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Article << Previous     |     Next >>   Contents Vol 11(3)

‘I demand to be treated as the person I am’: experiences of accessing primary health care for Australian adults who identify as gay, lesbian, bisexual, transgender or queer

Chee S. Koh A B, Melissa Kang A and Tim Usherwood A

A Department of General Practice, Sydney Medical School Westmead, The University of Sydney, PO Box 154, Westmead, NSW 2145, Australia.
B Corresponding author. Email: chee.koh@sydney.edu.au

Sexual Health 11(3) 258-264 http://dx.doi.org/10.1071/SH14007
Submitted: 9 January 2014  Accepted: 22 April 2014   Published: 3 July 2014

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Background: Individuals who identify as gay, lesbian, bisexual, transgender or queer (GLBTQ) suffer higher rates of illness and morbidity compared with the general population but may experience significant barriers to accessing primary health care. Method: We used an online questionnaire to explore GLBTQ adults’ experiences of accessing primary health care in Australia. We developed the questionnaire in consultation with individuals who belonged to or worked closely with the GLBTQ community. Questions were open-ended and sought information about four topic areas: sexual identity and its meaning, utilisation of primary health care services, disclosure of sexual identity to primary care providers and experiences of accessing primary health care. Data were analysed by coding free-text responses into themes. Results: Ninety-nine valid responses were received. Participants were 18–60+ years old (modal age group: 20–29 years); 70% lived in cities. Of these, 49% identified as gay, 35% as lesbian, 13% as bisexual, 8% as queer and 3% as transgender. Some participants indicated more than one identity. GLBTQ-identifying adults often divided care, seeking different primary care services for different health concerns. Themes in relation to disclosure of sexual identity were: taking a rights-based position, experiences of homophobia and clinical context. Themes about access to primary health care were: diversity and heterogeneity, real or perceived discrimination, visual symbols and respect. Conclusion: Despite diversity, GLBTQ adults experience many barriers to accessing health care due to sexual identity. General practitioners and other primary health care providers have a role in ensuring equitable access to health care.

Additional keywords: barriers, disclosure, diversity, sexual identity.


[1]  King M, Nazareth I. The health of people classified as lesbian, gay and bisexual attending family practitioners in London: a controlled study. BMC Public Health 2006; 6: 127
CrossRef | PubMed |

[2]  Hillier L, Jones T, Monagle M, Overton N, Gahan L, Blackman J. Writing themselves in 3: the 3rd national report on the sexual health & well-being of same sex attracted young people in Australia. Monograph series no. 78. Melbourne: Australian Research Centre in Sex, Health and Society, La Trobe University; 2010.

[3]  King M, Semlyen J, Tai SS, Killaspy H, Osborn D, Popelyuk D, et al A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry 2008; 8: 70
CrossRef | PubMed |

[4]  Rothman EF, Exner D, Baughman AL. The prevalence of sexual assault against people who identify as gay, lesbian, or bisexual in the United States: a systematic review. Trauma Violence Abuse 2011; 12: 55–66.
CrossRef | PubMed |

[5]  Rosenstreich G, Comfort J, Martin P. Primary health care and equity: the case of lesbian, gay, bisexual, trans and intersex Australians. Aust J Primary Health 2011; 17: 302–8.
CrossRef |

[6]  McNair RP, Hughes TL. Coming out: is the Mardi Gras still needed? Health providers can be advocates and opinion leaders for social change. Med J Aust 2012; 196: 224
CrossRef | PubMed |

[7]  Fethers K, Marks C, Mindel A, Estcourt CS. Sexually transmitted infections and risk behaviours in women who have sex with women. Sex Transm Infect 2000; 76: 345–9.
CrossRef | CAS | PubMed |

[8]  Carmichael JV. Daring to find our names: the search for lesbigay library history. Westport, CT: Greenwood Publishing Group; 1998.

[9]  Dohrenwend A. Perspective: a grand challenge to academic medicine: speak out on gay rights. Acad Med 2009; 84: 788–92.
CrossRef | PubMed |

[10]  Druzin P, Shrier I, Yacowar M, Rossignol M. Discrimination against gay, lesbian and bisexual family physicians by patients. CMAJ 1998; 158: 593–7.
| CAS | PubMed |

[11]  Fikar CR, Keith L. Information needs of gay, lesbian, bisexual, and transgendered health care professionals: results of an internet survey. J Med Libr Assoc 2004; 92: 56–65.
| PubMed |

[12]  Newman CE, Persson A, Paquette DM, Kidd MR. The new cultural politics of the waiting room: straight men, gay-friendly clinics and ‘inclusive’ HIV care. Sex Res Soc Policy 2013; 10: 87–96.
CrossRef |

[13]  Neville S, Henrickson M. Perceptions of lesbian, gay and bisexual people of primary healthcare services. J Adv Nurs 2006; 55: 407–15.
CrossRef | PubMed |

[14]  Riggle ED, Rostosky SS, Reedy CS. Online surveys for BGLT research. J Homosex 2005; 49: 1–21.
CrossRef | PubMed |

[15]  O’Reilly M, Parker N. ‘Unsatisfactory saturation’: a critical exploration of the notion of saturated sample sizes in qualitative research. Qual Res 2013; 13: 190–7.
CrossRef |

[16]  Hurley M. Who’s on whose margins? In Pitts M, Smith A, editors. Researching the margins: strategies for ethical and rigorous research with marginalised communities. London: Palgrave MacMillan; 2007. pp. 160–89.

