Researchers at Brighton and Sussex Medical School (BSMS) have advised doctors to display rainbow posters and other “visual clues” in their waiting rooms to encourage gay and bisexual patients to come out.
More than one in 20 of the population identify themselves as lesbian, gay, bisexual or transgender (LGBT), and there is good evidence that their healthcare and some health outcomes are inferior to those of heterosexuals - including mental health problems, diabetes and substance abuse.
Knowing and understanding patients' sexual orientation is essential for providing optimum health care, but there is also evidence that many barriers exist to disclosure.
BSMS researchers Hannah Brooks and Dr Carrie Llewellyn and colleagues have reviewed the international literature on this topic, analysing more than 30 research studies involving almost 2,500 patients.
They concluded that these problems have their origins in undergraduate medical education, where there is inadequate teaching about the healthcare of LGBT people, and also recognised the need for better postgraduate training along the same lines.
Dr Carrie Llewellyn, Reader in Applied Behavioural Medicine at BSMS, said: “This study shows that healthcare professionals and settings such as GP surgeries should be aware of the differing physical and psychological needs of the LGBT community and remain open minded regarding their patients’ sexual orientation in order to provide the best possible healthcare. Incorporating more LGBT-specific knowledge and communication skills into undergraduate medical education is essential to ensure that future healthcare professionals are armed with the tools they need to help their future patients disclose their sexual orientation if they feel comfortable to do so, and then provide them with appropriate care and advice.”
She suggests that healthcare settings such as GP surgeries could demonstrate a more “accepting atmosphere”, which needs to be reflected in the verbal and non-verbal communication of doctors and practice staff.
Patient information leaflets should reflect an awareness of the differing needs of LGBT individuals, the researchers argue.
Careful use of language in the consultation, a willingness to be direct and candid as well as sensitive, and an avoidance of making assumptions (in discussions about contraception and sexual health, for example), should form part of core training for general practice.
Professor Kamilla Hawthorne, vice-chairman of the Royal College of GPs (RCGP), told the Daily Telegraph: “Patients should never be made to feel as though they have to disclose their sexual orientation to their GP, if they don’t want to.“But at the same time, they should be reassured that anything they discuss with their GP is strictly confidential, and that the consultation room is a safe space.”
The study, 'Sexual orientation disclosure in health care: a systematic review', has been published by the British Journal of General Practice. Read the full study here >