In an attempt to uncover the potential for sexual orientation biases within healthcare environments, researchers from the University of Washington Health Sciences conducted a study to examine the attitudes of healthcare workers toward lesbian women and gay men.
The study, "Health care providers' implicit and explicit attitudes toward lesbian women and gay men," published in the American Journal of Public Health, found that heterosexual providers have moderate to strong implicit preferences for straight people over lesbian and gay people. It also found that lesbian and gay healthcare providers expressed implicit and explicit preferences for lesbian and gay people over straight people. Bisexual providers were found to have mixed preferences.
Mental health providers held the weakest implicit bias for heterosexual people over lesbian and gay people and nurses held the strongest implicit bias for heterosexual people over lesbian and gay people.
Since people tend to gravitate toward the familiar, it isn't all that surprising that heterosexual people might feel more comfortable around other heterosexuals and that lesbian and gay people might feel more comfortable around other lesbian women and gay men. In and of itself, personal preference isn't necessarily an issue as long as all patients are still treated the same. Therein lies the problem.
According to Medical Daily, instances of discrimination by healthcare workers toward LGBT people are more common than you may realize. For example, in a study published in the journal Health and Social Work, 42% of female-to-male transgender adults reported being confronted with verbal harassment, physical assault or flat out denial of treatment at hospitals and doctors' offices.
The imapt on health
In a Field Guide about communication, cultural competence and patient- and family-centered care for the LGBT community, The Joint Commission says that "discrimination and mistreatment have, in many cases, contributed to a long-standing distrust of the healthcare system by many in the LGBT community and have affected their health in profound ways."
Even when biases are not openly explicit, they can still result in less than equal treatment. The authors of the University of Washington Health Sciences say that "training for healthcare providers about treating sexual minority patients is an area in great need of attention." Education about LGBT patients can, and perhaps should be incorporated into cultural competency training. Staff and providers may also benefit from education on potential health disparities in the LGBT patient community, such as higher substance abuse rates, higher rates of anxiety and depression, a higher incidence of HIV/AIDS and an increased incidence of certain cancers.
The University of Washington study authors go on to say their data suggests that healthcare organizations that aim to serve LGBT populations should examine methods that are likely to mitigate implicit biases, such as eliminating discretion from decision-making, use of clinical guidelines, awareness of personal bias as self-caution, organizational policies that promote objective decision-making and inclusion of counter-stereotypical experiences in educational programs.
Creating a more welcoming environment for LGBT patients can also help to mitigate provider biases. Some strategies proposed by The Joint Commission include posting the hospital's nondiscrimination policy or patient bill of rights in a prominent area, providing LGBT-relevant brochures and other reading materials, posting LGBT-friendly symbols (e.g., rainbow flag, pink triangle) and providing unisex restrooms.
Want to read more? You may enjoy this story about 5 ways providers can deliver better care to LGBT consumers.