Providing Care While Ensuring a Patient’s Comfort

Doctors as well as advocates for gays and lesbians say there are nonjudgmental ways a health care provider can obtain medical information about a new patient that would put her at ease about sharing her sexual orientation and sexual history.

While taking a health history, make no assumptions. Instead of assuming a woman is having sex with a man and is therefore using contraception, the doctor or nurse might ask:

* Do you have a need for contraception?

* Do you use birth control and, if yes, what type?

* Have you had sex (in the past) with men, women or both?

* Are you in an intimate relationship with a man or a woman?

* If you become ill, is there anyone I should involve in your care?

Patient forms can be drafted to take into consideration that people are different. Forms could include the term “partner” or “domestic partner” and offer the option of “living with a partner” or “living as a couple.”

Doctors’ office staff members can be instructed to avoid referring to every patient as “Mrs.”

To protect patient confidentiality, doctors can use coded entries about sexual orientation on patient charts to prevent inadvertently “outing” a patient to a health insurer or anyone else who might have access to the medical record. The office should always offer the patient the right to refuse to answer a question.

To find doctors who are sensitive to lesbians’ needs, patients may want to contact their health plans or hospitals to determine if they have physician referral services that include such information. Patients nationwide and in Canada can call the Gay and Lesbian Medical Assn. in San Francisco at (415) 255-4547 for member physician referrals in their area.