When you go to the doctor, you want him or her to know everything about you that might affect your health. That’s why a new study says that medical records should include the patient’s sexual orientation. Without that information, the study says, medical groups will not be able to recognize disparities in care based on sexual orientation and take the necessary steps to correct them.
The authors of the study, published in the journal LGBT Health, note that data shows that lesbians are less likely to get screened for cervical cancer and that there is a higher incidence of mental health issues related to stress among LGBT patients. But without routine collection of data about sexual orientation, addressing those issues and identifying others will remain a problem.
“Given the outward invisibility of LGBT people and their history of invisibility in the health-care system, it is critical for clinicians to address and screen for health conditions disproportionately affecting LGBT people and have frank discussions with patients about sexual identity and behavior and gender identity,” the authors write. “However, most clinicians don’t ask questions about these topics; many are uncomfortable discussing sex with patients. Gathering data on sexual and gender identity in EHR [electronic health records] will improve our understanding of LGBT disparities and help improve clinicians’ conversations with patients about LGBT issues.”
There is a precedent for collecting such personal information. Medical records for Medicaid patients routinely includes information about race and language, allowing providers and researchers to analyze gaps in care. The government rejected including information about sexual orientation when it instituted the Medicaid guidelines but is reconsidering the issue. The study notes that 145 LGBT and HIV/AIDS organizations have submitted comments to the government in support of including the information in medical records.
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hyhybt
The problem isn’t what clinicians are comfortable with; people get used to pretty well anything they do every day. But on the other side of things, this isn’t the sort of thing a lot of people are going to want to discuss with a complete stranger on a first visit, or even, in some places, feel safe entrusting that information.
Longviewer
Great point! Has anyone actually asked gay and lesbian patients if they WANT to be asked about their sexual orientation by providers they don’t know and/or aren’t comfortable with? And if we DO want to volunteer this info, to someone we trust, how can we keep the info with that person, rather than putting it in our medical record for anyone to see? Check in with us patients about these bright ideas, please!
Jared MacBride
It would discourage a lot of people from seeking medical care. Might be an OK idea in NYC and LA, in rural GA not so much.
Scribe38
I went to a doctor 10 years or so ago requested a HIV test. The doctor was foreign and homophobic. He told me that only gay people needed the test and I didn’t seem gay. This was my first and last appointment with him. It is important to find doctors connected to the community. Found a great doctor through community out reach specializing in gay male health. I get more than general care, in office HIV rapid testing, anal and throat cancer screenings, and testosterone replacement.
mlbumiller
If you do not feel comfortable telling your doctor/clinic, then you really should not be seen there for your care.
Example: When I was working in a military sick call, we were seeing a male patient with complaint of abdomial pain. After weeks of test the doctors really couldnt figure out what the problem was. I just happen to see him a local gay club. On his next visit I convince the doctor to do a full stool work-up. Turned out the patient had a case of rectal GC (the clap). Granted there was a problem here, DADT was in full swing, but knowing basic information is key to correct treatment.
It has to be asked when a women’s last periode was, children if so how many preg. and how many births. Also, ask any kid old enough to be doing It, if they are sexually active; changes a whole lot of what is going to be done.
Fitz
It is important and relevant information about your health picture.
That being said, you have to make a personal assessment of your safety
with this doctor and their staff, and the general mood of the area you are in.
Trust the instincts that got you through life this far; if you aren’t safe
then shut up, get what you need in the moment, and then get out and go
find someone better for next time.
And, honestly, it needs to be even more than “I am gay”. It needs to include
if you are a top or a bottom, is you use things like poppers, if you use
toys do you clean them correctly (I know.. but lots don’t!).. all these things
are important. HIV is a real issue, but so are some other things like HPV,
violence, substance dependence, depression, all SORTS of stuff which really is a little different for us than them.
mlbumiller
@Fitz: Your so right.
hf2hvit
@hyhybt: Well, unless you’re both standing there with your pants down
hyhybt
@hf2hvit: In that setting, surely, *their* not wearing pants would be a reason to trust them even less.
Halston
When are doctors going to start seeing men who bottom and have them lay on the table like women do at the gynecologist?
SparkyNH
After reading some advice about coming out that suggested it was important to let your doctor know about your sexual preference, and having a good relationship with my PCP, I told him I was gay during one regular visit. I must have lucked out, because he was very good about it, and my nature is one of humor anyway (I told him I wanted him to know so that if I came into the ER with a gerbil up my butt he wouldn’t be totally surprised… – he laughed, as I had intended he should). He also said that he had done some time during his internship working at an AIDS clinic, and understood a lot of the issues, and had some training in the area. (Something I may never have known if I hadn’t brought it up.) But it was a decision based on my (professional) relationship with this doctor. I’m not sure I would just tell any/every doctor I meet, and maybe naively, I’m relying on his adherence to the doctor-patient confidentiality to not go blabbing it all around town…