Gay and Bisexual Men's Health Issu

WELLBEG OF GAY, LBIAN, AND BISEXUAL DOCTORSBRIAN P BURKE, GENERAL TERNISTA AND JOCELYN C WHE, TERNISTBBRIAN P BURKEALEGACY CLIC NORTHWT, 1130 NW 22ND AVE, SUE 220, PORTLAND, OR 97210, USA, BOREGON HEALTH SCIENC UNIVERSY, COLUMBIA UNIVERSY, JOSEPH L MAILMAN SCHOOL OF PUBLIC HEALTH, LEGACY PORTLAND HOSPALS, 1015 NW 22ND AVE, R-200, PORTLAND, OR 97210, USAFD ARTICL BY BRIAN P BURKEJOCELYN C WHEALEGACY CLIC NORTHWT, 1130 NW 22ND AVE, SUE 220, PORTLAND, OR 97210, USA, BOREGON HEALTH SCIENC UNIVERSY, COLUMBIA UNIVERSY, JOSEPH L MAILMAN SCHOOL OF PUBLIC HEALTH, LEGACY PORTLAND HOSPALS, 1015 NW 22ND AVE, R-200, PORTLAND, OR 97210, USAFD ARTICL BY JOCELYN C WHEAUTHOR RMATN COPYRIGHT AND LICENSE RMATN PMC DISCLAIMERALEGACY CLIC NORTHWT, 1130 NW 22ND AVE, SUE 220, PORTLAND, OR 97210, USA, BOREGON HEALTH SCIENC UNIVERSY, COLUMBIA UNIVERSY, JOSEPH L MAILMAN SCHOOL OF PUBLIC HEALTH, LEGACY PORTLAND HOSPALS, 1015 NW 22ND AVE, R-200, PORTLAND, OR 97210, USACORRPONNCE TO: B P BURKE COPYRIGHT © 2001, BMJGAY, LBIAN, AND BISEXUAL DOCTORS HAVE LONG HAD A LARGELY VERT PRENCE WH THE MEDIL PROFSN; THEIR VISIBILY IS A RELATIVELY RECENT PHENOMENON. THE AMERIN PSYCHIATRIC ASSOCIATN'S LANDMARK CISN 1973 TO REMOVE HOMOSEXUALY OM THE NOMENCLATURE OF PSYCHIATRIC DISORRS WAS A MAJOR TALYST FOR THIS, ALLOWG HOMOSEXUAL AND BISEXUAL DOCTORS TO TAKE TENTATIVE STEPS TO THE CULTURE AT LARGE. A SEARCH OF THE MEDIL LERATURE YIELDS RMATN ON MEDIL ATTUS TOWARDS HOMOSEXUAL AND BISEXUAL PATIENTS, BUT LTLE ABOUT HOMOSEXUAL AND BISEXUAL DOCTORS THEMSELV. THEIR CHALLENG AND TRIUMPHS ARE LIKELY TO BE SIAR TO THOSE OF OTHER MORY GROUPS WH THE PROFSN, EXCEPT THAT THEY N CHOOSE WHETHER TO MAKE THEIR MORY STAT KNOWN TO PATIENTS AND LLEAGU.1,2ALTHOUGH SOCIETAL TOLERANCE TOWARDS SEXUAL MORI HAS GREATLY IMPROVED SCE 1973, “G OUT” AS A HOMOSEXUAL OR BISEXUAL DOCTOR REMAS A DIFFICULT CISN, WH BOTH PERSONAL AND PROFSNAL NSEQUENC. SUCH DOCTORS HAVE TO ASK THEMSELV SEVERAL QUTNS CIDG WHETHER TO E OUT:IF I E OUT DURG MEDIL SCHOOL WILL AFFECT MY GRAS OR MY ABILY TO GET TO A PETIVE RINCY PROGRAMME?WILL I HAVE THE SUPPORT OF MY CLASSMAT OR WILL I BE OSTRACISED?CAN I EVEN BE A HOMOSEXUAL OR BISEXUAL PAEDIATRICIAN, GYNAELOGIST, OR UROLOGIST?IF I BEE A SPECIALIST, WILL MY OPENNS NEGATIVELY AFFECT REFERRALS TO ME OM LLEAGU?WILL PATIENTS SHUN ME?CAN I PRACTISE A SMALL TOWN, OR AM I NSIGNED TO A LARGE METROPOLAN AREA?WELLBEG IMPLI PERSONAL AND PROFSNAL SATISFACTN AND THE ABILY TO EFFECTIVELY TEGRATE THE TWO TO FORM SATISFYG RELATNSHIPS WH PATIENTS AND LLEAGU AND TO ATTA THEIR RPECT. IN THIS ARTICLE WE REVIEW THE LERATURE ON THOSE FACTORS MOST LIKELY TO AFFECT THE WELLBEG OF GAY, LBIAN, AND BISEXUAL DOCTORS: HOMOPHOBIA, THE DIFFICULTI ENUNTERED BY HOMOSEXUAL AND BISEXUAL MEDIL STUNTS AND STAFF, AND ANTI-HOMOSEXUAL DISCRIMATN. WE ALSO SUGGT DIRECTNS FOR FUTURE REARCH THIS TOPIC AND WAYS TO ENHANCE THE WELLBEG OF GAY, LBIAN, AND BISEXUAL DOCTORS. SUMMARY POTSWHILE REARCH HAS VTIGATED DOCTORS' ATTUS TOWARDS HOMOSEXUAL AND BISEXUAL PATIENTS, RELATIVELY LTLE ATTENTN HAS BEEN PAID TO GAY, LBIAN, AND BISEXUAL DOCTORSTHE FACTORS MOST LIKELY TO AFFECT THE WELLBEG OF SUCH DOCTORS ARE HOMOPHOBIA, DISCRIMATN, THE CHALLENG OF MEDIL SCHOOL AND RINCY, AND LACK OF SUPPORT SYSTEMSTHERE IS DOCUMENTED HOMOPHOBIA AMONG DOCTORS AND DIRECTORS OF MEDIL SCHOOL TNGAY, LBIAN, AND BISEXUAL DOCTORS EXPERIENCE VERBAL HARASSMENT OR SULTS OM MEDIL LLEAGU, AND MANY BELIEVE THAT THEY RISK LOSG THEIR JOB IF LLEAGU DISVER THEIR SEXUAL ORIENTATNALTHOUGH THE SUATN HAS IMPROVED, MORE NEEDS TO BE DONE TO ENHANCE THE WELLBEG OF GAY, LBIAN, AND BISEXUAL DOCTORSMETHODSWE NDUCTED A SEARCH OF THE MEDLE DATABASE OM 1966 TO JUNE 2000 G THE SEARCH TERMS “GAY,” “LBIAN,” “BISEXUAL,” OR “HOMOSEXUAL” AND “PHYSICIAN,” “DOCTOR,” OR “HEALTH PROFSNAL” AND “PROFSNAL PRACTICE.” WE LIMED OUR SEARCH TO PAPERS WRTEN ENGLISH. WE REVIEWED THE REFERENC OF THE SELECTED PAPERS TO INTIFY STUDI MISSED BY OUR IAL SEARCH.HOMOPHOBIASEVERAL STUDI HAVE LOOKED AT THE EXISTENCE OF HOMOPHOBIA WH THE MEDIL MUNY. IN 1982 MATHEWS ET AL SENT A QUTNNAIRE TO ALL MEMBERS