Should providers ask all patients about sexual orientation? 4 insights

Two health experts debated whether providers should ask all patients about their sexual orientation after the National Health Service of England released guidelines late last year arguing these questions could improve services for non-heterosexual patients.

The debate was part of an article published in The BMJ.

Here are four insights from the discussion.

1. Dr. Richard Ma, general practitioner and research fellow from Imperial College London, argued providers should ask all patients about their sexual orientation. Although some providers expressed concern over this policy due to fear of intruding patients' privacy or offending them, Dr. Ma said these concerns will result in a lack of progress for lesbian, gay, bisexual and transgender rights. "Failure to act undermines hard fought rights of LGBT patients to better healthcare" after decades of campaigning, Dr. Ma said.

2. Dr. Ma stated there are flaws in acknowledging different LGBT health needs, referencing a survey of approximately 7,000 gay and bisexual men commissioned by Stonewall, an LGBT charity. The survey found smoking, alcohol and drug use were more prevalent in this group compared to men in general. "Sexual orientation monitoring is necessary to make the health service for LGBT patients fairer," Dr. Ma concluded. "If we don't count our LGBT patients, they don't count."

3. Dr. Michael Dixon, a general practitioner and former chairman of NHS Alliance, said GPs should be able to decide whether or not it is appropriate to ask patients questions about sexual orientation. He argued the recommended approach of asking 'all' patients is wrong. "Surely the best way to avoid discrimination is by not knowing people's sexuality in the first place" he said.

4. Instead, Dr. Dixon argued good medical practice should recognize the patient's own needs, wishes, choices, beliefs, culture and perspective before adhering to the rules of any higher body.

More articles on patient engagement: 
Viewpoint: Access to affordable birth control is a maternal health issue
4 reasons patients struggle to shop for healthcare
Viewpoint: Physicians should be permitted to help patients die

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