Talking to the GP: How Gay Men in Germany Prefer to Disclose Their Sexual Orientation - A Qualitative Interview Study

Lesbian, gay, bisexual, trans*, and other queer (LGBTQ*) patients in German primary healthcare face discrimination and minority stress, contributing to health challenges. To provide comprehensive care, doctors need to be aware of their patients' sexual orientation. However, there is few evidence on how gay men in German-speaking contexts want to communicate their sexuality with their General Practitioners (GPs). This qualitative study used 19 episodic interviews with gay men from rural and urban Germany recruited by voluntary response sampling. Framework Analysis was used for data analysis, supported by MAXQDA software. Three disclosure types emerged: (1) Open, (2) ambivalent, and (3) reserved. While some participants proactively shared their sexual orientation, others disclosed only when necessary, and some avoided disclosure altogether. Fear of discrimination, past negative experiences, and lack of visible support shaped these decisions. Disclosure-or the lack thereof-had significant consequences, including delayed care, self-management of health issues, and actively seeking sensitized GPs. Participants emphasized the value of inclusive signals (e.g. in language, symbols, forms) and LGBTQ*-competent care. This study concludes that sexual orientation should become a routine part of communication in general practice. This might encourage more open health communication, reduce fear of stigmatization, and ultimately improve care.