Skip to main content
Top
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Associations between non-discrimination and training policies and physicians’ attitudes and knowledge about sexual and gender minority patients: a comparison of physicians from two hospitals

Authors: Jennifer M. Jabson, Jason W. Mitchell, Benjamin Doty

Published in: BMC Public Health | Issue 1/2016

Login to get access

Abstract

Background

Some physicians lack knowledge and awareness about health issues specific to sexual and gender minority (SGM) individuals. To help improve this, hospitals have implemented policies that mandate non-discrimination and training to promote sexual and gender minority health. There is limited evidence about how such policies relate to physicians’ knowledge, attitudes, and gender and sexual minority affirmative practices.

Method

A random sample of 1000 physicians was recruited from a complete list of physicians affiliated with one of two university Hospitals located in Tennessee and 180 physicians completed the survey concerning attitudes and knowledge about SGM individuals. Physicians were affiliated with either Hospital A that had not implemented policies for non-discrimination and training, or Hospital B that did.

Results

Physicians held different attitudes about SGM patients than non-patients. Physicians affiliated with Hospital A held more negative attitudes about SGM individuals who were non-patients than physicians affiliated with Hospital B. There were no differences between the two hospitals in physicians’ attitudes and knowledge about SGM patients.

Conclusion

Policies that mandate non-discrimination and training as they currently exist may not improve physicians’ attitudes and knowledge about SGM individuals. Additional research is needed to understand how these policies and trainings relate to physicians’ SGM affirmative practices.
Literature
1.
go back to reference McNair R, Szalacha LA, Hughes TL. Health status, health service use, and satisfaction according to sexual identity of young Australian women. Womens Health Issues. 2011;21(1):40–7.CrossRef McNair R, Szalacha LA, Hughes TL. Health status, health service use, and satisfaction according to sexual identity of young Australian women. Womens Health Issues. 2011;21(1):40–7.CrossRef
2.
go back to reference Heck JE, Sell RL, Gorin SS. Health care access among individuals involved in same-sex relationships. Am J Public Health. 2006;96(6):1111–8.CrossRef Heck JE, Sell RL, Gorin SS. Health care access among individuals involved in same-sex relationships. Am J Public Health. 2006;96(6):1111–8.CrossRef
3.
go back to reference Blosnich JR et al. Health inequalities among sexual minority adults: evidence from ten U.S. states. Am J Prev Med. 2010;46(4):337–49.CrossRef Blosnich JR et al. Health inequalities among sexual minority adults: evidence from ten U.S. states. Am J Prev Med. 2010;46(4):337–49.CrossRef
4.
go back to reference Clift JB, Kirby J. Health care access and perceptions of provider care among individuals in same-sex couples: findings from the Medical Expenditure Panel Survey (MEPS). J Homosex. 2012;59(6):839–50.CrossRef Clift JB, Kirby J. Health care access and perceptions of provider care among individuals in same-sex couples: findings from the Medical Expenditure Panel Survey (MEPS). J Homosex. 2012;59(6):839–50.CrossRef
5.
go back to reference Dahan R, Feldman R, Hermoni D. Is patients’ sexual orientation a blind spot of family physicians? J Homosex. 2008;55(3):524–32.CrossRef Dahan R, Feldman R, Hermoni D. Is patients’ sexual orientation a blind spot of family physicians? J Homosex. 2008;55(3):524–32.CrossRef
6.
go back to reference Westerstahl A, Segesten K, Bjorkelund C. GPs and lesbian women in the consultation: issues of awareness and knowledge. Scand J Prim Health Care. 2002;20(4):203–7.CrossRef Westerstahl A, Segesten K, Bjorkelund C. GPs and lesbian women in the consultation: issues of awareness and knowledge. Scand J Prim Health Care. 2002;20(4):203–7.CrossRef
7.
go back to reference Banwari G et al. Medical students and interns’ knowledge about and attitude towards homosexuality. J Postgrad Med. 2015;61(2):95–100.CrossRef Banwari G et al. Medical students and interns’ knowledge about and attitude towards homosexuality. J Postgrad Med. 2015;61(2):95–100.CrossRef
8.
go back to reference Schatz B, O’Hanlan K, American Association of Physicians for Human. Anti-gay discrimination in medicine, Results of a national survey of Lesbian, Gay and Bisexual physicians. San Francisco: American Association of Physicians for Human Rights (AAPHR); 1994. Schatz B, O’Hanlan K, American Association of Physicians for Human. Anti-gay discrimination in medicine, Results of a national survey of Lesbian, Gay and Bisexual physicians. San Francisco: American Association of Physicians for Human Rights (AAPHR); 1994.
