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Disclosure of Sexual Orientation Among Women Who Have Sex With Women During Gynecological Care: A Qualitative Study In Brazil

2018; Elsevier BV; Volume: 15; Issue: 7 Linguagem: Inglês

10.1016/j.jsxm.2018.04.648

1743-6109

Andréa Cronemberger Rufino, Alberto Pereira Madeiro, Adriana Silva Trinidad, Raiza Santos, Isadora Freitas,

HIV/AIDS Research and Interventions

Abstract Background Evidence shows that women who have sex with women (WSW) face disparities in access to health care when compared to heterosexual women in several countries. Aim To investigate the experiences WSW have after disclosure of sexual orientation during gynecological care in Brazil. Methods We performed a qualitative study using content analysis. We recorded and transcribed interviews with 34 WSW from the 5 regions in Brazil. Data were analyzed using descriptive content analysis. Outcomes The main categories of analysis were decision-making process to disclose and attitude of gynecologists after disclosure. Results WSW disclosed their sexual orientation in an un-favorable environment. Gynecologists rarely asked about patients’ sexual orientation and used a script for hetero-normative anamnesis. The reactions of gynecologists were discriminatory, resulting in abbreviated consultations and un-comfortable gynecological exams. They missed a window of opportunity for prevention, diagnosis, and treatment of various diseases. The experiences Brazilian WSW had during gynecological care demonstrated the dominant hetero-normativity in the health care scenario. The attitudes of the gynecologists precarized the existence of WSW in health service. Clinical Implications This study suggests that gynecologists missed an opportunity to use WSW's sexual orientation disclosure to offer specific care to them. Strengths & Limitations This is the first qualitative study about WSW’s experiences during gynecological care in Brazil. Future studies should be developed from a wider sampling, especially among lower-class WSW. Conclusion The results point out the need for a change in medical training and guidelines to assist WSW in the country.