Disclosure Experiences, Barriers, to Care, and Women\u27s Health Risk Factors and Outcomes for Rural Lesbians

Research with non-rural samples reveals that lesbians experience unique physical and mental health risk factors and outcomes, such as increased risks for reproductive cancers, heart disease, obesity, depression and anxiety, and substance abuse. These vulnerabilities are likely maintained and/or exacerbated by the fact that, due to fears of discrimination and homophobia, women who identify as lesbian tend to conceal their sexual orientation to their healthcare providers and therefore, may not actively seek and/or receive appropriate preventive and reproductive healthcare. There are currently no quantitative studies examining the disclosure practices and unique health risk factors of rural lesbians who are not only more likely to experience unique health risks as rural women, but also have a tendency to be less comfortable disclosing their sexual identity to others due to the conservative climate of the majority of rural areas. Nine hundred and sixteen lesbian-identified women from both rural and non-rural areas of the United States completed self-report measures of disclosure practices and experiences, barriers to care, and physical and mental health risk factors and outcomes. Results of the current study revealed that rural lesbians report greater barriers to both mental and physical health care and higher levels of psychological distress in comparison to their non-rural counterparts. In addition, significant differences in disclosure attitudes and beliefs, practices, and experiences were found between rural and non-rural lesbians. Implications for the health of rural lesbians, research, training, and clinical practice and policy are discussed