Lesbian Patients

Abstract

Attitudes of health care professionals affect the quality of care we provide to both heterosexual and lesbian populations. Many lesbians feel health care providers are “homophobic” and have negative attitudes toward lesbians. Homophobia is defined as antipathy or disdain for gay men and lesbians. Theories regarding how and why homosexuality occurs abound and reflect genetic, embryologic, hormonal, and personal experiences with and without associated sociopathology as possible contributing factors. The psychiatric literature conveys that gay and lesbian individuals are an integral part of normal expression of the natural diversity of human sexuality. Homosexuality was included in the 1981 edition of the Diagnostic and Statistical Manual, but the Manual has since been revised to exclude homosexuality as a psychiatric disorder. While there are no solid data it is quoted that 10% of the female population is homosexual, yet many health care providers assume everyone is heterosexual. Most often “negative” experiences are with male practitioners. Fear of a provider’s response to the gay patient “disclosing” or “coming out” remains paramount in the mind of lesbians. One report from Oregon noted it was easier for lesbians to be open with “alternative practitioners” than with allopathic health care providers. Several studies indicate that lesbians delay or totally avoid seeking medical care because of the insensitivity of health care providers and poor prior experiences with the system.