OF THE SAN DIEGO COUNTY MEDIL SOCIETY TO ELIC ATTUS TOWARDS HOMOSEXUAL PATIENTS AND LLEAGU.3 USG THE VALIDATED HETEROSEXUAL ATTUS TOWARD HOMOSEXUALY (HATH) SLE, THEY FOUND THAT 23% OF RPONNTS HAD HOMOPHOBIC ATTUS (37% SRED THE HOMOPHILIC RANGE, THE RT WERE NTRAL). IN FOUR SPECIALTI (ORTHOPAEDIC SURGERY, OBSTETRICS AND GYNAELOGY, GENERAL AND FAY PRACTICE, AND GENERAL SURGERY) OVER 30% OF RPONNTS DISPLAYED HOMOPHOBIC ATTUS. A 1988 SURVEY OF FAY PRACTICE RINTS AT NE UNIVERSY-BASED PROGRAMM SOUTHERN CALIFORNIA SHOWED OVERALL THAT 20% OF MALE RINTS WERE HOMOPHOBIC (PARED WH ONLY 3% OF WOMEN).4THE RISE OF AIDS DREW H ATTENTN TO GAY MEN AND GAVE HOMOSEXUAL AND BISEXUAL NCERNS A NEW VISIBILY. SOME HOMOPHOBIC VIEWS WERE PROBABLY SOFTENED THROUGH EMPATHY, WHILE OTHERS HARNED AMID CREASG VRL DIRECTED AT THE GAY MUNY. A 1989 SURVEY OF 1745 THIRD YEAR RINTS TERNAL MEDICE AND FAY PRACTICE LOOKED AT ATTUS TOWARD RG FOR PATIENTS WH AIDS AND TOWARD HOMOSEXUAL PEOPLE GENERAL.5 OF THE RPONNTS, 35% AGREED WH OR WERE UNSURE ABOUT THE STATEMENT “HOMOSEXUALY IS A MENTAL DISORR,” WHILE 20% ADMTED THAT THEY WEREN'T FORTABLE THE PRENCE OF HOMOSEXUALS.PERHAPS THE MOST EGREG EXAMPLE OF HOMOPHOBIA WH THE MEDIL LERATURE IS A 1984 EDORIAL THE SOUTHERN MEDIL JOURNAL.6 THE THOR SPECULAT ON THE AETLOGY OF AIDS AND, CG BIBLIL QUOTATNS, NCLUS THAT “HOMOSEXUAL MEN [ARE] REAPG . . . [THE] EXPECTED NSEQUENC OF SEXUAL PROMISCUY,” AND THAT “HOMOSEXUALY IS A PATHOLOGIC NDN.” THE THOR SUGGTS THAT DOCTORS SHOULD “SEEK REVERSAL TREATMENT FOR THEIR HOMOSEXUAL PATIENTS JT AS VIGOROLY AS THEY WOULD FOR ALHOLICS OR HEAVY CIGARETTE SMOKERS.”HOMOSEXUAL ISSU MEDIL TN AND TRAGGIVEN THAT HOMOPHOBIA IS MON PRACTISG DOCTORS, HOW ARE HOMOSEXUAL ISSU BEG ADDRSED MEDIL SCHOOL CURRICULA? A 1991 STUDY, WH A 65% RPONSE RATE, POLLED THE DIRECTORS OF MEDIL SCHOOL TN PSYCHIATRY AT ALL US MEDIL SCHOOLS AND FOUND THAT, ON AVERAGE, ABOUT 3.5 HOURS WAS VOTED TO THE TOPIC OF HOMOSEXUALY OVER THE FOUR YEARS.7 THE MOST MON TEACHG TECHNIQUE ED BY THE SCHOOLS WAS LECTUR (80%), AND ABOUT 40% OF THE URS ED DIRECT NTACT WH HOMOSEXUAL PEOPLE.SUPPORT SERVIC FOR GAY, LBIAN, AND BISEXUAL MEDIL STUNTS AND RINTS, WHILE NOT UBIQUO, SEEM TO BE GROWG. A 1994 SURVEY OF 185 HOMOSEXUAL AND BISEXUAL MEDIL STUNTS OM 92 MEDIL SCHOOLS 34 STAT FOUND THAT 70% OF THE STUNTS HAD A GAY, LBIAN, AND BISEXUAL SUPPORT GROUP AT THEIR SCHOOL. NE OF THE MEDIL SCHOOLS HAD AN OFFICIAL LIAISON FOR GAY, LBIAN, AND BISEXUAL STUNTS (UP OM FOUR 1990).8A STUDY 1994 OF 291 DIRECTORS OF FAY PRACTICE RINCY PROGRAMM AND 67 HOMOSEXUAL AND BISEXUAL THIRD AND FOURTH YEAR MEDIL STUNTS LOOKED AT ATTUS SURROUNDG SPECIALTY CHOICE, TERVIEWG FOR RINCY, AND THE RANKG OF RINTS.9 SEVENTY ONE PER CENT OF RINTS SAID THEIR HOMOSEXUALY AFFECTED THEIR CISN ABOUT CHOICE OF SPECIALTY, 52% FELT THAT AN OPENLY HOMOSEXUAL OR BISEXUAL STUNT WOULD BE RANKED LOWER A SHORTLIST FOR A PROGRAMME, LS THAN HALF PLANNED TO DISCLOSE THEIR SEXUAL ORIENTATN DURG TERVIEWS, AND 30% HAD EDED THEIR CURRICULUM VAE TO REMOVE ACTIVI OR MEMBERSHIPS THAT MIGHT REVEAL THEIR HOMOSEXUALY. WHEN ASKED QUTNS OM THE HATH SLE 8% OF THE PROGRAMME DIRECTORS SRED THE HOMOPHOBIC RANGE. A FEW DIRECTORS CLUD MENTS THAT HOMOSEXUALY WAS A “GEIC FECT,” A “PSYCHIATRIC DIAGNOSIS,” OR “AN ABERRATN.” A QUARTER SAID THAT THEY WOULD RANK AN OPENLY HOMOSEXUAL OR BISEXUAL NDIDATE LOWER, AND ANOTHER QUARTER THOUGHT THAT DISCLOSURE OF SEXUAL ORIENTATN DURG TERVIEW WAS APPROPRIATE. NOT SURPRISGLY, THE 32% OF DIRECTORS WHO HAD HAD RECENT EXPERIENCE WH HOMOSEXUAL OR BISEXUAL RINTS THEIR PROGRAMM HAD MORE HOMOPHILIC HATH SR.DISCRIMATNANTI-HOMOSEXUAL DISCRIMATN REPRENTS HOMOPHOBIA ACTN. THAT ACTN MAY BE A RELS REMARK OR JOKE THAT BELTL A HOMOSEXUAL OR BISEXUAL PATIENT, OR MAY BE NYG GAY, LBIAN, AND BISEXUAL STUNTS ADMISSN TO MEDIL SCHOOL OR MARKG THEM DOWN DURG TRAG ON THE BASIS OF THEIR SEXUALY. IT MAY ALSO VOLVE NYG A RINCY POSN TO A HOMOSEXUAL OR BISEXUAL DOCTOR OR REFG TO REFER PATIENTS TO SUCH A DOCTOR.A 1994 SURVEY OF S MEMBERSHIP BY THE AMERIN ASSOCIATN OF PHYSICIANS FOR HUMAN RIGHTS—SCE RENAMED THE GAY AND LBIAN MEDIL ASSOCIATN—ATTEMPTED