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March 6, 2026BMJ Open0 citationsOpen Access

Disclosure experiences in LGBTQ+ healthcare staff: a systematic review and meta-synthesis

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RPReem PrakkashLMLucy ManningLBLaia Bécares

Key Points

  • The study aims to understand the disclosure experiences of LGBTQ+ healthcare employees, focusing on their unique challenges and perspectives.
  • Conducted a systematic review of qualitative studies from 2011 to March 2023
  • Utilized Ovid and other academic databases for literature searches
  • Performed thematic analysis on identified studies
  • Evaluated study quality using the Critical Appraisal Skills Programme 2022 checklist
  • Identified seven studies with five main themes regarding LGBTQ+ disclosure
  • Highlighted risks and costs associated with disclosure and non-disclosure
  • Outlined the critical factors affecting disclosure decisions
  • Emphasized the balance between authenticity and conformity due to heteronormativity
  • Noted the significant mental toll on LGBTQ+ staff due to these challenges

Abstract

Objective Workplace disclosure of Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) identity by healthcare employees is an understudied area and existing reviews of LGBTQ+ disclosure in the healthcare sector focus on patient perspectives, overlooking the unique challenges that healthcare professionals encounter. The aim of this study was to conduct a systematic review and meta-synthesis of existing qualitative studies exploring disclosure experiences of LGBTQ+ healthcare employees. Method The literature search integrated current research from 2011 to March 2023 and focused on qualitative studies exploring disclosure experiences of LGBTQ+ healthcare professionals. Ovid served as the primary platform for literature searches, supplemented by forward and backward citation tracking and additional searches in academic databases such as Google Scholar and Scopus. The studies underwent quality evaluation using the Critical Appraisal Skills Programme 2022 checklist and were synthesised using thematic analysis. Results The findings revealed seven studies with five prominent themes: (1) risk associated with disclosure, (2) making the decision to disclose, (3) cost of non-disclosure, (4) cost of disclosure and (5) benefit of disclosure. Additionally, five critical factors of disclosure were identified: level, scope, time, elements and method. Finally, the risk–benefit analysis underscored the dilemma and balance between authenticity and conformity, largely influenced by pervasive heteronormativity, resulting in a significant mental toll. Conclusions The findings must be interpreted considering certain limitations, such as the lack of generalisability of studies. However, the findings emphasise the critical need for cultivating trusting and accepting healthcare work environments for LGBTQ+ staff.

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Cite This Study

Prakkash et al. (2026) studied this question.

synapsesocial.com/papers/69aa7066531e4c4a9ff5a34bhttps://doi.org/10.1136/bmjopen-2025-100412
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