'I daresay I might find it embarrassing': general practitioners' perspectives on discussing sexual health issues with lesbian and gay patients

Abstract

The present paper explores general practitioners' (GPs') perspectives on the difficulties which they face when discussing sexual health issues with lesbian and gay patients in primary care consultations. It draws upon data obtained from a qualitative interview study with 22 GPs aged between 34 and 57 years who were practising in Sheffield, UK. Interviews were transcribed verbatim and the data were analysed thematically. The results indicate that (non-hetero)sexual orientation could form a barrier to talking about sexual health matters for almost half of this GP sample. Difficulties related primarily to ignorance of lesbian and gay lifestyles and sexual practices, and also included concerns about the appropriate language to use and assumptions about the nature of gay men's relationships. Homophobic attitudes were also identified in a minority of the sample. Participants suggested improvements around improving communication about sexual health with lesbian and gay patients. These included training at undergraduate and postgraduate levels, taking a proactive role during consultations, not making assumptions about patients' sexual orientation and having a non-discriminatory policy for their practice.

Facilitating LGBT Medical, Health and Social Care Content in Higher Education Teaching

“…We found that training for medical, health and social care students at undergraduate and postgraduate levels about taking a proactive role during training consultations, not making assumptions about patients' sexual orientation and understanding what that may mean for their healthcare practice were all regarded as crucial factors for transforming healthcare for LGBT communities and is consistent with other recent research (Hinchliff, Gott, & Galena, 2005;Sequiera, Chakraborti, & Panunti, 2012). Particularly important was patient-centered communication in consultations, which has been associated with better health outcomes, owing to more recollection of information by the patient, treatment adherence and satisfaction with care (Hall, Roter, & Katz, 1988).…”

“…Anti-discriminatory policy is vital for improving healthcare provision for LGBT people (Hinchliff et al, 2005). A number of accreditation documents have been developed to ensure non-discrimination, such as that produced by the Council of Social Work Education (CSWE Commission on Accreditation, 2008), which explicitly requires that continuous efforts to provide a learning context in which respect for all persons and understanding of diversity are practiced.…”

“…We therefore argue that obstacles to LGBT curricula content cannot be overcome through changes to accreditation policies alone and a greater attention to curriculum reform is required (Hinchliff et al, 2005;Whittle, Turner, Combs, & Rhodes, 2008).…”

An Exploration of the Perspectives and Experiences of General Practitioners in Barbados in Relation to Lesbian, Gay, Bisexual and Transgender (LGBT) Patients

“…Similarly to GPs in the UK, consultation timing and context were major challenges to discussing sexual health, practices and identity (Gott, Galena, Hinchliff, & Elford, 2004). Health discussions with LGBT patients focused almost exclusively on safe sex and STIs, consistent with other studies (Boehmer, 2002), which is unsurprising given that medical discourse on LGBT health issues in the Caribbean centers on HIV, and globally doctors lack information on LGBT patients' broader health needs (Bjorkman & Malterud, 2009;Hinchliff et al, 2004;Rutherford, McIntyre, Daley, & Ross, Sandfort (2010) suggested, legislating non-discrimination and decriminalizing homosexuality can improve health professionals' attitudes, behaviors, and training approaches. Whilst this will require wider activism and structural reform, the medical profession can advocate for such change and, in its absence, model sensitive, culturally competent care for LGBT patients.…”

“The L Pack”: Addressing the Sexual Health Needs of Young Lesbians

“…Lesbian and bisexual women in numerous international studies continue to report the difficulties in accessing information on safe sexual practices, and feel that they cannot ''come out'' to their general practitioner or nurse because they have already assumed heterosexuality and/or fear being judged, discriminated against or having their confidentiality compromised (Bailey et al, 2003;Farquhar et al, 2001;Hunt & Fish, 2008;McNair, 2003;Platzer & James, 2000;Queiry, 2007;Steele, Tinmouth, & Lu, 2006;Stevens & Hall, 2001). These fears, it would appear, are not without some basis in that research with healthcare professionals has revealed assumptions of heterosexuality and uninformed attitudes regarding lesbian and gay lifestyles and sexual practices (Hinchliff, Gott, & Galena, 2005). Finally, and of particular importance here, young lesbian and bisexual women in Northern Ireland have reported that even when sexual health information and advice is offered to the lesbian, gay and bisexual community, it has tended to focus on male sexual orientation and the needs of young women are being overlooked (Lourdes, 2003).…”