TO QUANTIFY AND DOCUMENT STANC OF ANTI- HOMOSEXUAL DISCRIMATN MEDICE.10 OF THE 1311 MEMBERS, 711 (54%) RETURNED QUTNNAIR. AMONG THE FDGS WERE THAT 17% OF RPONNTS HAD BEEN NIED REFERRALS, 34% HAD EXPERIENCED “VERBAL HARASSMENT OR SULT BY THEIR MEDIL LLEAGU,” AND 66% FELT THAT MANY HOMOSEXUAL AND BISEXUAL DOCTORS WOULD RISK LOSG THEIR PRACTIC IF LLEAGU DISVERED THEIR SEXUAL ORIENTATN, WHILE ONLY 12% FELT THAT THEY WERE TREATED AS EQUALS WH THE PROFSN. EVEN MORE PELLG THAN THE STATISTICS WERE THE MANY PERSONAL ANECDOT TAILG LLONS, OSTRACISM, SULTS, RCD JOB OFFERS, AND VATNS TO UNRGO PSYCHOTHERAPY.THE RULTS WERE RROBORATED BY A 1993 SURVEY OF LBIAN DOCTORS REPORTG HARASSMENT FOR THEIR SEXUAL ORIENTATN: 41% REPORTED HARASSMENT AT SOME TIME THEIR LIFE, 18% DURG GRADUATE MEDIL TN, 19% DURG MEDIL PRACTICE, AND 33% ANY WORK AFTER MEDIL SCHOOL.11FORTUNATELY, THERE IS SOME EVINCE THAT THE NEGATIVE ATTUS ARE CHANGG. A STUDY OF OPNS OF NEW MEXI DOCTORS' TOWARD HOMOSEXUAL AND BISEXUAL LLEAGU, PUBLISHED 1996,12 PARALLELED THE QUTNS ASKED 1982 BY MATHEWS ET AL SAN DIEGO.3 FEWER DOCTORS THE 1996 STUDY WOULD NY ADMISSN TO MEDIL SCHOOL TO A HIGHLY QUALIFIED HOMOSEXUAL OR BISEXUAL APPLINT (4% V 30% THE 1982 STUDY). IN ADDN, LS THAN 10% (V 45% 1982) WOULD DISURAGE A HOMOSEXUAL OR BISEXUAL DOCTOR OM BEG A PAEDIATRICIAN. ON THE SUBJECT OF REFERRAL PRACTIC, 91% DITED THAT THEY WOULD STILL REFER PATIENTS TO A PSYCHIATRIST LLEAGUE IF THEY FOUND OUT THAT HE OR SHE WAS HOMOSEXUAL (PARED WH ONLY 57% THE SAN DIEGO STUDY).FUTURE REARCH AND POSSIBLE SOLUTNSALTHOUGH THERE IS EVINCE THAT THE CLIMATE OF ACCEPTANCE HAS IMPROVED OVER THE PAST QUARTER CENTURY, GAY, LBIAN, AND BISEXUAL DOCTORS STILL FACE MANY QUTNS, ISSU, AND DILEMMAS (SEE BOX). QUTNS AND ISSU STILL FACG GAY, LBIAN, AND BISEXUAL DOCTORSDO GAY, LBIAN, AND BISEXUAL DOCTORS FEEL ACCEPTED THEIR PROFSNAL LIFE?WOULD THEY ADVISE A HOMOSEXUAL OR BISEXUAL PREMEDIL STUNT TO CHOOSE MEDICE AS A REER?WOULD THEY THEMSELV DO AGA?WHAT CHANG MEDICE WOULD IMPROVE THEIR WELLBEG?ARE MOST GAY, LBIAN, AND BISEXUAL DOCTORS OPEN ABOUT THEIR SEXUAL ORIENTATN TO LLEAGU, OFFICE STAFF, AND PATIENTS?WHAT ARE THE PROFSNAL RAMIFITNS OF A CISN TO BE OPEN?ARE OPENLY GAY, LBIAN, AND BISEXUAL DOCTORS HAPPIER AND MORE SUCCSFUL, AND DO THEY SUFFER MORE OR LS STRS?HOW MANY EMPLOYERS OF DOCTORS CLU “SEXUAL ORIENTATN” THEIR NON-DISCRIMATN STATEMENT? HOW MANY OFFER BENEFS FOR HOMOSEXUAL PARTNERS?ANYONE NDUCTG REARCH THIS SUBJECT HAS TO NONT A MAJOR ISSUE: HOW TO OBTA A REPRENTATIVE SAMPLE. IF WE NSERVATIVELY TIMATE THE PERCENTAGE OF GAY, LBIAN, AND BISEXUAL PEOPLE THE US GENERAL POPULATN TO BE 3% AND ASSUME THEY ARE PROPORTNATELY REPRENTED WH MEDICE, THERE SHOULD BE OVER 20 000 GAY, LBIAN, AND BISEXUAL DOCTORS NATNWI. SCE THE LARGT US ANISATN FOR GAY, LBIAN, AND BISEXUAL DOCTORS HAS A MEMBERSHIP OF ABOUT 2000, IS CLEAR THAT SAMPLG ONLY THE MEMBERS OF SUCH ANISATNS IS AQUATE. SUGGTNS FOR ENHANCG WELLBEG AMONG GAY, LBIAN, AND BISEXUAL DOCTORSWHERE POSSIBLE E OUTJO A GAY, LBIAN, AND BISEXUAL ANISATN; IF NONE IS AVAILABLE NEAR YOU FORM ONEIF YOU WORK FOR A HOSPAL OR DOCTOR GROUP ASK THAT “SEXUAL ORIENTATN” BE ADD TO S NON-DISCRIMATN STATEMENT—IF NOT FOR YOURSELF THEN FOR YOUR PATIENTSSPONSOR A BOOTH AT THE LOL GAY PRI CELEBRATNJO A GAY, LBIAN, AND BISEXUAL EMAIL LIST, SUCH AS GLB-MEDIL. TO JO, SEND AN EMAIL MSAGE TO AC.OTNOROTU.VRTSIL@VRTSIL AND, THE BODY OF THE MSAGE, WRE: “SUBSCRIBE GLB-MEDIL-L (YOUR NAME)”IF YOU LIVE NEAR A MEDIL SCHOOL VOLUNTEER TO SPEAK AS PART OF THE HOMOSEXUAL AND BISEXUAL CURRICULUMACT AS A MENTOR FOR A HOMOSEXUAL OR BISEXUAL MEDIL STUNT OR RINTMAKADON HAS SUGGTED THAT GAY, LBIAN, AND BISEXUAL DOCTORS' OWN OPENNS AND HONTY THE HEALTH SERVIC PENDS ON EXPLIC ATTENTN TO MEDIL TN ON HOMOSEXUAL AND BISEXUAL HEALTH ISSU ALL ASPECTS OF TRAG.13 STUDI EVALUATG THE EFFECTIVENS OF MEDIL SCHOOL CURRICULA ON HOMOSEXUALY HAVE PENNTLY SHOWN THAT STUNTS WHO ARE ACQUATED WH A GAY MAN OR LBIAN HAVE IMPROVED ATTUS TOWARD THEM.14,15 IT IS NO SURPRISE TO FD THAT, ANECDOTALLY, MANY GAY, LBIAN, AND BISEXUAL DOCTORS PARTICIPATE DOCTOR TN ON HOMOSEXUAL HEALTH ISSU BY