The Toil and Toll of Impression Management for LGBTQ+ People in Health Encounters

• In Event: Putting Social Psychology to Work in Challenging Times

Abstract

Impression management is commonly framed as an individual strategy for controlling how others perceive us. We reconceptualize impression management in healthcare as interactional labor shaped by unequal power. Drawing on 40 in-depth interviews with LGBTQ+ patients, we examine how patients manage everyday clinical encounters in contexts marked by sexual- and gender-based bias. Respondents described three strategies: code switching to make themselves clinically legible, presenting a front to establish credibility, and face-saving to preserve clinicians’ authority and sustain the interaction. While these practices can help patients secure care, they also create a double bind: patients must appear credible and legible while avoiding behaviors that may trigger suspicion, stigma, or denial of care. Our findings show that impression management in healthcare is not merely self-presentation but interactional labor that stabilizes clinical encounters. In doing so, we extend scholarship in social psychology and medical sociology by highlighting its relational and asymmetrical character.

Authors

• stef m. shuster, Michigan State University

• Ning Hsieh, Michigan State University