[17]  Ministerial Advisory Committee on Gay, Lesbian, Bisexual, Transgender and Intersex Health and Wellbeing. Well proud: a guide to gay, lesbian, bisexual, transgender and intersex inclusive practice for health and human services. Melbourne: Department of Health Victorian Government; 2009.

[18]  Eysenbach G, Till JE. Ethical issues in qualitative research on internet communities. BMJ 2001; 323: 1103
CrossRef | CAS | PubMed |

[19]  Australian Bureau of Statistics (ABS). 8146.0 – Household use of information technology, Australia, 2010–11. Canberra: ABS; 2012. Available online at: http://www.abs.gov.au/ausstats/abs@.nsf/Latestproducts/D11394A54F8B9ED1CA25796600152C62?opendocument [verified May 2013].

[20]  Freedman E, Britt H, Harrison CM, Mindel A. Sexual health problems managed in Australian general practice: a national, cross sectional survey. Sex Transm Infect 2006; 82: 61–6.
CrossRef | CAS | PubMed |

[21]  Pell C, Donohoe S, Conway D. Health care services for men who have sex with men in different Australian states and territories since the emergence of HIV. Sex Health 2008; 5: 161–8.
CrossRef | PubMed |

[22]  Cassell JA, Brook MG, Mercer CH, Murphy S, Johnson A. Treating sexually transmitted infections in primary care: a missed opportunity? Sex Transm Infect 2003; 79: 134–6.
CrossRef | CAS | PubMed |

[23]  Durso LE, Meyer IH. Patterns and predictors of disclosure of sexual orientation to healthcare providers among lesbians, gay men, and bisexuals. Sex Res Soc Policy 2013; 10: 35–42.
CrossRef |

[24]  Hasegawa H, Reilly D, Mercer SW, Bikker AP. Holism in primary care: the views of Scotland’s general practitioners. Prim Health Care Res Dev 2005; 6: 320–8.
CrossRef |

[25]  Hughes C, Evan A. Health needs of women who have sex with women. BMJ 2003; 327: 939–40.
CrossRef | PubMed |

[26]  Sinnott V. Best practice models for the assessment, treatment and care of transgender people and people with transsexualism: a discussion paper for Victoria (Australia). Melbourne: Department of Human Services, Rural and Regional Health and Aged Care Services Division; 2005.

[27]  Rissel CE, Richters J, Grulich AE, de Visser RD, Smith AMA. Attitudes towards sex in a representative sample of adults. Aust N Z J Public Health 2003; 27: 118–23.
CrossRef | PubMed |

[28]  Mulligan E, Heath M. Seeking open minded doctors: how women who identify as bisexual, queer or lesbian seek quality health care. Aust Fam Physician 2007; 36: 469–71.
| PubMed |

[29]  McNair RP, Hegarty K, Taft A. From silence to sensitivity: a new identity disclosure model to facilitate disclosure for same-sex attracted women in general practice consultations. Soc Sci Med 2012; 75: 208–16.
CrossRef | PubMed |

[30]  Lee RS, Melhado TV, Chacko KM, White KJ, Huebschmann AG, Crane LA. The dilemma of disclosure: patient perspectives on gay and lesbian providers. J Gen Intern Med 2008; 23: 142–7.
CrossRef | CAS | PubMed |

[31]  Horner J, Roberts NJ. Time to recognise sexual orientation as a social determinant of health. Med J Aust 2014; 200: 137
CrossRef | PubMed |

[32]  Robinson KH, Bansel P, Denson N, Ovenden G, Davies C. Growing up queer: issues facing young Australians who are gender variant and sexuality diverse. Melbourne: Young & Well Cooperative Research Centre; 2013.

[33]  Harrison AE. Primary care of lesbian and gay patients: educating ourselves and our students. Fam Med 1996; 28: 57–8.

[34]  DNA magazine. Circulation and demographic. Lidcombe: DNA magazine; 2014. Available online at: http://www.dnamagazine.com.au/default.asp?section_id=446 [verified May 2013].

[35]  LOTL magazine. LOTL facts. Darlinghurst: LOTL magazine; 2013. Available online at: http://www.lotl.com/advertise/lotl-facts/ [verified May 2014].

[36]  The Gender Centre NSW. 2011–2012 annual report. Petersham: The Gender Centre; 2013. Available online at: http://www.gendercentre.org.au/resources/annual-reports/2011-2012-annual-report.htm#Polare [verified May 2013].

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