Teenagers keep doctors in the dark
MAIN STREET — Even if teenagers are out about their sexuality with family and friends, that doesn’t mean everyone is in the loop.
That’s what researchers at the RAND Corporation, a non-profit policy think tank in Santa Monica, and UCLA found in a study released last week that revealed most adolescents are not open about their sexuality with their physicians even if they are open about their sexual orientation with just about everyone else.
In a survey of 131 participants at the Models of Pride Youth Conference in 2003, senior author Dr. Mark A. Schuster and lead author Dr. Garth D. Meckler, of Oregon Health and Science University, found that only 35 percent of the teenagers had disclosed their sexuality to their physicians, even though 70 percent had said they were out of the closet with nearly everyone in their lives.
The results were somewhat surprising to Schuster, the director of health promotion and disease prevention at RAND and a professor of pediatrics and public health at UCLA, who was anticipating a sampling pool that was open about their sexuality since he was surveying teenagers at an empowerment conference.
“We would’ve hoped if they were open in [the other parts of their life], they would also be open with their physicians,” Schuster said this week.
Schuster and his colleagues at RAND and UCLA conducted the study to examine the interaction between gay, lesbian and bisexual youth with physicians and health care providers. The empowerment conference was selected as the perfect venue to scout for research subjects because those who would attend such an event would likely be out about their sexuality, according to researchers.
Approximately 90 percent of teenagers had seen their doctors in the past two years and 33 percent had seen a physician within the past year. About 66 percent of the adolescents agreed that doctors do need to know about their patient’s sexual orientation in order to provide health care to suit their needs.
It is necessary that gay, lesbian and bisexual teenagers be honest about their sexuality with their physicians in order to receive proper care. Likewise, doctors should make an effort to create an open, non-judgmental and comfortable environment for patients, Schuster said.
“They need to know if the teen patients are engaging in sexual activity; they need to know if they have to give advice for pregnancy prevention,” Schuster said.
The study states that the American Academy of Pediatrics, The American Medical Association [AMA] and the Society for Adolescent Medicine all agree that it is important that physicians discuss sexuality with teenagers.
The AMA policy states that physicians should be non-judgmental in regards to their patient’s sexuality in order to provide the best care possible.
“In the case of homosexual patients, this is especially true, since unrecognized homosexuality by the physician or the patient’s reluctance to report his or her sexual orientation and behavior can lead to failure to screen, diagnose or treat important medical problems,” the policy states.
Many of the teenagers who have yet to reveal their sexuality to physicians cited several reasons for staying in the closet, including: fear that the doctor would discriminate, worries that the doctor would inform parents who still might be in the dark, and embarrassment. About 64 percent of teenagers said physicians should just ask them about their sexual orientation.
The fear of discrimination is not unfound, considering there has been a history of medical professionals discriminating against their gay, lesbian and bisexual patients, even denying them health care on occasion, according to Brad Becker, executive director of the GLBT National Help Center, a San Francisco-based hotline that provides counseling to those in the gay and lesbian community.
Many doctors might inadvertently create a discriminatory environment in their office, even if they themselves are not homophobic. For example, a doctor might assume a male patient is heterosexual by asking them if they are sexually active with their girlfriend, rather than phrasing it as “partner.”
Health care practitioners at the Los Angeles Gay and Lesbian Center in Hollywood hear every day about how their patients have been mistreated or discriminated against at doctors’ offices.
A teenage patient that Nurse Practitioner Cynthia Harrison recently met with was turned away from a physician because they were gay. The patient was seeking treatment for a STD.
“Teenagers are especially vulnerable and afraid to disclose themselves for fear of being labeled or rejected,” Harrison said on Tuesday. “They’re in a time in their life when they may be... unsure of who they are.
“TEENAGERS ARE ESPECIALLY VULNERABLE AND AFRAID TO DISCLOSE THEMSELVES FOR FEAR OF BEING LABELED OR REJECTED.” — Cynthia Harrison Nurse Practitioner LA Gay and Lesbian Center
“The choices they make now can really impact them in the future.”
Researchers at RAND and UCLA hope that physicians will read the study and make an effort to create a comfortable environment for their patients.
“It’s not just about sexual orientation,” Schuster said.“We want our patients to be comfortable discussing all aspects of sexuality, as well as other issues in their lives, whether it relates to substance abuse or other topics that might be sensitive.”
Originally published in the Santa Monica Daily Press print edition on January 5, 2007. Read the original PDF.