Should all patients be asked about their sexual orientation?

January 17, 2018

In late 2017, NHS England released guidelines recommending that health professionals ask all patients about their sexual orientation in order to improve services for non-heterosexual patients, but should they? Experts debate the issue in The BMJ today.

After decades of campaigning from lesbian, gay, bisexual and trans (LGBT) charities, sexual orientation is now a protected characteristic that is written into the Equality Act 2010. General practitioner and research fellow Richard Ma, from Imperial College London says all patients should be asked about their sexual orientation.

Ma comments that it would seem like a welcome step for NHS England to include sexual orientation monitoring in health and social care systems.

"Some doctors and patients have expressed concerns about this policy, citing reasons such as intrusion or invasion of privacy, fear of causing offence, doubts about relevance, data security" he says. "Whilst I understand these concerns, they result in inertia; and failure to act undermines hard fought rights of LGBT patients to better healthcare."

Ma states there are flaws in recognising LGBT health needs. A survey of nearly 7000 gay and bisexual men, commissioned by LGBT charity, Stonewall, shows that 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. If we don't count our LGBT patients, they don't count." Ma concludes.

But Michael Dixon, a general practitioner, says that it should be up to the individual judgement of GPs as to when it's appropriate or useful to ask such questions about patient sexual orientation.

He says that whilst there are health benefits from knowing a patient's sexuality, the approach of asking 'all' patients is wrong.

"Apparently this is all to stop discrimination under the Equality Act, but surely the best way to avoid discrimination is by not knowing people's sexuality in the first place" he says.

"In good medical practice, the patient's own needs, wishes, choices, beliefs, culture, and perspective should come first - not the rules or diktats of any higher body" he concludes.

In a linked patient commentary, Tamás Bereczky, from the European AIDS Treatment Group, says whilst discussing sexual orientation between doctors and patients can be embarrassing, healthcare professionals should be able to talk about all sensitive topics.

"Visibility and honest discussion can also eventually reduce stigma" he concludes.
-end-


BMJ

Related Health Articles from Brightsurf:

The mental health impact of pandemics for front line health care staff
New research shows the impact that pandemics have on the mental health of front-line health care staff.

Modifiable health risks linked to more than $730 billion in US health care costs
Modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to over $730 billion in health care spending in the US in 2016, according to a study published in The Lancet Public Health.

New measure of social determinants of health may improve cardiovascular health assessment
The authors of this study developed a single risk score derived from multiple social determinants of health that predicts county-level cardiovascular disease mortality.

BU study: High deductible health plans are widening racial health gaps
The growing Black Lives Matter movement has brought more attention to the myriad structures that reinforce racial inequities, in everything from policing to hiring to maternal mortality.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

E-health resource improves men's health behaviours with or without fitness facilities
Men who regularly used a free web resource made significantly more health changes than men who did not, finds a new study from the University of British Columbia and Intensions Consulting.

Mental health outcomes among health care workers during COVID-19 pandemic in Italy
Symptoms of posttraumatic stress disorder, depression, anxiety and insomnia among health care workers in Italy during the COVID-19 pandemic are reported in this observational study.

Mental health of health care workers in china in hospitals with patients with COVID-19
This survey study of almost 1,300 health care workers in China at 34 hospitals equipped with fever clinics or wards for patients with COVID-19 reports on their mental health outcomes, including symptoms of depression, anxiety, insomnia and distress.

Health records pin broad set of health risks on genetic premutation
Researchers from the University of Wisconsin-Madison and Marshfield Clinic have found that there may be a much broader health risk to carriers of the FMR1 premutation, with potentially dozens of clinical conditions that can be ascribed directly to carrying it.

Attitudes about health affect how older adults engage with negative health news
To get older adults to pay attention to important health information, preface it with the good news about their health.

Read More: Health News and Health Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.