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Gays Keep Closet Door Shut at Doctor's Office

Poll says only half disclose their orientation

THURSDAY, Dec. 26, 2002 (HealthDayNews) -- Assumptions can spell trouble in the doctor's office, and a new poll suggests gays and lesbians may be especially vulnerable: Nearly half of those surveyed said they haven't revealed their sexual orientation to their physicians.

When there's an unwritten policy of "don't ask, don't tell," these patients might miss out on medical information and tests geared to their special health risks, experts say.

"How many times have we heard about lesbians who go to the gynecologist, are asked if they're sexually active, and leave with a prescription for birth control pills? Sorry to say, that's still occurring," says Dr. Michael Horberg, who specializes in treatment of AIDS in Santa Clara, Calif.

Pollsters with Harris Interactive contacted 2,221 people by e-mail and surveyed them online in late November and early December. Of those, a small sample -- 157, or 7 percent -- described themselves as gay, lesbian, bisexual or transgender.

The Washington, D.C. public relations firm Witeck-Combs Communications, which sponsored the survey, released the results last week. Gay men surveyed were most likely to be "out" to their doctors -- 67 percent said they had disclosed their sexual orientation. Fifty-five percent of lesbians said they'd revealed their orientation, and only 23 percent of bisexuals had done so.

Overall, 49 percent of gays, lesbians, bisexuals, and transgendered people said they weren't open with their doctors about their orientation. Transgendered people change their "gender appearance" through a variety of ways such as clothing or surgery.

Maureen O'Leary, executive director of the Gay & Lesbian Medical Association, says doctors bear much of the responsibility for communicating with patients about their sexual orientation.

It's no secret that gay men face risks from sexually transmitted diseases (STDs) such as HIV, syphilis and hepatitis; as with heterosexuals, the most sexually adventurous may be at the highest risk. However, it's less commonly known that lesbians also face STD risks of their own. They also have lifestyle risks: research has suggested that lesbians drink and smoke more than straight women and are more likely to be overweight.

Lesbians may also face higher rates of some kinds of cancer. Many do not have children, and they may lose the protective effects that bearing children affords against breast cancer.

Asking questions about sexual orientation in the doctor's office is no different than screening patients for diseases based on the risks that face their ethnic group, Horberg says. "It is primarily the physicians' responsibility to assume nothing and be open to all possibilities."

Gays and lesbians must be on the lookout for "cluelessness" among doctors, especially in regions of the country outside of metropolitan cities, he says. While big cities typically have gay neighborhoods and gay doctors, other areas lack such resources.

O'Leary, whose organization represents 2,000 medical professionals, says doctors must be educated early about the needs of their patients: "We need to get into the colleges and teach the physicians how to ask the right questions. Hopefully, that will make it easier for gays and lesbians to be comfortable to be coming out. There is still a lot of fear."

What To Do

To learn more about health risks facing gays and lesbians, check out the Gay & Lesbian Medical Association. You could also try gayhealth.com.

SOURCES: Maureen O'Leary, executive director, Gay & Lesbian Medical Association, San Francisco; Michael Horberg, M.D., medical director, HIV services, and chairman, Northern California Pharmacy and Therapeutics Committee, Kaiser Permanente Health Plan, Santa Clara, Calif.; Harris Interactive poll results
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