Do doctors need to know their patients’ sexual orientation and gender identity?

This article was exclusively written for The European Sting by Mr Luis Torres, a Doctor of Medicine graduated from the Universidad de Oriente Núcleo Bolívar And Honorary member of the Universidad de Oriente Núcleo Bolívar Scientific Association of Medical Students (SOCIEM UDO BOLIVAR). He is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

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Health professionals often assume that their patients are heterosexual, which can cause concern in the doctor-patient relationship. The assumption of heterosexuality, or heterosexism, not only makes patients feel uncomfortable, but can also lead a doctor to neglect certain aspects of medical care and to provide inappropriate counseling. Research continues to suggest that there are significant health disparities between LGBTI people and the general population due to social stigma and discrimination to which they may be exposed. With this in mind, should doctors ask about patients’ sexual orientation? A new study of both patients and providers in the journal JAMA Internal Medicine looked at the feasibility of gathering such information in emergency departments. Nearly 80 percent of providers surveyed believed that patients would refuse to disclose their sexual orientation. Doctors are concerned that asking a person’s sexual identity is too personal and not perceived as clinically relevant. During the profesional medical training, a specific approach of the patients belonging to the LGTB collective is not studied. We have no news that it appears as a teaching objective of any subject- In addition to the persistent social stigma, there are structural barriers that prevent access to health care for the LGBT community, such as that couples do not qualify for employer healthcare coverage. Although in the first instance it might seem that your work consists solely of addressing the health problems of your patients, in reality your role goes much further, because if you really want to offer a quality service and establish long-term relationships you should know to fund other aspects that can help you understand issues that a medical review sometimes does not offer. In the first instance, you must seek to generate trust with your patients, for which the empathy and humanization of your service is very important, so that they do not see you only as the person who will help them to be cured but as a companion who cares about aspects that go beyond physical health. Sometimes what bothers the patient is the sex of the interviewer. In this case, it is also convenient to approach the situation in an empathic and assertive manner, respecting that you prefer to talk with another professional. It is important for medical professionals to understand these types of scenarios and avoid being offended or angry because the patient refuses to discuss these issues with them,  which is especially important when people of different race, culture and / or religion coincide. It is necessary to understand that sexuality is part of the individual as a bio-psycho social being and it is essential that from the undergraduate level in the university, medical students are given tools in their study curriculum so that they know how to approach the LGBT community without any kind of cohersion. Ultimately, providing quality care. About the author Luis Torres is a Doctor of Medicine graduated from the Universidad de Oriente Núcleo Bolívar And Honorary member of the Universidad de Oriente Núcleo Bolívar Scientific Association of Medical Students (SOCIEM UDO BOLIVAR). He is Outgoing National Officer on Sexual and Reproductive Health Rights including HIV and AIDS (NORA)  of the Venezuelan Federation of Scientific Societies of Medical Students (FEVESOCEM) and member of the supervising council of the Venezuelan Federation of Scientific Societies of Medical Students (FEVESOCEM).