DISCLOSG THEIR OWN SEXUAL ORIENTATN AND ACTG AS THE “ACQUATANCE” ROURCE FOR STUNTS, RINTS, AND LLEAGU THEIR LEARNG PROCS. KATSUAKIS HAS EXPLORED THE RISKS AND BENEFS OF SERVG THIS ROLE.2 THE LONG TERM EFFECTS OF THIS STRATEGY ON WELLBEG HAVE NOT BEEN REARCHED BUT SERVE FURTHER STUDY, AS MORE DOCTORS ARE G OUT THE WORKPLACE.FROM THE LIMED DATA AVAILABLE AND OUR OWN PERSONAL EXPERIENC, WE NNOT REMEND THAT ALL GAY, LBIAN, AND BISEXUAL DOCTORS SHOULD E OUT TO STUNTS AND LLEAGU EN MASSE, WH THE GOAL OF IMPROVG TN, ATTUS, AND REER LIFE. INSTEAD, WE SUGGT THAT—WHEN AND WHERE FEELS SAFE—LBIAN, GAY, AND BISEXUAL DOCTORS JO OTHERS THE WORKPLACE THE SUAL, HONT NVERSATNS THAT PERTA TO REER, FAY, AND PERSONAL CHOIC. IN OUR EXPERIENCE THE RMAL NVERSATNS ARE A GREAT AID TO DOCTOR WELLBEG. WE ALSO SUGGT THAT THE LLEAGU OF SUCH DOCTORS LISTEN RPECTFULLY TO THIS SHARED RMATN, REALISG THE ST AT WHICH HAS BEEN SPOKEN, AND WELE THE DOCTORS TO NVERSATNS. FOR THOSE WHO ARE NOT READY TO E OUT—BEE OF A REAL OR PERCEIVED THREAT TO THEIR LIVELIHOOD, FAY, OR PERSONAL SAFETY—WE ADVISE TOLERANCE AND PATIENCE WH THE HOMOSEXUAL AND BISEXUAL DOCTOR MUNY. OTHER PRACTIL SUGGTNS ARE LISTED THE BOX.CONCLNDPE THE ENURAGG DITORS, AT PRENT IS DIFFICULT TO ASSS WHETHER GAY, LBIAN, AND BISEXUAL DOCTORS HAVE CROSSED A MAJOR THRHOLD OR WILL NTUE TO STGGLE FOR EQUAL TREATMENT AND RPECT OM THEIR PEERS, TWO SENTIAL PONENTS OF WELLBEG. THE OPTIMIST TSTS THAT THE FUTURE WILL BE NSIRABLY BRIGHTER.FOOTNOTCOMPETG TERTS: NONE CLAREDREFERENC1. GOLDFARB A. WEARG A RABOW. J GAY LBIAN MED ASSOC. 1997;1:245. [GOOGLE SCHOLAR]2. KATSUAKIS PJ. ORIENTATN WEEK. J GAY LBIAN MED ASSOC. 1997;1:181–182. [GOOGLE SCHOLAR]3. MATHEWS WC, BOOTH MW, TURNER JD, KSLER L. PHYSICIANS' ATTUS TOWARD HOMOSEXUALY—SURVEY OF A CALIFORNIA UNTY MEDIL SOCIETY. WT J MED. 1986;144:106–110. [PMC EE ARTICLE] [PUBMED] [GOOGLE SCHOLAR]4. PRICHARD JG, DIAL LK, HOLLOWAY RL, MOSLEY M, BALE RM, KAPLOWZ HJ. ATTUS OF FAY MEDICE RINTS TOWARD HOMOSEXUALY. J FAM PRACT. 1988;27:637–639. [PUBMED] [GOOGLE SCHOLAR]5. HAYWARD RA, WEISSFELD JL. COMG TO TERMS WH THE ERA OF AIDS: ATTUS OF PHYSICIANS US RINCY PROGRAMS. J GEN INTERN MED. 1993;8:10–18. [PUBMED] [GOOGLE SCHOLAR]6. FLETCHER JL. HOMOSEXUALY: KICK AND KICKBACK. SOUTH MED J. 1984;77:149–150. [PUBMED] [GOOGLE SCHOLAR]7. WALLICK MM, CAMBRE KM, TOWNSEND MH. HOW THE TOPIC OF HOMOSEXUALY IS TGHT AT US MEDIL SCHOOLS. AD MED. 1992;67:601–603. [PUBMED] [GOOGLE SCHOLAR]8. TOWNSEND MH, WALLICK MM, CAMBRE KM. FOLLOW-UP SURVEY OF SUPPORT SERVIC FOR LBIAN, GAY, AND BISEXUAL MEDIL STUNTS. AD MED. 1996;71:1012–1014. [PUBMED] [GOOGLE SCHOLAR]9. ORIEL KA, MADLON-KAY DJ, GOVAKER D, MERSY DJ. GAY AND LBIAN PHYSICIANS TRAG: FAY PRACTICE DIRECTORS' ATTUS AND STUNTS' PERCEPTNS OF BIAS. FAM MED. 1996;28:720–725. [PUBMED] [GOOGLE SCHOLAR]10. SCHATZ B, O'HANLAN KA. ANTI-GAY DISCRIMATN MEDICE: RULTS OF A NATNAL SURVEY OF LBIAN, GAY AND BISEXUAL PHYSICIANS. SAN FRANCIS, CA: GAY AND LBIAN MEDIL ASSOCIATN; 1994. [GOOGLE SCHOLAR]11. BROGAN DJ, FRANK E, ELON L, SIVANAN SP, O'HANLAN KA. HARASSMENT OF LBIANS AS MEDIL STUNTS AND PHYSICIANS. JAMA. 1999;282:1290–1292. [PUBMED] [GOOGLE SCHOLAR]12. RAMOS MM, TLLEZ CM, PALLEY TB, UMLAND BE, SKIPPER BJ. ATTUS OF PHYSICIANS PRACTICG NEW MEXI TOWARD GAY MEN AND LBIANS THE PROFSN. AD MED. 1998;73:436–438. [PUBMED] [GOOGLE SCHOLAR]13. MAKADON HJ. IMPROVG OUR HEALTH RE AND OUR HEALTH: AN TNAL IMPERATIVE. J GAY LBIAN MED ASSOC. 1998;2:153–154. [GOOGLE SCHOLAR]14. OLSEN CG, MANN BL. MEDIL STUNT ATTUS ON HOMOSEXUALY AND IMPLITNS FOR HEALTH RE. J GAY LBIAN MED ASSOC. 1997;1:149–154. [GOOGLE SCHOLAR]15. MULLER MJ, WHE JC. MEDIL STUNT ATTUS TOWARD HOMOSEXUALY: EVALUATN OF A SEND YEAR CURRICULUM. J GAY LBIAN MED ASSOC. 1997;1:155–160. [GOOGLE SCHOLAR]BMJ. 2001 FEB 17; 322(7283): 422–425. » COMMENTARY: THE MEDIL PROFSN SHOULD FACE UP TO S OWN HOMOPHOBIA 2001 FEB 17; 322(7283): 422–425. COMMENTARY: THE MEDIL PROFSN SHOULD FACE UP TO S OWN HOMOPHOBIA
PHYSICIAN AND GAY: AM I SAFE AT WORK? : AMIC MEDICE
GAY AND BISEXUAL MEN'S HEALTH ISSU
'AS A BLACK, GAY PHYSICIAN, I'VE SURVIVED IN AMERI BY EMBRACG MY ANGER'

