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Date of Graduation


Degree Type

Capstone Project (On-Campus Access Only)

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Mary Von, MS PA-C

Second Advisor

Jonathon W. Gietzen MS PA-C


Objective: The aim of this project was to examine whether the degree of disclosure of one's sexual orientation could be a predictor of certain health seeking behaviors including illegal drug use, alcohol and tobacco use, sexual practices, medication compliance and health care utilization. We hypothesized a positive correlation between the degree of self disclosure, or "outness" and health seeking behavior so that the more "out" an individual is, the more likely they will be to seek out positive health behavior.

Methods: Participants answered a thirty question online survey which included a scale developed by the author to categorize degrees of self disclosure of sexual orientation, named the Silmell Outness Scale. Participants volunteered to take the survey after receiving an invitation via the "snowball method," and after viewing the invitation on online discussion forums pertaining to the target population. The survey link was also advertised on and

Study Selection: The target population included people who identified as gay, lesbian, bisexual, queer, or questioning. It also included men who have sex with men or women who have sex with women but who; otherwise identify as heterosexual. The survey software employed "skip logic" so that participants who identified as heterosexual were prevented from taking the survey. Participants were excluded if they were under the age of 18.

Results: A total of 311 subjects responded to at least one question with 256 respondents completing the entire survey. A crosstabulation between the dependent variable "outness" and the various independent variables related to health-seeking behaviors and demographics was completed to test for associations between these variables. Participants who were less "out" were more likely to use illegal drugs. Those that were more "out" were more likely to disclose their sexual orientation to their primary care provider. There was a positive correlation between the level of outness and age and the level of social support, and the level of outness and higher levels of education.

Conclusion: While showing useful correlations, the Silmell Outness Scale cannot, at this point, be proven accurate and would require further study if used to predict certain health seeking behaviors.


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