SOGIE disclosure leads to better medical care
address their patient’s specific medical needs, according to a 2017 article published by Medical Economics.
Many health experts believe that by knowing a patient’s sexual orientation and gender identity/expression (SOGIE), clinicians can be more alert to possible medical issues and responsive to the unique vulnerabilities faced by LGBTQ+ patients.
Why LGBTQ+ patients should disclose their SOGIE to doctors
Every doctor must treat each patient as an individual, and a patient’s SOGIE may be the most helpful piece of information.
For example, a transgender patient who is on hormones may have specific health needs related to current gender or assigned sex at birth: a trans woman might still have prostate problems; a trans man might still need routine pap testing.
Additionally, understanding a patient’s SOGIE facilitates more thoughtful interactions between doctors and their LGBTQ+ patients.
For instance, during a well-woman visit, it is appropriate to first determine the relationship status and the current partner’s sex in order to have a meaningful conversation about a range of topics including sexual health, risk-appropriate STI screening, and reproductive health and/or contraception.
An extreme example of an LGBTQ+ patient’s ‘unique vulnerability’
Michael Mencias, MD, shared an extreme example: “I took care of a gay patient who was the victim of a hate crime; he sustained a traumatic brain injury.”
“Knowing my patient’s and his partner’s sexual orientation from the very beginning allowed me and other members of the care team to provide very specialized comprehensive care,” he told the publication.
Mencias elaborated: “We were able to provide and recommend very specific social services to both men that addressed their isolation, loneliness, fear, anger, depression and other concerns that are common for this population and victims of such a crime.”
SOGIE: Touchy subject for some LGBTQ+ patients
For some patients, however, this information can be very sensitive.
“We recently had a young person who is gay and felt his parents were anti-gay, so he did not want to disclose to them […] but [he] was engaging in high-risk sexual experiences with other men and definitely was a candidate for PrEP,” Donna Futterman, MD, shared.
Futterman further explained: “The problem was he couldn’t afford to take it because he was on his parent’s insurance and didn’t want them to know, so [he] didn’t tell his doctor.”
Disclosing your SOGIE to doctors: ‘Do ask, do tell’
Asking about sexual orientation can be even more uncomfortable for the provider than for the patient sometimes. Some physicians can be wary about making anyone anxious by broaching the subject.
Most doctors, however, are not- should not be- afraid to ask. And you should not be afraid to tell.
Establishing a safe connection, between doctor and patient, is very important: if you cannot be yourself and talk honestly and openly, your provider cannot give you the best care.
(ProTip: LGBTQ+-friendly doctors have a rainbow flag prominently displayed outside their office.)