Sexuality Please, We’re British! by Pat Conrad MD

This is really getting tiresome.  Every minor celebrity from chefs to actresses to has-been athletes has to go skipping to the microphones to announce their gender-identity-sexuality-cis-trans-WTF or whatever else will make their hearts and assorted giblets sing to the breathless virtual masses.  And.  I.  Don’t.  Care.  I really don’t.  In medical school, we all got the lectures about asking about a patient’s sexual orientation as part of a complete history, and if you really think it matters then be my guest.  When treating the usual various ailments in primary care, and later when dealing with typical ER zaniness, it, for the most part, has just never mattered.  Like you, I have had all sorts of non-traditional patients traveling in non-traditional directions, and it has not affected my choice of anti-hypertensive, how I dealt with their hyponatremia, or where I chose to attempt the central line.

Across the pond, our increasingly demented cultural progenitors continue to push back the frontiers of irrelevance.  The British NHS Service “users over the age of 16 visiting their local GP or hospital may be asked to confirm whether they are straight, gay, bisexual or other,” answers to which the providers are now expected to record.  “The health service said the move was to keep in line with equality legislation to ensure those who do not identify as heterosexual are treated fairly.”

Nurse:  I have a few questions.

Patient:  I have a sore throat.

Nurse:  Ok, but first, when was your last tetanus?

Patient:  It really hurts to talk.

Nurse:  I’m sure it does.

Patient:  (coughs)

Nurse:  Do you identify as straight, bisexual, gay or lesbian, or other?

Patient:  (hoarse) huh?

Nurse:  You are allowed to change your answer on subsequent visits.

There are certainly times and settings where it is appropriate to discuss patient sexuality, but making it a mandatory reporting event is as stupid as it is insulting to both parties.  A good clinician will deal with this subset of concerns when appropriate and doesn’t need to feel obligated to turn every encounter into a Rocky Horror Picture Show introspective.  And what if a patient would rather not say?  Should they be encouraged to then lie, or choose “other”?  I’d love to see real studies that show that patients are actually treated inadequately based on their sexuality.  I’m sure any number of concerned groups would claim to have said studies, but that would surely contradict my own observations in the medical field over the last quarter century.  This is the kind of idiocy I can completely expect to see here.  It is tiresomely going to be another case where the medical field is used to push special interest politics and to make their respective advocates feel better about themselves, but it will not be about rendering equitable care.  We already do that.

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  2 comments for “Sexuality Please, We’re British! by Pat Conrad MD

  1. Sir Hakum of Hugo
    October 18, 2017 at 11:21 am

    Doug,

    We recently changed our office EMR, and we are now a FQHC, so we ask ALL the “necessary” questions. A long standing patient of mine, a healthcare worker, in the section on orientation, wrote in the blank space next to OTHER. He wrote the word “Horny” for his orientation.

    I appreciate his honesty. And he was not British.

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    • Kimberly Russell
      October 18, 2017 at 3:12 pm

      Dilly, dilly!

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