title: How to reach sexual minority youth in the health care setting: the teens offer guidance.
abstract: OBJECTIVE
  To explore factors sexual minority youth believe make them feel safe in a health care setting.
  
  
  METHODS
  Participants in three urban programs serving lesbian/gay/bisexual/transgendered and questioning (LGBTQ) youth engaged in a four-stage process to generate, prioritize, and explain their own ideas. In Stage III, 94 youth, aged 14 to 23 years, completed a survey comprised of the 34 highest rated items generated in earlier stages. Using a Likert scale, they answered, "How important are each of the following ideas in making you feel safe as an LGBTQ youth when you go for health care?" In Stage IV, youth discussed the results in focus groups. The Marginal Homogeneity Test divided the items into priority ranks and the Kruskal-Wallis test explored subgroup differences in item ratings.
  
  
  RESULTS
  The 34 items were divided into six ranks. Five items shared the top rank: the clinician maintaining privacy, demonstrating cleanliness, offering respect, being well-educated, and being honest. The second rank was shared by the following: the clinician not talking down to patients, being a good listener, not downplaying patients' fears, being professional, holding a nonjudgmental stance of the LGBTQ lifestyle, and not assuming every LGBTQ youth has HIV. Interspersed among other ranks were items specific to the needs of sexual minority youth: the clinician not assuming LGBTQ sexual behavior was painful or dangerous; the clinician being educated about the gay lifestyle; clinician sensitivity to the needs of same-sex partners; staff sensitivity to the needs of closeted youth; having a choice of an LGBTQ provider; and the clinician not assuming heterosexuality. Youth who had not publicly disclosed their sexuality rated health information being offered in a private place higher (p =.01).
  
  
  CONCLUSIONS
  LGBTQ youth value the same clinician characteristics desired by all adolescents: privacy, cleanliness, honesty, respect, competency, and a nonjudgmental stance. They clearly describe what attracts them (e.g., clinicians educated about their lifestyle) and what offends them (e.g., equating their sexuality with HIV). Clinicians need to achieve and convey a higher comfort level in addressing the special needs of sexual minority youth.
authors.affiliation: Craig-Dalsimer Division of Adolescent Medicine, The Children's Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Philadelphia, PA 19104, USA. ginsburg@email.chop.edu
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Ginsburg
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Winn
authors.forename: Bret J
authors.initials: BJ
authors.lastname: Rudy
authors.forename: James
authors.initials: J
authors.lastname: Crawford
authors.forename: Huaqing
authors.initials: H
authors.lastname: Zhao
authors.forename: Donald F
authors.initials: DF
authors.lastname: Schwarz
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D003142:Communication; D003219:Confidentiality; D005260:Female; D017144:Focus Groups; D006282:Health Personnel; D018452:Homosexuality, Female / Q000523:psychology*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D008019:Life Style; D008297:Male; D012309:Risk-Taking; D011795:Surveys and Questionnaires; D014505:Urban Population