“The doctor said I didn’t look gay”: Young adults’ experienc of disclosure and non-disclosure of LGBTQ inty to healthre provirs - PMC

Contents:

• GAY AND TRANSGENR PATIENTS TO DOCTORS: WE’LL TELL. JT ASK.
• AFTER FACG DISCRIMATN, DR. JON BEME THE GAY DOCTOR EVERY QUEER PERSON NEEDS
• THE BENEFS OF SEEG A GAY DOCTOR
• 141 DOCTOR AND GAY PATIENT STOCK VIOS, 4K FOOTAGE, & VIO CLIPS
• “A GAY MAN AND A DOCTOR ARE JT LIKE, A RECIPE FOR STCTN”: HOW RACISM AND HOMONEGATIVY HEALTHRE SETTGS FLUENCE PREP UPTAKE AMONG YOUNG BLACK MSM
• LBIAN, GAY, BISEXUAL, TRANSGENR, AND QUTNG OR QUEER (LGBTQ) HEALTH TOOLK
• “THE DOCTOR SAID I DIDN’T LOOK GAY”: YOUNG ADULTS’ EXPERIENC OF DISCLOSURE AND NON-DISCLOSURE OF LGBTQ INTY TO HEALTHRE PROVIRS
• 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

GAY AND TRANSGENR PATIENTS TO DOCTORS: WE’LL TELL. JT ASK.

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. And blueprts for natnal health goals remend llectg the rmatn om all knowg whether a patient is lbian, gay, bisexual, transgenr or straight, say public health experts, clicians n be more alert to a person’s medil needs and more thoughtful teractns. Nearly 80 percent of provirs surveyed believed that patients would refe to disclose their sexual ntrast, only 10 percent of patients om a randomized, natnal sample of lbian, gay, bisexual and heterosexual subjects said they would refe.

Two pennt advisory anizatns, the Instute of Medice (now the Natnal Amy of Medice) and the Jot Commissn, have both strongly remend dog Febary more than 1, 400 health centers that receive feral funds and treat more than 24 ln people annually were given the optn to report to the ernment percentag of patients who intified the prev year as lbian, gay, bisexual or creasgly, hospals and provirs who participate a fancial centive program wh the Centers for Medire and Mediid Servic will be shiftg to electronic health rerds which, by 2018, mt have the pacy to store sexual orientatn and genr inty data.

AFTER FACG DISCRIMATN, DR. JON BEME THE GAY DOCTOR EVERY QUEER PERSON NEEDS

Shipherd, director of the Lbian, Gay, Bisexual and Transgenr Health Program for the Veterans Health Admistratn, noted that the JAMA study, patients and provirs were on the same page about how to ask. Ined, this study, which 53 gay and bisexual patients and 26 emergency partment provirs were terviewed pth to rm the natnal survey of 1, 516 patients and 429 health re profsnals, provirs challenged the necsy of gatherg such so ltle time and private space to treat patients a by emergency partment, clicians tradnally have been reluctant to ask rmatn that they believed was not clilly relevant, said Dr.

If you are a member of the LGBTQ+ muny, below are a few addnal reasons you may want to nsir seekg healthre om a medil gay this Article:Specialized LGBT Health MattersA Gay Friendly, Fear-Free EnvironmentTips for Talkg to Your Gay Doctor.

THE BENEFS OF SEEG A GAY DOCTOR

A Gay-Friendly, Fear-ee EnvironmentGay doctors have a specialized awarens of LGBTQ+ health ncerns that n make queer patients more nfint discsg sensive health matters.

141 DOCTOR AND GAY PATIENT STOCK VIOS, 4K FOOTAGE, & VIO CLIPS

Tips for Talkg to Your Gay DoctorDiscsg sensive health topics may be pecially difficult for queer patients, but seeg a gay medil doctor n make the procs easier. Talkg to your gay iendly doctor about everythg om your dietary habs and physil activy to relatnship stat and sexual health n help them better unrstand how to bt serve you. All medice affects the body some way and orr to gui you makg the most rmed cisns on your health, the gay doctor needs to know all the trici of your liftyle.

This discreet re mol ensur that personal rmatn remas only between you and your gay iendly doctor (somethg that may ter patients om beg hont and thorough their munitn) Osra Medil we are mted to supportg the health of the LGBTQ+ muny through rmative, affordable, personalized primary re and specialize servg gay and bisexual men. Published fal eded form as:PMCID: PMC6571052NIHMSID: NIHMS1516922AbstractYoung, Black, gay bisexual or other MSM are signifintly ls likely to e PrEP than their Whe unterparts. Keywords: Medil mistst, racial dispari, PrEP dispari, young adults, qualative, racism, homonegativyHIV pre-exposure prophylaxis (PrEP) is a promisg ponent of HIV preventn, particularly for gay, bisexual, and other men who have sex wh men (MSM), monstratg high efficy among adherent ers1, 2.

Incln creria required that participants intify as Black or Ain Amerin, were assigned male genr at birth, intified as gay, bisexual, or other men who have sex wh men, were between the ag of 16 and 25, and reported an HIV-negative or unknown serostat. We explicly asked about experienc of discrimatn, racism, and homonegativy om health re provirs and sought to unrstand how the factors may affect PrEP uptake among young Black analysisFoc groups were d-rerd, transcribed verbatim, and d g MAXQDA qualative analysis software. The fal book clud barriers to PrEP (cludg stigma, lack of support, and perceptn of need), benefs of PrEP, medil mistst, discrimatn healthre settgs, PrEP stigma, homonegativy (cludg ‘down low’, homonegativy wh the Black muny, ternalized homonegativy, and anticipated homonegativy), and racism (cludg differenc healthre treatment by race and racial discrimatn).

