Disclosure of lesbian, gay and bisexual identity, what do we need to know?

Introduction
Disclosure of Lesbian, Gay and Bisexual (LGB) orientation is identified as a continual process with negative and positive experiences holding long and short-term health and wellbeing impacts (Ryan, Legate and Weinstein, 2015). Occupational therapists claim holistic practice encompassing individuals' diverse values, beliefs, and behaviours, yet evidence in addressing issues related to sexuality and disclosure is limited. It remains an under-researched area and from some perspectives, its relevance to occupational therapy is contested as illustrated in Couldrick (2005). A lack of understanding of the impact of disclosure on people's occupational lives emphasises a need for this review of existing knowledge and its relevance to occupational therapy.

Method
A structured database search and critical appraisal identified 17 articles that met the review criteria relating to LGB, disclosure, health wellbeing and occupation. Data were extracted and analysed for themes according to Aveyard (2014).

Findings
The review identified the factors influencing disclosure and the impact of disclosing sexual orientation on people's health and wellbeing. Disclosure was a need, which increased alongside LGB identity affirmation. Analysis revealed how nondisclosure or negative disclosure experiences contributed to occupational deprivation, reduced participation and occupational performance. A lack of education amongst health professionals and 'heteronormative' practice was one of the key factors for negative impacts of disclosure.

Conclusion
Disclosure of sexual orientation is a complex process impacting on individuals' occupational identity, performance and engagement. This confirms the importance of developing occupational therapists' understanding in order to support service users with an LGB orientation whom they may encounter in practice. The review has presented some foundations for future research directions and professional practice.