LGBT-Sensitive Physicians Still A Rarity

When Allison L. Diamant, M.D., an adjunct professor at the UCLA Geffen School of Medicine, began practicing medicine in the 1990s, there was still a lot of apprehension among lesbians, gays and transgender patients about disclosing their sexual or gender orientations to physicians.

Some 20 years later, with same sex marriage legal in a majority of states and transgender characters in two popular television shows, a lot of attitudes have changed. But according to Diamant, members of the LGBT community still have issues accessing providers sensitive to their needs.

“Societal views have changed, but access to culturally competent care for the community remains a challenge,” Diamant said.

A new study by UCLA researchers led by Diamant and published in the most recent edition of the American Journal of Public Health, surveyed roughly half of the 138 practices attached to academic medical centers in the United States. The findings were grim: Fewer than 5% had procedures in place to identify LGBT-competent physicians, and fewer than 15% kept lists of physicians who would be able to appropriately treat LGBT patients. Less than 16% provided comprehensive training to ensure their medical staff would be LGBT competent.

Overall, only six facilities had practices in place that would ensure every patient could be directed to a culturally competent physician. The predominant number are privately-operated facilities, suggesting the publicly-operated academic medical centers do not have the resources to develop their Some had lists of such physicians, but no formal procedure in place to direct patients to them.

“Some institutions still do not perceive lack of LGBT cultural competency as an issue and may benefit from increased awareness of LGBT health disparities,” the study concluded.

According to Diamant, many sectors of the LGBT community are far less likely to have health insurance than their straight counterparts. 

Lesbians are more likely to have breast and ovarian cancer because fewer have children than straight women, and gay men may be more likely to have anal cancer. That makes their access to culturally competent physicians more crucial, according to Diamant.

“There is a big difference between self-defined sexual orientation and behaviors, and knowing to ask questions about behaviors and gender identity are important,” she said.