[More sensitive approach to question of sexual orientation].

Ned Tijdschr Geneeskd

Radboudumc, afd. Eerstelijnsgeneeskunde, Nijmegen.

Published: May 2018

Doctors encounter lesbian, gay and bisexual (LGB) patients. Most LGBs are physically and mentally healthy, but LGBs also have unique healthcare needs, that is mental health issues, sexually-transmitted diseases including HIV infection, substance use, and avoidance of healthcare. Sexual minority stress due to stigmatisation, rejection, internalised homophobia, bullying and violence is a causal issue. Optimising care for LGBs involves knowing patients' sexual orientation by asking them. As sexual orientation comprises the domains of sexual identity, sexual attraction and sexual behaviour, all should be addressed appropriately as these domains together or separately determine the impact on health. Sexual identity correlates closely, but not completely, with sexual behaviour. Individuals may engage in same-sex sexual behaviour, but not identify themselves as lesbian, gay or bisexual. Patients are willing to answer questions about their sexual orientation. Doctors should take the initiative to discuss sexual orientation and avoid making heteronormative assumptions. The uptake of LGB-related issues in guidelines and educational programmes may improve doctors' awareness.

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