Lay Summary
Disclosure experiences in LGBTQ+ healthcare staff: a systematic review and meta-synthesis
Written by: Reem Prakkash and the Collective Action for Race Equity in Health & Social Care (CARE-HSC) study team
What is this study about?
This study explores LGBTQ+ healthcare staff experiences when deciding whether to share their sexual orientation or gender identity at work, including how they navigate these decisions and the factors that influence them.
How did we do the study?
The researchers reviewed existing qualitative studies that explored LGBTQ+ healthcare workers’ experiences of identity disclosure in the workplace. They brought together findings from seven studies published between 2011 and 2023. The researchers compared and combined findings across these studies to identify common patterns and themes in staff experiences.
What did we find?
Five key themes emerged across the studies:
The themes describe how staff often carried out a form of risk assessment before deciding whether to disclose their identity at work. Many weighed the potential benefits of openness against concerns about discrimination, negative reactions from colleagues, or possible impacts on career progression. Disclosure was rarely viewed as a single moment. Rather, it emerged as a continuum shaped by trust, acceptance, and personal judgement. Participants frequently described the mental effort and discomfort involved in navigating these decisions.
Non-disclosure also carried costs. Concealing aspects of identity was often experienced as stressful and could make it more difficult to feel authentic at work. At the same time, disclosure sometimes brought adverse outcomes, including professional repercussions or strained relationships with colleagues or clients. For some, however, being open provided a sense of relief, belonging, and greater empowerment. Overall, disclosure tended to be context-dependent, with staff choosing to share different aspects of their identity in different situations.
Why are these finding important?
Research on LGBTQ+ health often focuses on patients, while the experiences of healthcare staff are less often explored. This study shows that many LGBTQ+ healthcare professionals must carefully consider whether being open about their identity may affect workplace relationships, career progression, or their sense of belonging. These decisions can carry a significant emotional toll. Supportive and inclusive workplaces can help staff feel safer to being open about their identity, if they choose to disclose. This may include clear anti-discrimination policies, visible leadership support, and workplace cultures that respect LGBTQ+ identities.
Key Findings
Some staff reported stress or emotional strain when hiding their identity.
Many described weighing the risks of being open against the need to feel safe at work.
When workplaces were supportive, being open could bring relief and stronger relationships with colleagues.
What can I do with this?
I am a policy maker: These findings support the need to strengthen policies and practices that promote inclusive and psychologically safe healthcare workplaces. They also highlight the importance of ensuring clear reporting systems and accountability for discrimination and exclusion.
I am NHS staff: This research shows how everyday workplace interactions influence whether LGBTQ+ colleagues feel able to be open about their identity. You can support inclusive environments by challenging discriminatory behaviour and engaging with initiatives such as LGBTQ+ staff networks.
I am NHS staff manager: Managers play an important role in creating inclusive workplace cultures. You can do this by implementing equality policies in practice and responding appropriately to discrimination or exclusion.
I am a researcher: This research identifies gaps in evidence on LGBTQ+ healthcare workforce experiences. You can help address these gaps through research that informs policies and practices to better support LGBTQ+ staff.
I am a student: This research highlights the importance of inclusive workplace cultures in healthcare. You can apply these insights in your training and future practice to support respectful and inclusive workplaces.
I want to know more!
Read the primary paper here:
Prakkash, R., Manning, L., Becares, L., Hatch, S., Akande, I. O., & Dorrington, S. (2026). Disclosure experiences in LGBTQ+ healthcare staff: a systematic review and meta-synthesis. BMJ Open. https://doi.org/10.1136/bmjopen-2025-100412
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