How can GPs meet the needs of lesbian, gay and bisexual patients?
Assumptions are the biggest issue facing LGB patients in the surgery, says Dennis Baldwin of the Lesbian & Gay Foundation
Lesbian, gay and bisexual people face considerable health inequalities and are disproportionately likely to suffer from poor sexual, mental and physical health, as well as increased levels of substance misuse. Yet the lack of sexual orientation monitoring by health services means there remains a distinct lack of information relating to the health and social care needs of LGB patients.
This lack of monitoring, means it's impossible to determine the extent of inequality of outcomes, and so there is little attention given to the specific needs of the LGB community.
GPs usually assume their patients are straight, leading to the wrong information being given and patients being forced to "come out" to their doctors.
A lesbian patient in Stockport shares her experience: "The GP at my surgery consistently and frequently assumes I am straight, ending up in embarrassed conversations when they realise their mistake. I feel I am treated abnormally and discriminated against regularly."
Dr Tim Crocker-Buque from the British Medical Association explains: "All patients are worried about their health, and LGB patients have the added worry about disclosing their sexual orientation on top of that."
Recent research by the LGF found almost two-thirds of people felt their GP could improve the services offered to LGB patients.
It's not just our research that highlights the problem; in the independent GP Patient Survey 2011 almost 10,000 LGB people responded, reporting that they were approximately twice as likely to rate their GP as poor or very poor, when compared to heterosexual people, across a range of measures.
One in 10 lesbian, gay, bisexual and trans individuals have avoided using public services for fear of homophobia, and one in five health care professionals have admitted to being homophobic.
This can easily be remedied; using inclusive language, referring to "partner" rather than making assumptions about gender, and ensuring LGB patients feel welcome by seeing LGB specific materials.
The Lesbian & Gay Foundation, a charity based in Manchester, hopes to address these inequalities. In February 2011 we launched Pride in Practice, a benchmarking tool that identifies GP surgeries that are fully committed to assuring LGB patients are treated fairly and able to discuss issues openly with healthcare providers.
Surgeries will be sent a toolkit which aims to help them understand the issues faced by LGB patients and respond to their specific needs. The toolkit contains resources, fact sheets and outlines an action plan so surgeries can make positive changes.
After undertaking a self-assessment, surgeries will be awarded a gold, silver or bronze Pride in Practice charter mark, depending on the level of service they provide to LGB patients.
Pride in Practice is designed with GPs for GPs. It brings together, in one easy to use toolkit, everything a family doctor will need to effectively engage with and support their LGB patients.
The project has backing from the Royal College of General Practitioners. "The Pride in Practice toolkit is music to my ears," says Dr Clare Gerada, the college's chair. "It's so important that we raise awareness of lesbian, gay and bisexual issues and debunk myths."
The Lesbian & Gay Foundation's full report, Taking Pride in Practice: lesbian gay and bisexual patient experiences of their GP, will be released later this month.
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