title: Screening for sexual orientation in psychiatric emergency departments.
abstract: BACKGROUND
  Our goal was to explore whether emergency department (ED) patients would disclose their sexual orientation in a research evaluation and to examine demographic and clinical characteristics of patients by self-identified sexual orientation.
  
  
  METHODS
  Participants (n=177) presented for psychiatric treatment at three urban EDs in New York City, Rochester, NY, and Philadelphia, PA. Participants were interviewed in the context of a larger study of a standardized suicide risk assessment. We assessed participants' willingness to answer questions regarding sexual orientation along three dimensions: a self-description of sexual orientation, a self-description of sexual attraction, and the gender of any prior sexual partners.
  
  
  RESULTS
  No participants (0/177) refused to respond to the categorical question about sexual orientation, 168/177 (94.9%) agreed to provide information about prior sexual partners, and 100/109 (91.7%) provided information about current sexual attraction toward either gender. Of all 177 participants, 154 (87.0%) self-identified as heterosexual, 11 (6.2%) as bisexual, 10 (5.6%) as gay or lesbian, and 2 (1.1%) indicated they were not sure. As compared with heterosexual patients, lesbian, gay and bisexual (LGB) patients were significantly younger and more likely to be non-white, but did not differ significantly in terms of education, income, employment, or religious affiliation or participation. Further, LGB participants did not differ from self-identified heterosexual participants for lifetime suicide attempt rate or lifetime history of any mood, substance-related, psychotic spectrum, or other Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) Axis I disorder. Of self-identified heterosexual participants 5.6% (5/89) reported sexual attraction as other than 'only opposite sex,' and 10.3% (15/142) of sexually active 'heterosexual' participants reported previous same-gender sexual partners.
  
  
  CONCLUSIONS
  Assessing patients' sexual orientation in the ED by a three-question approach appeared feasible in the ED and acceptable to ED patients. However, since many patients have sexual experiences not suggested by simple labels, self-report of sexual identity alone may not inform clinicians of health risks inherent in same or opposite gender sexual contact.
authors: University of Rochester Medical Center, Department of Psychiatry, Rochester, New York ; University of Rochester Medical Center, Department of Emergency Medicine, Rochester, New York.
authors: Glenn W
authors: GW
authors: Currier
authors: University of Pennsylvania School of Medicine, Department of Psychiatry, Philadelphia, Pennsylvania.
authors: Gregory
authors: G
authors: Brown
authors: University of Rochester Medical Center, Department of Psychiatry, Rochester, New York.
authors: Patrick G
authors: PG
authors: Walsh
authors: University of Pennsylvania School of Medicine, Department of Psychiatry, Philadelphia, Pennsylvania.
authors: Shari
authors: S
authors: Jager-Hyman
authors: Columbia University School of Medicine, Department of Psychiatry, New York, New York.
authors: Sadia
authors: S
authors: Chaudhury
authors: Columbia University School of Medicine, Department of Psychiatry, New York, New York.
authors: Barbara
authors: B
authors: Stanley
mesh_terms: D000328:Adult; D001727:Bisexuality / Q000523:psychology; D004636:Emergency Service, Hospital; D004637:Emergency Services, Psychiatric; D005240:Feasibility Studies; D005260:Female; D020010:Heterosexuality / Q000523:psychology; D018452:Homosexuality, Female / Q000523:psychology; D018451:Homosexuality, Male / Q000523:psychology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D009519:New York City; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D015143:Philadelphia; D057566:Self Report; D019529:Sexuality / Q000523:psychology*