Roughly half of sexual medicine clinicians routinely ask their patients about sexual orientation, according to a recent survey by Johns Hopkins Medicine researchers.
The 92 respondents were members of the Sexual Medicine Society of North America (SMSNA), one of the ISSM’s affiliated societies.
The 18-question survey, conducted between August and November 2016, asked healthcare providers about their assessment of patients’ sexual orientation and their approach to care for men who have sex with men (MSM).
Most of the respondents (93%) said they treat MSM. Of those, about 52% said they usually asked about sexual orientation.
Of those who didn’t ask, 37% said sexual orientation was “irrelevant to my management.” Another 26% answered, “If the patient wants me to know, he will self-disclose.”
Clinicians who did ask about sexual orientation were more likely to work in urban settings, inquire about more sexual behaviors, tailor care to the needs of their LGBT patients, believe that homosexual and bisexual patients have unique sexual concerns, and provide visual cues in waiting rooms pertinent to LGBT health.
“There’s apparently a great lack of awareness even among those with a special interest in sexual medicine of the many health considerations a provider must take into consideration when patients are members of the LGBT community,” said lead author Amin Herati, MD in a press release.
“For example, men who mostly have sex with men are at much higher risk of some sexually transmitted infections [STIs], and if providers don’t ask, patients may not provide important medical information pertinent to their lifestyle,” Dr. Herati added.
Past research has shown that MSM have worse health outcomes than the general population, the study authors noted. In addition to STIs mentioned above, MSM are more likely to have substance, mood, and anxiety disorders and take greater health risks, like smoking. Disclosing orientation has been associated with better mental health.
When providers know their patients’ sexual orientation, they can better address their needs, but patients may be reluctant to disclose, the authors explained.
The survey was originally sent to 696 participants, but only 92 responded. This small number was considered a limitation to the research. Social desirability bias might have also been present, as respondents might have been uncomfortable revealing any prejudices.
“Facilitation of orientation disclosure is considered a facet of culturally competent care,” the authors wrote. They recommended interventions designed to “increase clinician inquiry.”
Resources
Eurekalert
“Survey of Sexual Medicine Society members reveals only half ask for patients’ sexual orientation”
(July 31, 2018)
https://www.eurekalert.org/pub_releases/2018-07/jhm-sos073018.php
The Journal of Sexual Medicine
Kashaf, Michael Saheb, MSc, et al.
“Sexual Health Care Practitioners’ Evaluation of Men Who Have Sex With Men”
(Full-text. First published online: June 5, 2018)
https://www.jsm.jsexmed.org/article/S1743-6095(18)30992-5/fulltext