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'Are You LGBT?' Simple Question Has Profound Health Care Impact

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The doctor/patient relationship is one of the most personal; it can be even more complicated for the Lesbian, Gay, Bisexual and Transgender community. There’s a fear that if doctors discover their orientation, they would be treated differently.

That was the finding of a 2011 study done by the LGBT advocacy group One Colorado. 55 percent of respondents were fearful of being treated differently should their sexuality be disclosed.

Dr. Mark Thrun, director of HIV/STD prevention and control at Denver Health and a One Colorado board member, says that sets up a ‘don’t ask don’t tell’ situation in the medical field.

“We in the LGBT community are afraid to share who we are with our medical provider for fear of a homophobic response,” Thrun said. “Physicians and clinicians are afraid to bring up sexual orientation or gender identity because they’re afraid they’re going to offend somebody.”

When that happens, the conversation simply never occurs.

Following the previous study, One Colorado has released a new study that hopes to help Colorado physicians be more open to asking a simple question.

Credit One Colorado

‘Are you LGBT?’

“Physicians really have the upper hand and the power dynamic in the physicians/patient relationship in the office,” Thrun said. “[They need to] ask. Who you are having sex with? Who is your partner? Who are you in a relationship with? Very simple questions, enormously important in building that relationship with their patient, but they’re just afraid to ask.”

While the study finds three quarters of Colorado physicians believe awareness of a patient’s sexual orientation is important for a positive doctor-patient relationship, nearly 1-in-5 reports that they never ask the question.

“I think there’s a reason to do it at all levels. I think, one, you don’t get perfect the first time you try something, so it takes repetition,” said Rita Lee, Associate Professor at the Colorado School of Medicine. “I think, especially medical students are more at a time point where they’re a little bit more open to new ideas and they’re just learning how to practice.”

The Colorado Medical Society has created an interactive continuing medical education program to help medical schools and practicing doctors learn how to ask gender neutral and sexual identity questions.

“Providers like to have a certain amount of expertise and we don’t want to ask questions that we’re not comfortable asking, or if we don’t know what to do with that information afterward,” Lee said. “And our goal in developing this CME is that we provide all of that basic information, so that they can ask the questions, the know what do with that information and they can provide safe, comprehensive, clinical care for their patients.”

Dr. Mark Thun says simply making the waiting room or entry forms more LGBT friendly also goes a long way in improving the doctor/patient relationship.

“Just having an option to say that I’m in a domestic partnership, or that I have a significant other as opposed to just married, single, divorced. None of which necessarily applies to me,” Thun said.

One Colorado says with the implementation of the Affordable Care Act, many LGBT Coloradans who have previously not had access to health care will now have the ability to go to a doctor and get medical care. The study, they say, is a way to get doctors thinking about how to fully assist the increase in LGBT patients and provide positive, helpful medical care.

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