Patterns of communication between gay and lesbian patients and their health care providers.
OBJECTIVE
To determine whether gay men and lesbians disclose their sexual orientation, and other sensitive behaviors to their primary care physicians; whether they have a chance of finding a gay friendly physician; and what factors are involved.


METHODS
A self-report questionnaire was administered to 66 gay men and 28 lesbians at a gay and lesbian community center.


RESULTS
Less than half of participants felt their health insurance plan gave them a choice of finding a lesbian, gay, or bisexual (LGB) doctor. Those who did were more likely to be older, male, and to feel more comfortable discussing sex. Men were more likely to disclose their sexual orientation to their health care provider (HCP), to feel very comfortable discussing sex, to have a male doctor, to have a choice of finding a LGB provider through their insurance plan, and to think their provider is LGB. Those who disclosed their sexual orientation to their providers were more likely to be white males with male doctors, who felt their doctor was very gay friendly, and to have also discussed substance use, sexual behavior, and HIV with their HCP, and to feel comfortable discussing sex.


CONCLUSIONS
Lesbians in particular have difficulty disclosing their sexual orientation to providers, possibly due to continuing stigma, and to have less of a choice of finding a gay or lesbian provider. The data suggest that health insurance plans should provide patients with the opportunity to find gay friendly physicians, as it may facilitate communication about substance use, high risk sexual behavior and other health topics.
Klitzman
Robert L
RL
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University Department of Psychiatry, New York 10032, USA. RLK2@columbia.edu
Greenberg
Jason D
JD
D000328:Adult; D003142:Communication; D030881:Disclosure; D005260:Female; D018452:Homosexuality, Female; D018451:Homosexuality, Male; D006801:Humans; D007348:Insurance, Health; D008297:Male; D010817:Physician-Patient Relations; D012737:Sex Factors