Managing the Conversation: How Sexual Minority Women Reveal Sexual Orientation

•Lesbian and bisexual women (LBW) engage in a process of Managing the Conversation about revealing their sexual orientation during health care encounters.•Before a health care encounter, LBW have a conversation within themselves about whether or not to reveal their sexual orientation.•One of 3 interactions can occur during the encounter related to a discussion of sexual orientation: not starting the conversation, starting the conversation, and having the conversation started for you.•The conversations that ensued, related to sexual orientation, were perceived by participants as awkward, frustrating, or traumatic or, alternatively, helpful and supportive.

Lesbian and bisexual women (LBW) are hesitant to reveal their sexual orientation in health care encounters for fear of discrimination and stigmatization, thus compromising their health care. The purpose of this grounded theory study was to construct a theoretical framework that depicts the process by which LBW reveal their sexual orientation to health care providers. Narratives obtained from interviews with 13 LBW were used to develop the theoretical framework. The central phenomenon, Managing the Conversation, includes having the conversation with oneself, not starting the conversation, starting the conversation, having the conversation started, and having the conversation with health care providers.