Characterizing stereotypes that perpetuate sexual minorities’ anticipated stigma in healthcare settings

Abstract

Sexual minorities report avoiding disclosure of their sexual orientation to healthcare providers to prevent encounters with bias. The present work explores the unique anticipated stereotypes that sexual minorities in the United States expect from healthcare providers using open-text responses and novel machine learning methods to code anticipated stereotypes into stereotype content dimensions. Sexual minority participants (N = 361) reported the traits or characteristics that they would expect a healthcare provider to believe to be true about them under two conditions; one wherein they just met the provider and one wherein their sexual orientation was disclosed. As expected, the valence of expected stereotypes was more negative in the identity disclosed condition, and, critically, participants expected more morality and deviance-based stereotypes when their sexual orientation was known. Further, these stereotype dimensions differentially predicted healthcare visit expectations (i.e., anticipated treatment quality, anticipated concealment of health behaviors/symptoms, anticipated comfort disclosing sexual orientation) and healthcare avoidance. As sexual minority individuals may vary in the types of stereotypes that they expect from healthcare providers and in the valence of stereotypes that they expect from healthcare providers when their identity becomes known, research on anticipated healthcare stigma needs to capture unique stereotypes that should be targeted to reduce healthcare disparities.