Similar but Different: The Gaps and Barriers Present in the Practice of Medicine and Health Services for Lesbian, Gay, and Bisexual Patients.
Preliminary data results of a study.
The survey was conducted by Hoshen (Education and Change) in cooperation with the Faculty of Health Sciences at Ben-Gurion University, Clalit Gan Meir, and other LGBT community bodies. The studys purpose was to asses disparities in health care treatment between LGBT and heterosexual patients. The study arm included LGBT individuals and the control arm composed of non-LGBT individuals. Participants were asked to complete an electronic questionnaire with regards to health behaviors, utilization of health care, and preferences in term of sexual orientation of their providers.
4,420 participants completed the questionnaire. Of the 2,618 (59%) men, 45% of them were gay or bisexual, and 1,802 (41%) women, 20% were lesbian or bisexual. 70% of the respondents live in Tel Aviv and the Tel Aviv Metropolitan area.
Background
Lesbian, gay, bisexual and transgender (LGBT) people have sexual identities that are distinct from the general society. Their sexual identity may refer to their gender identity (how they perceive themselves) and / or their sexual orientation (who is the object of sexual attraction).
LGBT people are more susceptible to some diseases and distinct psycho-social issues.
The issue of sexual identity or preference does not arise very often in medical settings, and some of those problems do not receive adequate attention.
Exposing the preference to the doctor
8% of LGB indicated lying to the family doctor about their sexual preference.
73% of LGB were not asked by the family doctor about their sexual preference.
About 20% did not disclose their sexual orientation because of shame, fear of hostility, fear of harming the quality of care and doctor-patient confidentiality.
20% of the participants reported that disclosing their sexual preference to their doctor increased their satisfaction of health care services.
The Physicians' Attitude
10 (0.6%) respondents reported that after revealing their sexual orientation they received abusive treatment. In four cases, the doctor refused to continue treatment after the disclosure of the patient's sexual orientation.
Only 20% indicated that after disclosing their sexual orientation they received an appropriate response from the doctor, as well as proper treatment.
30 (1.7%) respondents indicated turning to private doctors due to concern about discriminatory and/or lack of knowledge among HMO doctors about sexual orientation issues.
Doctors' Training
61% could not tell if their doctor is LGBT friendly.
63% said they would prefer to see an LGBT friendly doctor.
68% said that in order to create an atmosphere that is open about sexuality the doctor should provide a comfortable feeling and just ask.
Over one-third indicated that placing leaflets and posters will help create a friendly atmosphere.
68% said they would prefer to be treated by a physician trained about sex, sexuality and gender.
Discussion and Conclusions
Although this is a preliminary analysis, it is possible to conclude that:
The issue of sexual preference is not sufficiently discussed at doctor visits.
Patients expect doctors to raise the issue during the interview.
In Israel, patients still report experiencing discrimination and avoiding medical treatment due to their sexual preference.
LGBT people expect medical service providers to be knowledgeable and trained with regard to sex, sexuality and gender.
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