Just Ask! The Primary Care Pediatrician’s Role in Adolescent Disclosure of Gender Identity and Sexual Orientation

Disclosure of sexual orientation and gender identity (SOGI) to primary care providers (PCPs) can reduce inequities for lesbian, gay, bisexual, transgender, and queer/questioning youth. We surveyed adolescents at a pediatric primary care practice in 2023 to determine associations between disclosure and PCP questioning in addition to other facilitators and barriers of disclosure. The response rate was 56.7% (77 of 136 completed). Most PCPs asked about SO (85.7%) and GI (76.6%). Most patients disclosed SO (84.2%) and GI (74.0%). Patients directly asked were significantly more likely to disclose their SO (98% vs 22%, P < .001) and GI (86% vs 15%, P < .001). The primary facilitator for disclosure was being directly asked (43.8% SO; 59.6% GI), and the primary barrier was not being asked (66.7% SO; 73.3% GI). Primary care providers asking their patients about SOGI promotes disclosure. Future efforts should aim to facilitate disclosure and improve care by optimizing PCP training on inclusive history-taking.