WELLBEG OF GAY, LBIAN, AND BISEXUAL DOCTORSBRIAN P BURKE, GENERAL TERNISTA AND JOCELYN C WHE, TERNISTBBRIAN P BURKEALEGACY CLIC NORTHWT, 1130 NW 22ND AVE, SUE 220, PORTLAND, OR 97210, USA, BOREGON HEALTH SCIENC UNIVERSY, COLUMBIA UNIVERSY, JOSEPH L MAILMAN SCHOOL OF PUBLIC HEALTH, LEGACY PORTLAND HOSPALS, 1015 NW 22ND AVE, R-200, PORTLAND, OR 97210, USAFD ARTICL BY BRIAN P BURKEJOCELYN C WHEALEGACY CLIC NORTHWT, 1130 NW 22ND AVE, SUE 220, PORTLAND, OR 97210, USA, BOREGON HEALTH SCIENC UNIVERSY, COLUMBIA UNIVERSY, JOSEPH L MAILMAN SCHOOL OF PUBLIC HEALTH, LEGACY PORTLAND HOSPALS, 1015 NW 22ND AVE, R-200, PORTLAND, OR 97210, USAFD ARTICL BY JOCELYN C WHEAUTHOR RMATN COPYRIGHT AND LICENSE RMATN PMC DISCLAIMERALEGACY CLIC NORTHWT, 1130 NW 22ND AVE, SUE 220, PORTLAND, OR 97210, USA, BOREGON HEALTH SCIENC UNIVERSY, COLUMBIA UNIVERSY, JOSEPH L MAILMAN SCHOOL OF PUBLIC HEALTH, LEGACY PORTLAND HOSPALS, 1015 NW 22ND AVE, R-200, PORTLAND, OR 97210, USACORRPONNCE TO: B P BURKE COPYRIGHT © 2001, BMJGAY, LBIAN, AND BISEXUAL DOCTORS HAVE LONG HAD A LARGELY VERT PRENCE WH THE MEDIL PROFSN; THEIR VISIBILY IS A RELATIVELY RECENT PHENOMENON. THE AMERIN PSYCHIATRIC ASSOCIATN'S LANDMARK CISN 1973 TO REMOVE HOMOSEXUALY OM THE NOMENCLATURE OF PSYCHIATRIC DISORRS WAS A MAJOR TALYST FOR THIS, ALLOWG HOMOSEXUAL AND BISEXUAL DOCTORS TO TAKE TENTATIVE STEPS TO THE CULTURE AT LARGE. A SEARCH OF THE MEDIL LERATURE YIELDS RMATN ON MEDIL ATTUS TOWARDS HOMOSEXUAL AND BISEXUAL PATIENTS, BUT LTLE ABOUT HOMOSEXUAL AND BISEXUAL DOCTORS THEMSELV. THEIR CHALLENG AND TRIUMPHS ARE LIKELY TO BE SIAR TO THOSE OF OTHER MORY GROUPS WH THE PROFSN, EXCEPT THAT THEY N CHOOSE WHETHER TO MAKE THEIR MORY STAT KNOWN TO PATIENTS AND LLEAGU.1,2ALTHOUGH SOCIETAL TOLERANCE TOWARDS SEXUAL MORI HAS GREATLY IMPROVED SCE 1973, “G OUT” AS A HOMOSEXUAL OR BISEXUAL DOCTOR REMAS A DIFFICULT CISN, WH BOTH PERSONAL AND PROFSNAL NSEQUENC. SUCH DOCTORS HAVE TO ASK THEMSELV SEVERAL QUTNS CIDG WHETHER TO E OUT:IF I E OUT DURG MEDIL SCHOOL WILL AFFECT MY GRAS OR MY ABILY TO GET TO A PETIVE RINCY PROGRAMME?WILL I HAVE THE SUPPORT OF MY CLASSMAT OR WILL I BE OSTRACISED?CAN I EVEN BE A HOMOSEXUAL OR BISEXUAL PAEDIATRICIAN, GYNAELOGIST, OR UROLOGIST?IF I BEE A SPECIALIST, WILL MY OPENNS NEGATIVELY AFFECT REFERRALS TO ME OM LLEAGU?WILL PATIENTS SHUN ME?CAN I PRACTISE A SMALL TOWN, OR AM I NSIGNED TO A LARGE METROPOLAN AREA?WELLBEG IMPLI PERSONAL AND PROFSNAL SATISFACTN AND THE ABILY TO EFFECTIVELY TEGRATE THE TWO TO FORM SATISFYG RELATNSHIPS WH PATIENTS AND LLEAGU AND TO ATTA THEIR RPECT. IN THIS ARTICLE WE REVIEW THE LERATURE ON THOSE FACTORS MOST LIKELY TO AFFECT THE WELLBEG OF GAY, LBIAN, AND BISEXUAL DOCTORS: HOMOPHOBIA, THE DIFFICULTI ENUNTERED BY HOMOSEXUAL AND BISEXUAL MEDIL STUNTS AND STAFF, AND ANTI-HOMOSEXUAL DISCRIMATN. WE ALSO SUGGT DIRECTNS FOR FUTURE REARCH THIS TOPIC AND WAYS TO ENHANCE THE WELLBEG OF GAY, LBIAN, AND BISEXUAL DOCTORS. SUMMARY POTSWHILE REARCH HAS VTIGATED DOCTORS' ATTUS TOWARDS HOMOSEXUAL AND BISEXUAL PATIENTS, RELATIVELY LTLE ATTENTN HAS BEEN PAID TO GAY, LBIAN, AND BISEXUAL DOCTORSTHE FACTORS MOST LIKELY TO AFFECT THE WELLBEG OF SUCH DOCTORS ARE HOMOPHOBIA, DISCRIMATN, THE CHALLENG OF MEDIL SCHOOL AND RINCY, AND LACK OF SUPPORT SYSTEMSTHERE IS DOCUMENTED HOMOPHOBIA AMONG DOCTORS AND DIRECTORS OF MEDIL SCHOOL TNGAY, LBIAN, AND BISEXUAL DOCTORS EXPERIENCE VERBAL HARASSMENT OR SULTS OM MEDIL LLEAGU, AND MANY BELIEVE THAT THEY RISK LOSG THEIR JOB IF LLEAGU DISVER THEIR SEXUAL ORIENTATNALTHOUGH THE SUATN HAS IMPROVED, MORE NEEDS TO BE DONE TO ENHANCE THE WELLBEG OF GAY, LBIAN, AND BISEXUAL DOCTORSMETHODSWE NDUCTED A SEARCH OF THE MEDLE DATABASE OM 1966 TO JUNE 2000 G THE SEARCH TERMS “GAY,” “LBIAN,” “BISEXUAL,” OR “HOMOSEXUAL” AND “PHYSICIAN,” “DOCTOR,” OR “HEALTH PROFSNAL” AND “PROFSNAL PRACTICE.” WE LIMED OUR SEARCH TO PAPERS WRTEN ENGLISH. WE REVIEWED THE REFERENC OF THE SELECTED PAPERS TO INTIFY STUDI MISSED BY OUR IAL SEARCH.HOMOPHOBIASEVERAL STUDI HAVE LOOKED AT THE EXISTENCE OF HOMOPHOBIA WH THE MEDIL MUNY. IN 1982 MATHEWS ET AL SENT A QUTNNAIRE TO ALL MEMBERS OF THE SAN DIEGO COUNTY MEDIL SOCIETY TO ELIC ATTUS TOWARDS HOMOSEXUAL PATIENTS AND LLEAGU.3 USG THE VALIDATED HETEROSEXUAL ATTUS TOWARD HOMOSEXUALY (HATH) SLE, THEY FOUND THAT 23% OF RPONNTS HAD HOMOPHOBIC ATTUS (37% SRED THE HOMOPHILIC RANGE, THE RT WERE NTRAL). IN FOUR SPECIALTI (ORTHOPAEDIC SURGERY, OBSTETRICS AND GYNAELOGY, GENERAL AND FAY PRACTICE, AND GENERAL SURGERY) OVER 30% OF RPONNTS DISPLAYED HOMOPHOBIC ATTUS. A 1988 SURVEY OF FAY PRACTICE RINTS AT NE UNIVERSY-BASED PROGRAMM SOUTHERN CALIFORNIA SHOWED OVERALL THAT 20% OF MALE RINTS WERE HOMOPHOBIC (PARED WH ONLY 3% OF WOMEN).4THE RISE OF AIDS DREW H ATTENTN TO GAY MEN AND GAVE HOMOSEXUAL AND BISEXUAL NCERNS A NEW VISIBILY. SOME HOMOPHOBIC VIEWS WERE PROBABLY SOFTENED THROUGH EMPATHY, WHILE OTHERS HARNED AMID CREASG VRL DIRECTED AT THE GAY MUNY. A 1989 SURVEY OF 1745 THIRD YEAR RINTS TERNAL MEDICE AND FAY PRACTICE LOOKED AT ATTUS TOWARD RG FOR PATIENTS WH AIDS AND TOWARD HOMOSEXUAL PEOPLE GENERAL.5 OF THE RPONNTS, 35% AGREED WH OR WERE UNSURE ABOUT THE STATEMENT “HOMOSEXUALY IS A MENTAL DISORR,” WHILE 20% ADMTED THAT THEY WEREN'T FORTABLE THE PRENCE OF HOMOSEXUALS.PERHAPS THE MOST EGREG EXAMPLE OF HOMOPHOBIA WH THE MEDIL LERATURE IS A 1984 EDORIAL THE SOUTHERN MEDIL JOURNAL.6 THE THOR SPECULAT ON THE AETLOGY OF AIDS AND, CG BIBLIL QUOTATNS, NCLUS THAT “HOMOSEXUAL