9.
go back to reference Grant JM, Mottet LA, Tanis J, Herman JL, Harrison J, Keisling M. National transgender discrimination survey report on health and health care. Washington: National Center for Transgender Equality and National Gay and Lesbian Task Force; 2010. Grant JM, Mottet LA, Tanis J, Herman JL, Harrison J, Keisling M. National transgender discrimination survey report on health and health care. Washington: National Center for Transgender Equality and National Gay and Lesbian Task Force; 2010.
10.
go back to reference Norton A, Herek G. Heterosexuals’ attitudes toward transgender people: findings from a national probability sample of U.S. Adults. Sex Roles. 2013;68(11):738–53.CrossRef Norton A, Herek G. Heterosexuals’ attitudes toward transgender people: findings from a national probability sample of U.S. Adults. Sex Roles. 2013;68(11):738–53.CrossRef
11.
go back to reference Larsen KS, Reed M, Hoffman S. Attitudes of heterosexuals toward homosexuality: a likert-type scale and construct validity. J Sex Res. 1980;16(3):245–57.CrossRef Larsen KS, Reed M, Hoffman S. Attitudes of heterosexuals toward homosexuality: a likert-type scale and construct validity. J Sex Res. 1980;16(3):245–57.CrossRef
12.
go back to reference Herek GM, Glunt EK. Interpersonal contact and heterosexuals’ attitudes toward gay men: results from a national survey. J Sex Res. 1993;30(3):239–44.CrossRef Herek GM, Glunt EK. Interpersonal contact and heterosexuals’ attitudes toward gay men: results from a national survey. J Sex Res. 1993;30(3):239–44.CrossRef
13.
go back to reference Mansh M, Garcia G, Lunn MR. From patients to providers: changing the culture in medicine toward sexual and gender minorities. Acad Med. 2015;90(5):574–80. Mansh M, Garcia G, Lunn MR. From patients to providers: changing the culture in medicine toward sexual and gender minorities. Acad Med. 2015;90(5):574–80.
14.
go back to reference The Joint Commission for the Accreditation of Healthcare Organizations, Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care for the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community: A Field Guide. Oakbrook, IL: The Joint Commission; 2011. The Joint Commission for the Accreditation of Healthcare Organizations, Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care for the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community: A Field Guide. Oakbrook, IL: The Joint Commission; 2011.
15.
go back to reference Center for Medicade Services. Conditions of participation: Patient’s rights. 2011. Center for Medicade Services. Conditions of participation: Patient’s rights. 2011.
16.
go back to reference Snowdon S. Healthcare equality index 2013: promoting equitable and inclusive care for lesbian, Gay, bisexual and transgender patients and their families. Washington: Human Rights Campaign Foundation; 2013. Snowdon S. Healthcare equality index 2013: promoting equitable and inclusive care for lesbian, Gay, bisexual and transgender patients and their families. Washington: Human Rights Campaign Foundation; 2013.
18.
go back to reference US Census Bureau: State and County Quickfacts Index [Internet]. Washington, DC; 2013 US Census Bureau: State and County Quickfacts Index [Internet]. Washington, DC; 2013
20.
go back to reference Ingram DD, F.S., 2013 NCHS urban–rural classification scheme for counties, N.C.f.H.S.V.H. Stat, Editor. Washington, D.C; 2014 Ingram DD, F.S., 2013 NCHS urban–rural classification scheme for counties, N.C.f.H.S.V.H. Stat, Editor. Washington, D.C; 2014
21.
go back to reference Thorpe C et al. How to obtain excellent response rates when surveying physicians. Fam Pract. 2009;26(1):65–8.CrossRef Thorpe C et al. How to obtain excellent response rates when surveying physicians. Fam Pract. 2009;26(1):65–8.CrossRef
22.
go back to reference Herek GM. Assessing heterosexuals’ attitudes toward lesbians and gay men: A review of empirical research with the ATLG scale, in lesbian and gay psychology: theory, research, and clinical applications. Thousand Oaks: Sage Publications, Inc; 1994. p. 206–28. Herek GM. Assessing heterosexuals’ attitudes toward lesbians and gay men: A review of empirical research with the ATLG scale, in lesbian and gay psychology: theory, research, and clinical applications. Thousand Oaks: Sage Publications, Inc; 1994. p. 206–28.
23.
go back to reference Strong, K.L., Assessing Undergraduate Nursing Students’ Knowledge, Attitudes and Cultural Competence in Caring for LGBT Patients, in School of Nursing. 2013, Illinois Wesleyan University, Bloomington IL. p.48 Strong, K.L., Assessing Undergraduate Nursing Students’ Knowledge, Attitudes and Cultural Competence in Caring for LGBT Patients, in School of Nursing. 2013, Illinois Wesleyan University, Bloomington IL. p.48
