Being Out: Impact of Disclosure on Sexual and Reproductive Healthcare Receipt in a Sample of Sexual Minority Women and Gender Diverse Youth

Purpose: Sexual minority women and gender diverse youth in the United States experience disparities in sexual and reproductive health. We evaluated whether sexual partner type, identity, and attraction were associated with healthcare disclosure, and whether healthcare disclosure was associated with sexual and reproductive healthcare receipt in a sample of sexual minority and gender diverse youth aged 18–24 years assigned female at birth. Methods: 103 youth assigned female at birth completed a behavioral health survey. Data were analyzed to determine whether healthcare disclosure was associated with receipt of the human papillomavirus (HPV) vaccine, human immunodeficiency virus (HIV) testing, contraception method, and long-acting reversible contraception. We examined whether sexual partner type, identity, and attraction were associated with healthcare disclosure. Results: Over half of the 103 participants self-identified as Black (78%) and had at least one female partner (55%); 14.6% identified as gender diverse. 51.5% received an HPV vaccine, 52.4% were HIV tested in the last year, 38.8% received any contraception method, and 19.4% received long-acting reversible contraception. The majority (63.1%) of youth reported healthcare disclosure. Healthcare disclosure was associated with sexual and reproductive healthcare receipt. Participants who had only male partners, identified as heterosexual or were unsure of their sexual identity were less likely to disclose their sexual orientation and receive HIV and HPV services. Discussion: Reducing barriers to healthcare disclosure and care receipt will be critical to overcoming sexual and reproductive health disparities for all youth.