MEN [ARE] REAPG . . . [THE] EXPECTED NSEQUENC OF SEXUAL PROMISCUY,” AND THAT “HOMOSEXUALY IS A PATHOLOGIC NDN.” THE THOR SUGGTS THAT DOCTORS SHOULD “SEEK REVERSAL TREATMENT FOR THEIR HOMOSEXUAL PATIENTS JT AS VIGOROLY AS THEY WOULD FOR ALHOLICS OR HEAVY CIGARETTE SMOKERS.”HOMOSEXUAL ISSU MEDIL TN AND TRAGGIVEN THAT HOMOPHOBIA IS MON PRACTISG DOCTORS, HOW ARE HOMOSEXUAL ISSU BEG ADDRSED MEDIL SCHOOL CURRICULA? A 1991 STUDY, WH A 65% RPONSE RATE, POLLED THE DIRECTORS OF MEDIL SCHOOL TN PSYCHIATRY AT ALL US MEDIL SCHOOLS AND FOUND THAT, ON AVERAGE, ABOUT 3.5 HOURS WAS VOTED TO THE TOPIC OF HOMOSEXUALY OVER THE FOUR YEARS.7 THE MOST MON TEACHG TECHNIQUE ED BY THE SCHOOLS WAS LECTUR (80%), AND ABOUT 40% OF THE URS ED DIRECT NTACT WH HOMOSEXUAL PEOPLE.SUPPORT SERVIC FOR GAY, LBIAN, AND BISEXUAL MEDIL STUNTS AND RINTS, WHILE NOT UBIQUO, SEEM TO BE GROWG. A 1994 SURVEY OF 185 HOMOSEXUAL AND BISEXUAL MEDIL STUNTS OM 92 MEDIL SCHOOLS 34 STAT FOUND THAT 70% OF THE STUNTS HAD A GAY, LBIAN, AND BISEXUAL SUPPORT GROUP AT THEIR SCHOOL. NE OF THE MEDIL SCHOOLS HAD AN OFFICIAL LIAISON FOR GAY, LBIAN, AND BISEXUAL STUNTS (UP OM FOUR 1990).8A STUDY 1994 OF 291 DIRECTORS OF FAY PRACTICE RINCY PROGRAMM AND 67 HOMOSEXUAL AND BISEXUAL THIRD AND FOURTH YEAR MEDIL STUNTS LOOKED AT ATTUS SURROUNDG SPECIALTY CHOICE, TERVIEWG FOR RINCY, AND THE RANKG OF RINTS.9 SEVENTY ONE PER CENT OF RINTS SAID THEIR HOMOSEXUALY AFFECTED THEIR CISN ABOUT CHOICE OF SPECIALTY, 52% FELT THAT AN OPENLY HOMOSEXUAL OR BISEXUAL STUNT WOULD BE RANKED LOWER A SHORTLIST FOR A PROGRAMME, LS THAN HALF PLANNED TO DISCLOSE THEIR SEXUAL ORIENTATN DURG TERVIEWS, AND 30% HAD EDED THEIR CURRICULUM VAE TO REMOVE ACTIVI OR MEMBERSHIPS THAT MIGHT REVEAL THEIR HOMOSEXUALY. WHEN ASKED QUTNS OM THE HATH SLE 8% OF THE PROGRAMME DIRECTORS SRED THE HOMOPHOBIC RANGE. A FEW DIRECTORS CLUD MENTS THAT HOMOSEXUALY WAS A “GEIC FECT,” A “PSYCHIATRIC DIAGNOSIS,” OR “AN ABERRATN.” A QUARTER SAID THAT THEY WOULD RANK AN OPENLY HOMOSEXUAL OR BISEXUAL NDIDATE LOWER, AND ANOTHER QUARTER THOUGHT THAT DISCLOSURE OF SEXUAL ORIENTATN DURG TERVIEW WAS APPROPRIATE. NOT SURPRISGLY, THE 32% OF DIRECTORS WHO HAD HAD RECENT EXPERIENCE WH HOMOSEXUAL OR BISEXUAL RINTS THEIR PROGRAMM HAD MORE HOMOPHILIC HATH SR.DISCRIMATNANTI-HOMOSEXUAL DISCRIMATN REPRENTS HOMOPHOBIA ACTN. THAT ACTN MAY BE A RELS REMARK OR JOKE THAT BELTL A HOMOSEXUAL OR BISEXUAL PATIENT, OR MAY BE NYG GAY, LBIAN, AND BISEXUAL STUNTS ADMISSN TO MEDIL SCHOOL OR MARKG THEM DOWN DURG TRAG ON THE BASIS OF THEIR SEXUALY. IT MAY ALSO VOLVE NYG A RINCY POSN TO A HOMOSEXUAL OR BISEXUAL DOCTOR OR REFG TO REFER PATIENTS TO SUCH A DOCTOR.A 1994 SURVEY OF S MEMBERSHIP BY THE AMERIN ASSOCIATN OF PHYSICIANS FOR HUMAN RIGHTS—SCE RENAMED THE GAY AND LBIAN MEDIL ASSOCIATN—ATTEMPTED TO QUANTIFY AND DOCUMENT STANC OF ANTI- HOMOSEXUAL DISCRIMATN MEDICE.10 OF THE 1311 MEMBERS, 711 (54%) RETURNED QUTNNAIR. AMONG THE FDGS WERE THAT 17% OF RPONNTS HAD BEEN NIED REFERRALS, 34% HAD EXPERIENCED “VERBAL HARASSMENT OR SULT BY THEIR MEDIL LLEAGU,” AND 66% FELT THAT MANY HOMOSEXUAL AND BISEXUAL DOCTORS WOULD RISK LOSG THEIR PRACTIC IF LLEAGU DISVERED THEIR SEXUAL ORIENTATN, WHILE ONLY 12% FELT THAT THEY WERE TREATED AS EQUALS WH THE PROFSN. EVEN MORE PELLG THAN THE STATISTICS WERE THE MANY PERSONAL ANECDOT TAILG LLONS, OSTRACISM, SULTS, RCD JOB OFFERS, AND VATNS TO UNRGO PSYCHOTHERAPY.THE RULTS WERE RROBORATED BY A 1993 SURVEY OF LBIAN DOCTORS REPORTG HARASSMENT FOR THEIR SEXUAL ORIENTATN: 41% REPORTED HARASSMENT AT SOME TIME THEIR LIFE, 18% DURG GRADUATE MEDIL TN, 19% DURG MEDIL PRACTICE, AND 33% ANY WORK AFTER MEDIL SCHOOL.11FORTUNATELY, THERE IS SOME EVINCE THAT THE NEGATIVE ATTUS ARE CHANGG. A STUDY OF OPNS OF NEW MEXI DOCTORS' TOWARD HOMOSEXUAL AND BISEXUAL LLEAGU, PUBLISHED 1996,12 PARALLELED THE QUTNS ASKED 1982 BY MATHEWS ET AL SAN DIEGO.3 FEWER DOCTORS THE 1996 STUDY WOULD NY ADMISSN TO MEDIL SCHOOL TO A HIGHLY QUALIFIED HOMOSEXUAL OR BISEXUAL APPLINT (4% V 30% THE 1982 STUDY). IN ADDN, LS THAN 10% (V 45% 1982) WOULD DISURAGE A HOMOSEXUAL OR BISEXUAL DOCTOR OM BEG A PAEDIATRICIAN. ON THE SUBJECT OF REFERRAL PRACTIC, 91% DITED THAT THEY WOULD STILL REFER PATIENTS TO A PSYCHIATRIST LLEAGUE IF THEY FOUND OUT THAT HE OR SHE WAS HOMOSEXUAL (PARED WH ONLY 57% THE SAN DIEGO STUDY).FUTURE REARCH AND POSSIBLE SOLUTNSALTHOUGH THERE IS EVINCE THAT THE CLIMATE OF ACCEPTANCE HAS IMPROVED OVER THE PAST QUARTER CENTURY, GAY, LBIAN, AND BISEXUAL DOCTORS STILL FACE MANY QUTNS, ISSU, AND DILEMMAS (SEE BOX). QUTNS AND ISSU STILL FACG GAY, LBIAN, AND BISEXUAL DOCTORSDO GAY, LBIAN, AND BISEXUAL DOCTORS FEEL ACCEPTED THEIR PROFSNAL LIFE?WOULD THEY ADVISE A HOMOSEXUAL OR BISEXUAL PREMEDIL STUNT TO CHOOSE MEDICE AS A REER?WOULD THEY THEMSELV DO AGA?WHAT CHANG MEDICE WOULD IMPROVE THEIR WELLBEG?ARE MOST GAY, LBIAN, AND BISEXUAL DOCTORS OPEN ABOUT THEIR SEXUAL ORIENTATN TO LLEAGU, OFFICE STAFF, AND PATIENTS?WHAT ARE THE PROFSNAL RAMIFITNS OF A CISN TO BE OPEN?ARE OPENLY GAY, LBIAN, AND BISEXUAL DOCTORS HAPPIER AND MORE SUCCSFUL, AND DO THEY SUFFER MORE OR LS STRS?HOW MANY EMPLOYERS OF DOCTORS CLU “SEXUAL ORIENTATN” THEIR NON-DISCRIMATN STATEMENT? HOW MANY OFFER BENEFS FOR HOMOSEXUAL PARTNERS?ANYONE NDUCTG REARCH THIS SUBJECT HAS TO NONT A MAJOR ISSUE: HOW TO OBTA A REPRENTATIVE SAMPLE. IF WE NSERVATIVELY TIMATE THE PERCENTAGE OF GAY, LBIAN, AND BISEXUAL PEOPLE THE US GENERAL POPULATN TO BE 3% AND ASSUME THEY ARE