24.
go back to reference Harris MB, Nightengale J, Owen N. Health care Professionals’ experience, knowledge, and attitudes concerning homosexuality. J Gay Lesbian Soc Serv. 1995;2(2):91–108.CrossRef Harris MB, Nightengale J, Owen N. Health care Professionals’ experience, knowledge, and attitudes concerning homosexuality. J Gay Lesbian Soc Serv. 1995;2(2):91–108.CrossRef
25.
go back to reference Handbook of sexuality-related measures. In: Davis CM, Fisher T, Davis C, Yarber W, Davis S, editors. Thousand Oaks, Calif: Sage Publications; 1998. Handbook of sexuality-related measures. In: Davis CM, Fisher T, Davis C, Yarber W, Davis S, editors. Thousand Oaks, Calif: Sage Publications; 1998.
26.
go back to reference Crisp C. The Gay affirmative practice scale (GAP): a New measure for assessing cultural competence with Gay and lesbian clients. Soc Work. 2006;51(2):115–26.CrossRef Crisp C. The Gay affirmative practice scale (GAP): a New measure for assessing cultural competence with Gay and lesbian clients. Soc Work. 2006;51(2):115–26.CrossRef
27.
go back to reference Merport A et al. The use of cancer treatment summaries and care plans among Massachusetts physicians. Support Care Cancer. 2012;20(7):1579–83.CrossRef Merport A et al. The use of cancer treatment summaries and care plans among Massachusetts physicians. Support Care Cancer. 2012;20(7):1579–83.CrossRef
28.
go back to reference Cook JV, Dickinson HO, Eccles MP. Response rates in postal surveys of healthcare professionals between 1996 and 2005: an observational study. BMC Health Serv Res. 2009;9:160.CrossRef Cook JV, Dickinson HO, Eccles MP. Response rates in postal surveys of healthcare professionals between 1996 and 2005: an observational study. BMC Health Serv Res. 2009;9:160.CrossRef
30.
go back to reference Institute of Medicine The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. Washington, DC: The Joint Commission; 2011. Institute of Medicine The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. Washington, DC: The Joint Commission; 2011.
31.
go back to reference Herek GM. Sexual prejudice and gender: Do heterosexuals’ attitudes toward lesbians and gay men differ? J Soc Issues. 2000;56(2):251–66.CrossRef Herek GM. Sexual prejudice and gender: Do heterosexuals’ attitudes toward lesbians and gay men differ? J Soc Issues. 2000;56(2):251–66.CrossRef
32.
go back to reference Center PR. Changing attitudes on same sex marriage, gay friends and family. Washington: Pew Research Center; 2013. Center PR. Changing attitudes on same sex marriage, gay friends and family. Washington: Pew Research Center; 2013.
33.
go back to reference Smith DM, Mathews WC. Physicians’ attitudes toward homosexuality and HIV: survey of a California Medical Society- revisited (PATHH-II). J Homosex. 2007;52(3–4):1–9.CrossRef Smith DM, Mathews WC. Physicians’ attitudes toward homosexuality and HIV: survey of a California Medical Society- revisited (PATHH-II). J Homosex. 2007;52(3–4):1–9.CrossRef
34.
go back to reference Eliason MJ. Who cares? : institutional barriers to health care for lesbian, gay, and bisexual persons. New York: NLN Press; 1996. Eliason MJ. Who cares? : institutional barriers to health care for lesbian, gay, and bisexual persons. New York: NLN Press; 1996.
35.
go back to reference Willging CE, Salvador M, Kano M. Brief reports: Unequal treatment: mental health care for sexual and gender minority groups in a rural state. Psychiatr Serv. 2006;57(6):867–70.CrossRef Willging CE, Salvador M, Kano M. Brief reports: Unequal treatment: mental health care for sexual and gender minority groups in a rural state. Psychiatr Serv. 2006;57(6):867–70.CrossRef
36.
go back to reference Abdulaziz K et al. National survey of physicians to determine the effect of unconditional incentives on response rates of physician postal surveys. BMJ Open. 2015;5(2):e007166.CrossRef Abdulaziz K et al. National survey of physicians to determine the effect of unconditional incentives on response rates of physician postal surveys. BMJ Open. 2015;5(2):e007166.CrossRef
37.
go back to reference Bronfenbrenner U. The ecology of human development. Cambridge, Ma: Harvard University Press; 1979. Bronfenbrenner U. The ecology of human development. Cambridge, Ma: Harvard University Press; 1979.
Metadata
Title
Associations between non-discrimination and training policies and physicians’ attitudes and knowledge about sexual and gender minority patients: a comparison of physicians from two hospitals
Authors
Jennifer M. Jabson
Jason W. Mitchell
Benjamin Doty
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-2927-y

Other articles of this Issue 1/2016

BMC Public Health 1/2016 Go to the issue