Even Physicians Shy about Gay/Sexual Health
By Stephen J. Busalacchi

Even four years of medical school isn’t always enough to get people comfortable with the idea of homosexuality, or sexuality, period.

A past chair of an AMA advisory committee regarding gay, lesbian and transgender issues, Paul Wertsch, MD, says his colleagues are often rather sheepish about such matters.

“There are a lot of people who thank me for doing this and they tell me about their gay brothers or gay children or their gay everything,” says Dr. Wertsch, a family physician from Madison, Wisconsin who has a gay son. “But they’re quiet little mice, all the rest of the time.”

Despite their reticence to discuss homosexuality openly, Dr. Wertsch says doctors need to get over their angst in order to be effective for all patients. “We don’t understand illnesses that affect gay and lesbian people as well as we should,” he explains. “It’s a significant thing how to take an adequate sexual history, which a lot of doctors feel uncomfortable taking, anyway. There was very little discussion of sexuality at all when I went to medical school.”

One of the ways this plays out is that doctors will not ask patients if they have a partner, and instead will just ask if they’re married. One of Wertsch’s goals is to develop a list of self-acknowledging physicians who are “gay friendly,” so patients have a better idea of whom to see for care.

Besides individual patient care concerns, Wertsch is also concerned more globally about health insurance coverage for gay, lesbian and transgender families. He notes that one-third of lesbians have dependent children and 22% of gay couples have young kids. With the national effort for states to ban civil unions and gay marriage, as Wisconsin did in 2006, Dr. Wertsch fears some of these kids may lose their health insurance coverage as we narrowly define what a family is.

“Why in the world, even if you don’t believe in gay marriage, would you want to penalize kids?” he asks. From a professional standpoint, Wertsch is optimistic that doctors are becoming more enlightened and things are changing for the better. He notes that the AMA’s non-discrimination policy now includes sexual orientation.

“The AMA is very interested because they have a lot of gay doctors and certainly a lot of gay patients with dependent children, so they’re very far-sighted to look at this issue and deal with it,” says Dr. Wertsch.
 
Stephen J. Busalacchi is a medical journalist and author of White Coat Wisdom: Extraordinary doctors talk about what they do, how they got there, and why medicine is so much more than a job. © 2008 See www.whitecoatwisdom.com.