PROPORTNATELY REPRENTED WH MEDICE, THERE SHOULD BE OVER 20 000 GAY, LBIAN, AND BISEXUAL DOCTORS NATNWI. SCE THE LARGT US ANISATN FOR GAY, LBIAN, AND BISEXUAL DOCTORS HAS A MEMBERSHIP OF ABOUT 2000, IS CLEAR THAT SAMPLG ONLY THE MEMBERS OF SUCH ANISATNS IS AQUATE. SUGGTNS FOR ENHANCG WELLBEG AMONG GAY, LBIAN, AND BISEXUAL DOCTORSWHERE POSSIBLE E OUTJO A GAY, LBIAN, AND BISEXUAL ANISATN; IF NONE IS AVAILABLE NEAR YOU FORM ONEIF YOU WORK FOR A HOSPAL OR DOCTOR GROUP ASK THAT “SEXUAL ORIENTATN” BE ADD TO S NON-DISCRIMATN STATEMENT—IF NOT FOR YOURSELF THEN FOR YOUR PATIENTSSPONSOR A BOOTH AT THE LOL GAY PRI CELEBRATNJO A GAY, LBIAN, AND BISEXUAL EMAIL LIST, SUCH AS GLB-MEDIL. TO JO, SEND AN EMAIL MSAGE TO AC.OTNOROTU.VRTSIL@VRTSIL AND, THE BODY OF THE MSAGE, WRE: “SUBSCRIBE GLB-MEDIL-L (YOUR NAME)”IF YOU LIVE NEAR A MEDIL SCHOOL VOLUNTEER TO SPEAK AS PART OF THE HOMOSEXUAL AND BISEXUAL CURRICULUMACT AS A MENTOR FOR A HOMOSEXUAL OR BISEXUAL MEDIL STUNT OR RINTMAKADON HAS SUGGTED THAT GAY, LBIAN, AND BISEXUAL DOCTORS' OWN OPENNS AND HONTY THE HEALTH SERVIC PENDS ON EXPLIC ATTENTN TO MEDIL TN ON HOMOSEXUAL AND BISEXUAL HEALTH ISSU ALL ASPECTS OF TRAG.13 STUDI EVALUATG THE EFFECTIVENS OF MEDIL SCHOOL CURRICULA ON HOMOSEXUALY HAVE PENNTLY SHOWN THAT STUNTS WHO ARE ACQUATED WH A GAY MAN OR LBIAN HAVE IMPROVED ATTUS TOWARD THEM.14,15 IT IS NO SURPRISE TO FD THAT, ANECDOTALLY, MANY GAY, LBIAN, AND BISEXUAL DOCTORS PARTICIPATE DOCTOR TN ON HOMOSEXUAL HEALTH ISSU BY DISCLOSG THEIR OWN SEXUAL ORIENTATN AND ACTG AS THE “ACQUATANCE” ROURCE FOR STUNTS, RINTS, AND LLEAGU THEIR LEARNG PROCS. KATSUAKIS HAS EXPLORED THE RISKS AND BENEFS OF SERVG THIS ROLE.2 THE LONG TERM EFFECTS OF THIS STRATEGY ON WELLBEG HAVE NOT BEEN REARCHED BUT SERVE FURTHER STUDY, AS MORE DOCTORS ARE G OUT THE WORKPLACE.FROM THE LIMED DATA AVAILABLE AND OUR OWN PERSONAL EXPERIENC, WE NNOT REMEND THAT ALL GAY, LBIAN, AND BISEXUAL DOCTORS SHOULD E OUT TO STUNTS AND LLEAGU EN MASSE, WH THE GOAL OF IMPROVG TN, ATTUS, AND REER LIFE. INSTEAD, WE SUGGT THAT—WHEN AND WHERE FEELS SAFE—LBIAN, GAY, AND BISEXUAL DOCTORS JO OTHERS THE WORKPLACE THE SUAL, HONT NVERSATNS THAT PERTA TO REER, FAY, AND PERSONAL CHOIC. IN OUR EXPERIENCE THE RMAL NVERSATNS ARE A GREAT AID TO DOCTOR WELLBEG. WE ALSO SUGGT THAT THE LLEAGU OF SUCH DOCTORS LISTEN RPECTFULLY TO THIS SHARED RMATN, REALISG THE ST AT WHICH HAS BEEN SPOKEN, AND WELE THE DOCTORS TO NVERSATNS. FOR THOSE WHO ARE NOT READY TO E OUT—BEE OF A REAL OR PERCEIVED THREAT TO THEIR LIVELIHOOD, FAY, OR PERSONAL SAFETY—WE ADVISE TOLERANCE AND PATIENCE WH THE HOMOSEXUAL AND BISEXUAL DOCTOR MUNY. OTHER PRACTIL SUGGTNS ARE LISTED THE BOX.CONCLNDPE THE ENURAGG DITORS, AT PRENT IS DIFFICULT TO ASSS WHETHER GAY, LBIAN, AND BISEXUAL DOCTORS HAVE CROSSED A MAJOR THRHOLD OR WILL NTUE TO STGGLE FOR EQUAL TREATMENT AND RPECT OM THEIR PEERS, TWO SENTIAL PONENTS OF WELLBEG. THE OPTIMIST TSTS THAT THE FUTURE WILL BE NSIRABLY BRIGHTER.FOOTNOTCOMPETG TERTS: NONE CLAREDREFERENC1. GOLDFARB A. WEARG A RABOW. J GAY LBIAN MED ASSOC. 1997;1:245. [GOOGLE SCHOLAR]2. KATSUAKIS PJ. ORIENTATN WEEK. J GAY LBIAN MED ASSOC. 1997;1:181–182. [GOOGLE SCHOLAR]3. MATHEWS WC, BOOTH MW, TURNER JD, KSLER L. PHYSICIANS' ATTUS TOWARD HOMOSEXUALY—SURVEY OF A CALIFORNIA UNTY MEDIL SOCIETY. WT J MED. 1986;144:106–110. [PMC EE ARTICLE] [PUBMED] [GOOGLE SCHOLAR]4. PRICHARD JG, DIAL LK, HOLLOWAY RL, MOSLEY M, BALE RM, KAPLOWZ HJ. ATTUS OF FAY MEDICE RINTS TOWARD HOMOSEXUALY. J FAM PRACT. 1988;27:637–639. [PUBMED] [GOOGLE SCHOLAR]5. HAYWARD RA, WEISSFELD JL. COMG TO TERMS WH THE ERA OF AIDS: ATTUS OF PHYSICIANS US RINCY PROGRAMS. J GEN INTERN MED. 1993;8:10–18. [PUBMED] [GOOGLE SCHOLAR]6. FLETCHER JL. HOMOSEXUALY: KICK AND KICKBACK. SOUTH MED J. 1984;77:149–150. [PUBMED] [GOOGLE SCHOLAR]7. WALLICK MM, CAMBRE KM, TOWNSEND MH. HOW THE TOPIC OF HOMOSEXUALY IS TGHT AT US MEDIL SCHOOLS. AD MED. 1992;67:601–603. [PUBMED] [GOOGLE SCHOLAR]8. TOWNSEND MH, WALLICK MM, CAMBRE KM. FOLLOW-UP SURVEY OF SUPPORT SERVIC FOR LBIAN, GAY, AND BISEXUAL MEDIL STUNTS. AD MED. 1996;71:1012–1014. [PUBMED] [GOOGLE SCHOLAR]9. ORIEL KA, MADLON-KAY DJ, GOVAKER D, MERSY DJ. GAY AND LBIAN PHYSICIANS TRAG: FAY PRACTICE DIRECTORS' ATTUS AND STUNTS' PERCEPTNS OF BIAS. FAM MED. 1996;28:720–725. [PUBMED] [GOOGLE SCHOLAR]10. SCHATZ B, O'HANLAN KA. ANTI-GAY DISCRIMATN MEDICE: RULTS OF A NATNAL SURVEY OF LBIAN, GAY AND BISEXUAL PHYSICIANS. SAN FRANCIS, CA: GAY AND LBIAN MEDIL ASSOCIATN; 1994. [GOOGLE SCHOLAR]11. BROGAN DJ, FRANK E, ELON L, SIVANAN SP, O'HANLAN KA. HARASSMENT OF LBIANS AS MEDIL STUNTS AND PHYSICIANS. JAMA. 1999;282:1290–1292. [PUBMED] [GOOGLE SCHOLAR]12. RAMOS MM, TLLEZ CM, PALLEY TB, UMLAND BE, SKIPPER BJ. ATTUS OF PHYSICIANS PRACTICG NEW MEXI TOWARD GAY MEN AND LBIANS THE PROFSN. AD MED. 1998;73:436–438. [PUBMED] [GOOGLE SCHOLAR]13. MAKADON HJ. IMPROVG OUR HEALTH RE AND OUR HEALTH: AN TNAL IMPERATIVE. J GAY LBIAN MED ASSOC. 1998;2:153–154. [GOOGLE SCHOLAR]14. OLSEN CG, MANN BL. MEDIL STUNT ATTUS ON HOMOSEXUALY AND IMPLITNS FOR HEALTH RE. J GAY LBIAN MED ASSOC. 1997;1:149–154. [GOOGLE SCHOLAR]15. MULLER MJ, WHE JC. MEDIL STUNT ATTUS TOWARD HOMOSEXUALY: EVALUATN OF A SEND YEAR CURRICULUM. J GAY LBIAN MED ASSOC. 1997;1:155–160. [GOOGLE SCHOLAR]BMJ. 2001 FEB 17; 322(7283): 422–425. » COMMENTARY: THE MEDIL PROFSN SHOULD FACE UP TO S OWN HOMOPHOBIA 2001 FEB 17; 322(7283): 422–425. COMMENTARY: THE MEDIL PROFSN SHOULD FACE UP TO S OWN HOMOPHOBIA

