Coming out or staying in? Disclosure experiences of lesbian and gay radiation therapists in practice

Introduction: The healthcare environment reflects and embeds sociocultural norms, including hetero-normativity. Coming out for sexual and gender minority (SGM) people is often a process of continual identity management. There is evidence that lesbian and gay people (LG), both patients and healthcare professionals, engage in significant emotional work to manage who they tell about their sexual identity, and when. This qualitative study explored the experiences of LG radiation therapists (RTs) managing their sexual identity at work, and how this impacts relationships with co-workers and patients. Methods: The research used an authoethnographic narrative inquiry approach. Narrative inquiry incorporates story-based methods to acquire a deep understanding of how individuals make sense of events. Autoethnography uses personal experience to understand and reflect on a broader culture. Three LG participants from a Canadian urban cancer centre worked with the researcher to co-construct stories of coming out at work using their shared personal histories. Results: The co-constructed stories included fictionalised narratives of coming out at work, relationships with patients/peers, the experiences of sexual minority patients and the researcher's accompanying embodied research journey. They were written in a variety of genres and from a number of different perspectives. The results showed the participants engaged in highly contextualised and continual identity management which depended on a series of different strategies or tools. Additionally, it was clear that both the discourse around professionalism, and the pervasive biomedical healthcare culture served to further inhibit disclosure at work. Purposeful disclosure to LG patients was uncommon. Conclusion: Coming out at work might be a risky business for some lesbian and gay RTs. However, focused attention on improving the work environment so RTs can be open about their identities in the professional setting would be beneficial for patients and staff. Implications for practice: LG RTs who are out at work can be a source of support and comfort to SGM patients. They may also feel more satisfied and engaged at work. Organizations should ensure they provide overt support for SGM RTs from frontline staff to leadership roles. (C) 2021 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.