transgender people experience sexual assault, according to the CDC.
• Smoking, alcohol, and substance use Tobacco use is higher with LGBTQ+ adults and teens than non-LGBTQ+ peers — three times higher for those in middle school, according to the CDC.

These disparities may be caused in part by discrimination in healthcare (or fear of it), lower rates of health insurance, higher rates of homelessness, lower rates of certain screenings, and the effects of stress from lack of social acceptance, according to the National LGBT Health Education Center.

Open Communication With Your Doctor Can Lead to Better Care

Jorge Ramallo, MD, MPH, the medical director of Inova Pride Clinic in Falls Church, Virginia — a primary care clinic with an LGBTQ+ focus — says that a main reason to come out to your doctor is to help them understand the full you.

“You want to create that trust with the clinician that’s going to be taking care of you and looking at your health holistically,” Dr. Ramallo says. “You want somebody that actually knows your background, understands where you’re coming from, understands your circumstances, and can connect it to resources depending on your situation.”

For example, he says, if you’re facing challenges around food security, housing security, access to health insurance, or paying for your medications, a physician could connect you to a social worker or programs to help with those issues, which are all connected to your overall health.

“We cannot connect you to resources if we don’t know what you’re going through,” Ramallo says. Awareness of your full present and past health and life circumstances enables them to get you the best care — and if they know your identities, they can know what screenings to recommend based on your increased risks.