Getting to Know You: Why It’s Essential for Providers to Ask their Patients about Sexual Orientation, Behavior, and Gender Identity

The relationship between health care providers and their patients can range from a very distant to very close, and the amount of information that patients feel comfortable disclosing can range widely as well. Creating a warm environment in which patients feel that they can share their multiple identities with their providers is essential, and in addition, we as health care providers have a responsibility to ask our patients about their lives.

Frequently, I hear from health care providers that it is challenging to ask the important questions about sexuality and gender, but we know that we as providers ask many “sensitive” questions. We have become used to asking about violence in the home and use of substances, for example, and there’s no reason that we can’t get used to asking these questions as well.

Patients may be afraid of judgment and many are used to a long history of constantly debating whether it is “safe” to come out to a variety of people in their lives. They may not want to initiate the conversation themselves, but may be likely to open up to a provider who asks them kindly, but directly, about their sexuality and gender.

The Institute of Medicine and The Joint Commission have both expressed the importance of asking and collecting data about patient sexuality and gender, and plentiful research supports the importance of knowing the details of patients’ lives. Normalizing the asking of these questions can go a long way towards preventing and decreasing the health disparities faced by LGBTQ+ patients.

It can be challenging to squeeze all of the information that a provider needs in the short time frame of an appointment or interaction with a patient. However, we must also face our own implicit biases discussing sexuality with patients in general, and especially with LGBTQ+ patients.

Consider asking about gender identity, sexuality and sexual behavior, surgery related to gender, and plans for self-treatment. It is essential to not ignore these important aspects that are central to the lives of our patients and clients. Sexuality and gender are an important part of any complete medical history.