The dilemma of disclosure: patient perspectives on gay and lesbian providers

J Gen Intern Med. 2008 Feb;23(2):142-7. doi: 10.1007/s11606-007-0461-4. Epub 2007 Nov 28.


Background: Discrimination toward gay and lesbian patients by health care providers has been documented. No study has determined if patient behavior would change when seeing a gay/lesbian provider.

Objective: The objective of the study was to examine whether a provider's sexual orientation would affect the choice of provider, practice, or preference for a chaperone during genital exams.

Design: The design of the study was an anonymous, cross-sectional survey.

Participants: The participants were a random national sample of persons 18 years or older residing in the USA able to read English.

Measurements: The measurements were self-reported perceptions and chaperone preference based on provider gender and sexual orientation.

Results: The response rate was 32% (n = 502). Many respondents indicated they would change providers upon finding out their provider was gay/lesbian (30.4%) or change practices if gay/lesbian providers were employed there (35.4%). Female respondents preferred chaperones most with heterosexual male providers (adjusted odds ratio [OR] 1.50, 95% confidence interval [CI] = 1.15 to 1.95) followed by homosexual male (OR 1.17, 95% CI = 0.93 to 1.47), lesbian (reference), and heterosexual female providers (OR 0.63, 95% CI = 0.51 to 0.77). Male respondents showed an increased preference for chaperones with gay/lesbian providers of either gender (OR 1.52, 95%, CI = 1.22 to 1.90, for gay male provider, [reference] for lesbian provider) than with either heterosexual male (OR 0.36, 95% CI = 0.26 to 0.52) or heterosexual female providers (OR 0.39, 95% CI = 0.29 to 0.54).

Conclusions: Patients may change providers, practices, or desire for chaperone based on a provider's gender and sexual orientation. Although the low response rate may limit generalizability, these findings have the potential to impact aspects of practice structure including chaperone use and provider-patient relationships.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Disclosure*
  • Female
  • Health Personnel
  • Homosexuality, Female
  • Homosexuality, Male
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Prejudice*
  • Professional-Patient Relations*
  • Public Opinion
  • United States