title: Physicians Use of Inclusive Sexual Orientation Language During Teenage Annual Visits.
abstract: OBJECTIVE
  Physicians are encouraged to use inclusive language regarding sexuality in order to help all adolescent patients feel accepted. Non-inclusive language by physicians may influence relationships with adolescent patients, especially those with still-developing sexual identities. The aim of this study was to identify patterns of physicians' use of inclusive and non-inclusive language when discussing sexuality.
  
  
  METHODS
  A total of 393 conversations between 393 adolescents and 49 physicians from 11 clinics located throughout the Raleigh-Durham, North Carolina, area were audio recorded. Conversations were coded for the use of inclusive talk (language use that avoids the use of specific gender, sex, or sexual orientation language), direct non-inclusive talk (language use that assumes the teenager is heterosexual or exclusively engages in heterosexual sexual activity), and indirect non-inclusive talk (language use that frames talk heterosexually but does not pre-identify the adolescent as heterosexual).
  
  
  RESULTS
  Nearly two-thirds (63%, 245) of the visits contained some sexuality talk. Inclusive talk rarely occurred (3.3%) while non-inclusive language was predominant (48.1% direct and 48.6% indirect). There were no significant differences in language use by gender, age, adolescent race, or visit length. These non-significant findings suggest that all adolescents regardless of race, gender, or age are receiving non-inclusive sexuality talk from their providers.
  
  
  CONCLUSIONS
  Physicians are missing opportunities to create safe environments for teenagers to discuss sexuality. The examples of inclusive talk from this study may provide potentially useful ways to teach providers how to begin sexuality discussions, focusing on sexual attraction or asking about friends' sexual behavior, and maintain these discussions.
authors.affiliation: 1 Department of Consumer Science, Purdue University , West Lafayette, Indiana.
authors.forename: Stewart C
authors.initials: SC
authors.lastname: Alexander
authors.affiliation: 2 Department of Pediatrics, Indiana University School of Medicine , Indianapolis, Indiana.
authors.forename: J Dennis
authors.initials: JD
authors.lastname: Fortenberry
authors.affiliation: 3 Cancer Prevention, Detection and Control Research Program, Duke University Medical Center , Durham, North Carolina.|4 Department of Community and Family Medicine, Duke University Medical Center , Durham, North Carolina.
authors.forename: Kathryn I
authors.initials: KI
authors.lastname: Pollak
authors.affiliation: 5 Division of Pediatrics and Communicable Diseases, University of Michigan , Ann Arbor, Michigan.
authors.forename: Terrill
authors.initials: T
authors.lastname: Bravender
authors.affiliation: 4 Department of Community and Family Medicine, Duke University Medical Center , Durham, North Carolina.
authors.forename: Truls
authors.initials: T
authors.lastname: Østbye
authors.affiliation: 6 Department of Human Development and Family Studies, Purdue University , West Lafayette, Indiana.
authors.forename: Cleveland G
authors.initials: CG
authors.lastname: Shields
keywords: adolescents; annual visits; preventive health visits; sexuality