* are doctors gay *

2% to 5%, and those intifyg as gay or lbian creased om 3. 2% of AAFP members intify as gay, bisexual or uncerta. Durg the vis, the hband ma a homophobic joke about his effemate psychiatrist, who is openly gay.

If you are lbian, gay, bisexual, transgenr, queer, and/or intify as a sexual and/or genr mory and are lookg for LGBTQ+ affirmg doctors, physicians, clicians, and healthre provirs, you have e to the right place. Gay, lbian, and bisexual doctors have long had a largely vert prence wh the medil profsn; their visibily is a relatively recent phenomenon. The Amerin Psychiatric Associatn's landmark cisn 1973 to remove homosexualy om the nomenclature of psychiatric disorrs was a major talyst for this, allowg homosexual and bisexual doctors to take tentative steps to the culture at large.

A search of the medil lerature yields rmatn on medil attus towards homosexual and bisexual patients, but ltle about homosexual and bisexual doctors themselv. 1, 2Although societal tolerance towards sexual mori has greatly improved sce 1973, “g out” as a homosexual or bisexual doctor remas a difficult cisn, wh both personal and profsnal nsequenc.

PHYSICIAN AND GAY: AM I SAFE AT WORK? : AMIC MEDICE

Rearch has shown that the followg are some of the most mon health ncerns faced by gay and bisexual men. * are doctors gay *

Can I even be a homosexual or bisexual paediatrician, gynaelogist, or urologist? In this article we review the lerature on those factors most likely to affect the wellbeg of gay, lbian, and bisexual doctors: homophobia, the difficulti enuntered by homosexual and bisexual medil stunts and staff, and anti-homosexual discrimatn. We also suggt directns for future rearch this topic and ways to enhance the wellbeg of gay, lbian, and bisexual doctors.

Summary potsWhile rearch has vtigated doctors' attus towards homosexual and bisexual patients, relatively ltle attentn has been paid to gay, lbian, and bisexual doctorsThe factors most likely to affect the wellbeg of such doctors are homophobia, discrimatn, the challeng of medil school and rincy, and lack of support systemsThere is documented homophobia among doctors and directors of medil school tnGay, lbian, and bisexual doctors experience verbal harassment or sults om medil lleagu, and many believe that they risk losg their job if lleagu disver their sexual orientatnAlthough the suatn has improved, more needs to be done to enhance the wellbeg of gay, lbian, and bisexual doctorsMethodsWe nducted a search of the Medle database om 1966 to June 2000 g the search terms “gay, ” “lbian, ” “bisexual, ” or “homosexual” and “physician, ” “doctor, ” or “health profsnal” and “profsnal practice. HomophobiaSeveral studi have looked at the existence of homophobia wh the medil muny.

In 1982 Mathews et al sent a qutnnaire to all members of the San Diego County Medil Society to elic attus towards homosexual patients and lleagu. 3 Usg the validated heterosexual attus toward homosexualy (HATH) sle, they found that 23% of rponnts had homophobic attus (37% sred the homophilic range, the rt were ntral). In four specialti (orthopaedic surgery, obstetrics and gynaelogy, general and fay practice, and general surgery) over 30% of rponnts displayed homophobic attus.

A 1988 survey of fay practice rints at ne universy-based programm southern California showed overall that 20% of male rints were homophobic (pared wh only 3% of women). 4The rise of AIDS drew h attentn to gay men and gave homosexual and bisexual ncerns a new visibily.

'AS A BLACK, GAY PHYSICIAN, I'VE SURVIVED IN AMERI BY EMBRACG MY ANGER'

Some homophobic views were probably softened through empathy, while others harned amid creasg vrl directed at the gay muny.

A 1989 survey of 1745 third year rints ternal medice and fay practice looked at attus toward rg for patients wh AIDS and toward homosexual people general. 5 Of the rponnts, 35% agreed wh or were unsure about the statement “Homosexualy is a mental disorr, ” while 20% admted that they weren't fortable the prence of homosexuals. Perhaps the most egreg example of homophobia wh the medil lerature is a 1984 edorial the Southern Medil Journal.

6 The thor speculat on the aetlogy of AIDS and, cg biblil quotatns, nclus that “homosexual men [are] reapg...

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PHYSICIAN AND GAY: AM I SAFE AT WORK? : AMIC MEDICE