Getting to Know You: Why It’s Essential for Providers to Ask their Patients about Sexual Orientation, Behavior, and Gender Identity
The relationship between health care providers and their patients can range from very distant to very close, and the amount of information that patients feel comfortable disclosing can range widely as well. Creating a warm environment in which patients feel that they can share their multiple identities with their providers is essential, and in addition, we as health care providers have a responsibility to ask our patients about their lives.
Frequently, I hear from health care providers that it is challenging to ask the important questions about sexuality and gender, despite the “sensitive” questions that we, as providers, already ask. For example, we have become accustomed to asking about violence in the home and use of substances, so there’s no reason that we can’t get used to asking questions about gender and sexuality, as well.
Patients may be afraid of judgment and many are used to a long history of constantly debating whether it is “safe” to come out to a variety of people in their lives. They may not want to initiate the conversation themselves, but may be likely to open up to a provider who asks them kindly, but directly, about their sexuality and gender.
The Institute of Medicine and The Joint Commission have both expressed the importance of asking and collecting data about patient sexuality and gender, and plentiful research supports the importance of knowing the details of patients’ lives. Normalizing the asking of these questions can go a long way towards preventing and decreasing the health disparities faced by LGBTQ+ patients.
It can be challenging to squeeze all of the information that a provider needs in the short time frame of an appointment or interaction with a patient. However, we must also face our own implicit biases discussing sexuality with patients in general, and especially with LGBTQ+ patients.
Consider asking about gender identity and/or expression, sexuality and sexual behavior, and plans for self-treatment. It is essential to not ignore these important aspects that are central to the lives of our patients and clients, but also, of course, important to respect a patient who prefers not to speak about their gender or sexuality, as well. Making your office or area LGBTQ+ friendly can be a good first step towards demonstrating openness to discuss these issues with patients or clients who may be uncomfortable. Sexuality and gender are an important part of any complete medical history.