Healthcare providers react more positively to men than women who reveal they're gay

Men and people over 40 are much more likely to report positive experiences when they tell healthcare providers they are not heterosexual, according research in the latest UK-based Journal of Advanced Nursing.

Women patients reported that healthcare providers were more likely to assume they were heterosexual, adding that more than one in ten were uncomfortable when they disclosed they were lesbian or bisexual.

They were also twice as likely as men to report that their care was negatively affected by their disclosure.

Researchers from Massey University in Auckland, New Zealand, surveyed 2,269 lesbian, gay and bisexual people to discover how they felt about revealing their sexuality and the reaction of primary healthcare providers, such as family doctors and practice nurses, when they did.

"It's important that healthcare providers are aware of people's sexuality as non disclosure has been shown to have a negative impact on their health" says nurse researcher and lecturer Dr Stephen Neville.

"For example, people who are lesbian, gay and bisexual are more likely to face an increased risk of suicide, depression and other mental health problems."

Key findings included:

• Both sexes said that their healthcare professional's attitude to sexual identity was important to them when they chose a provider. This was particularly important for women and people under 40.
• 83 per cent of women and 66 per cent of men said that their healthcare provider assumed they were heterosexual. They were more likely to make that assumption if the patient was under 40 (76 per cent) than over 40 (71 per cent).
• Women were more likely to disclose their sexuality in a primary healthcare setting than men (72 per cent compared with 65 per cent) and there was a similar gap between people over 40 (76 per cent) and under 40 (61 per cent).
• 78 per cent of women and 86 per cent of men said their healthcare provider was "completely comfortable" with their disclosure, but 11 per cent of women and six per cent of men said they were "somewhat uncomfortable". 11 per cent of women and eight per cent of men said their provider ignored the disclosure.
• Healthcare professionals seemed to respond better to disclosures by older patients, with 85 per cent of people over 40 and 78 per cent of people under 40 saying that their healthcare provider was "completely comfortable" with their disclosure.
• 43 per cent of men said that they felt their healthcare provider's attitude to their disclosure influenced the care they received in a positive way, compared with 28 per cent of women. Five per cent of women - twice as many as men - felt it had a negative effect.
• Older people were also more positive. 38 per cent of those over 40 and 33 per cent of those under 40 reported a positive effect. Five per cent of people under 40 – twice as many as in the over 40 age bracket – reported a negative effect.
• 33 per cent of women and 61 per cent of men under 40 reported having more than one partner in the 12 months before the survey, compared with 10 per cent of women and 60 per cent of men over 40
• 24 per cent of men over 40 reported having more than 10 partners during that period, but none of the women said that they did.

The study forms part of the "Lavender Island" project - the first major study to be undertaken in New Zealand about access to health care by lesbian, gay and bisexual people and the attitudes of the people who care for them.

Participants were surveyed in 2004 having been recruited through mainstream and lesbian, gay and bisexual media and venues. 84 per cent responded via a website and 16 per cent completed a freepost copy of the questionnaire, which was developed with input from a community advisory group of lesbian, gay and bisexual people.

55 per cent of the respondents were male and the sample was highly educated, with just over half having a degree, compared to 15 per cent of the general New Zealand population.

45 per cent were in a relationship with a same-sex partner they lived with and 14 per cent with a same-sex partner who lived elsewhere.

Four per cent said their main relationship was with a member of the opposite sex.

23 per cent of the 1,846 people who responded to the question about children said they had some kind of parenting relationship. This equated to 18 per cent of the total sample.

"It is clear from our study that providing lesbian, gay and bisexual people with the chance to disclose their sexual identity is an integral part of providing high quality, appropriate healthcare" says Dr Neville.

"Previous studies have shown that people are more likely to seek healthcare and adhere to treatment regimes if they know that healthcare providers will be comfortable with their sexuality and not automatically assume they are heterosexual.

"A number of health problems do tend to be more prevalent in lesbian, gay and bisexual people, such as depression. And in the era of HIV and hepatitis B and C, appropriate sex and lifestyle healthcare education must be a core part of any health assessment.

"Being aware of a patient's sexual orientation enables healthcare providers to tailor care to their individual needs and tackle any risk areas, in the same way that they would do by taking any other personal characteristics, such as a person's age, race or family health history, into account."