“A GAY MAN AND A DOCTOR ARE JT LIKE, A RECIPE FOR STCTN”: HOW RACISM AND HOMONEGATIVY HEALTHRE SETTGS FLUENCE PREP UPTAKE AMONG YOUNG BLACK MSM

Analys revealed the ntued effects of racial and enomic disadvantage on health re accs and the ways which racism and homonegativy fluenced young men’s fort discsg sexual behavr wh physicians. [Foc group six]Although this excerpt they were discsg healthre more generally, the perceptn of receivg ferr medil treatment n ntribute to dividuals’ reluctance to start discsg perceived substandard re for Black gay men, foc group three participants scribed how racism, homonegativy, discrimatn, and poor medil re had bee expected and accepted as part of their health re.

Precedg the followg excerpt om foc group three, several participants had jt shared personal stori of discrimatn and poor treatment:Facilator: Why do we, as a gay Black muny, why do we allow suatns like that to bee a mon thg? Through their own experienc and those of their fay, iends, and muny members, participants uld rell so many experienc of stigma and mistreatment that they had e to expect and accept homonegativy, racism, and discrimatn.

This is not to say they did not intify the jtice this or sire better re, but such experienc had bee so monplace that they were no longer shockg or Black MSM rced to their sexualy by doctorsThe perceived racism participants faced was plited by the tersectn of homonegativy. While the lack of a tsted, regular provir was one factor this, this disfort was also rooted anticipated homonegativy and poor treatment om physicians. P1: I don’t want to say ’s all Whe doctors, ‘e I’ve had some good on, but ’s jt that they treat gay men like we nasty… I even asked, “If you don’t wanna do , you n brg a woman nurse here if you want to.

LBIAN, GAY, BISEXUAL, TRANSGENR, AND QUTNG OR QUEER (LGBTQ) HEALTH TOOLK

The fear of both race- and sexualy-based discrimatn and prejudice om Whe physicians ntributed to the notn that a gay man and doctor is a “recipe for stctn. Participants noted that, upon revealg sexual behavrs, physicians only looked at them as young gay men at risk for HIV, rather than treatg them as a whole person, wh other healthre needs.

“THE DOCTOR SAID I DIDN’T LOOK GAY”: YOUNG ADULTS’ EXPERIENC OF DISCLOSURE AND NON-DISCLOSURE OF LGBTQ INTY TO HEALTHRE PROVIRS

Specifilly, several men raised ncerns about the ‘ttg’ of meditns on Black and gay people and exprsed skepticism about the targetg of PrEP toward Black MSM. This skepticism about physician tentns was amplified for the young men who were ntendg wh racism and homonegativy healthre settgs, which rerced medil mistst. Seeg a new physician at every vis meant that, if they were to disclose their sexual orientatn, they would be ‘g out’ over and over aga and face the strs and risks associated wh disclosure at every vis, as they anticipated homonegativy and mistreatment.

Although genr was not as notable a factor as race, there were several participants who exprsed preference for female provirs, whom they perceived to be more motherly and ls homophobic. Racism and homonegativy have alienated young Black MSM om the health re system and created signifint systematic barriers to health re and has been documented prev rearch35, 36, generatns of medil mistreatment and historil disadvantage have ntributed to stctural and cultural barriers that ma difficult for the young men to tablish re wh a tsted physician. Addnally, young men expected substandard treatment medil facili, cg racism and homonegativy, ferr clics ‘the hood’, and beg geographilly and socially exclud om higher qualy health re.

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

53 Addnally, tnal efforts and medil school pipele programs are need to enhance the racial and sexual inty makp of the healthre workforce, creasg the number of Black provirs, particularly those who are also gay and bisexual. Participants overwhelmgly exprsed a preference for Ain Amerin and/or gay provirs, who they believed they uld better relate to and receive better servic om. Stigma, medil mistst, and perceived racism may affect PrEP awarens and uptake black pared to whe gay and bisexual men Jackson, Mississippi and Boston, Massachetts.

Published fal eded form as:PMCID: PMC5772907NIHMSID: NIHMS932647AbstractShiftg cultural attus and legislatn have creased foc on the healthre needs of lbian, gay, bisexual, transgenr, and queer (LGBTQ) patients. Siar negative health out are seen lbian, gay, bisexual, transgenr and queer (LGBTQ1) populatns, wh LGB dividuals beg at even higher risk for certa STIs like HIV/AIDS (Wolsky, Stall, & Valdiserri, 2008) and behavral risk factors such as smokg, alhol, and substance e (Ward et al., 2014) than their heterosexual unterparts.

This omissn is problematic given that rat of nondisclosure are higher among younger LGBTQ dividuals and those who intify as bisexual, queer, or transgenr (Grant et al., 2011; Meckler et al., 2006) – groups who are at elevated risk for adverse health out relative to gay and lbian adults. Addnally, while the lerature on disclosure ntas multiple qualative studi foced on lbian and bisexual women and gay men, there exist notable gaps unrstandg how other dividuals wh the LGBTQ populatn experience the disclosure procs.