Author ORCID Identifier

Date Available


Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation





First Advisor

Dr. Terry Lennie


The purpose of this research was to determine relationships among depression, anxiety, self-rated physical and mental health, self-advocacy, internalized homophobia, and quality of patient-provider communication to satisfaction with health care interactions. These were measured while controlling for select demographic variables: age; ethnicity; urban or rural domicile; relationship status; household income; highest educational attainment; health insurance; disclosure to health care provider as a gay man; reason for last healthcare visit; and, general health self-rating. The specific aims of this study were to: 1) identify general characteristics of gay men in this sample; 2) examine how levels of satisfaction with health care differed by each characteristic; 3) assess relationships between each potential predictor of satisfaction and the level of satisfaction; and, 4) determine the relationship between each predictor and satisfaction after controlling for the most significant covariate(s).

A quantitative study was conducted in which 42 adult gay men participated. The author hypothesized that gay men who reported lower levels of depression, higher self-rated physical and mental health, lower levels of anxiety, higher self-advocacy scores, lower levels of internalized homophobia, and stronger evaluations of patient-provider communication would report more positive satisfaction with health care interactions. The hypothesis was supported by results of this research.

This research established that variables with the strongest effect on gay men’s satisfaction with health care interactions were whether the patient had revealed his sexual orientation to the provider, how he rated his anxiety, and how he rated the quality of communication with his provider.

These results emphasize the importance of health care providers’ awareness of specific psychosocial factors that influence communication during care of gay men, who understand their sexual orientation places them at a disadvantage when receiving health care services. Despite the pursuit of equitable, high quality, and satisfying health care, its achievement has been hampered by barriers that gay men encounter. Understanding those barriers while addressing health related needs of gay men will be important for providers who seek to improve satisfaction with health care interactions.

Digital Object Identifier (DOI)