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The sexual health of lesbian, gay, and bisexual patients in general practice: a review of the literature on barriers to discussion and medical training programs

The sexual health of lesbian, gay, and bisexual patients in general practice: a review of the literature on barriers to discussion and medical training programs

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An essay for the 2011 Undergraduate Awards (Ireland) Competition by Don Brandon Stott. Originally submitted for MB BCH BAO at University College Cork, with lecturer Dr. Louise Burgoyne in the category of Medical Sciences
An essay for the 2011 Undergraduate Awards (Ireland) Competition by Don Brandon Stott. Originally submitted for MB BCH BAO at University College Cork, with lecturer Dr. Louise Burgoyne in the category of Medical Sciences

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Published by: Undergraduate Awards on Aug 31, 2012
Copyright:Attribution Non-commercial

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10/27/2013

 
The Sexual Health of Lesbian, Gay,and Bisexual Patients in GeneralPractice: a review of the literatureon barriers to discussion andmedical training programs
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Abstract
Introduction/Background:
Sexual health is an important contributor to the overall well-being of a person and must be understood by medical professionals in a non-judgmentalway. This demands adequate knowledge and excellent communication. Sex andsexuality are still taboo subjects in society and medicine and have resulted in healthdisparities for lesbian, gay, and bisexual patients because of unique healthcare needs. It isimperative that medical practitioners understand the health needs of this patientpopulation. However, studies show that medical training in this area is widely lacking inworldwide.
Aim:
To identify and review literature on the barriers to sexual healthdiscussion in general practice, especially pertaining to the sexual health of lesbian, gay,and bisexual patients and the current medical training identified or implemented toovercome these barriers.
Methods:
Online databases including PubMed, Interscience,Science Direct, and Google Scholar were used to search for articles examining sexualhealth barriers pertaining to the sexual health of lesbian, gay, and bisexual patients, aswell as articles exploring training or medical education in this area.
Results:
12 primaryresearch studies into the barriers to sexual health discussion with lesbian, gay, andbisexual patients were identified. In addition 8 primary articles and 1 opinion paper onmedical training programs in the area of diversity training and lesbian, gay, and bisexualhealth were reviewed. Barriers were either related to the physician or to the patient andincluded: negative past experiences, sex/gender, age, lack of knowledge, non-disclosure,heterosexist assumption, fear of discrimination, embarrassment, lack of appropriatelanguage, lack of training, time constraints. The results showed that very little training indiversity or sexual health is done by medical schools or medical training schemes aroundthe world. Research discovered that simply lecturing on the subjects was not effective andtraining courses must actively challenge belief systems through reflective, guided learning.
Discussion/Conclusion:
Very few studies exist which examine barriers to providingsexual healthcare to sexual minorities and even fewer studies which examine the state ofmedical curricula in this area. No studies reviewed were from Ireland, and all studiesfailed to adequately address both perceived barriers to sexual health discussion in generalpractice and the training needs of GPs together. My research study, “The training needs ofgeneral practitioners in the exploration of sexual health matters and providing sexualhealthcare to lesbian, gay, and bisexual patients”, seeks to identify barriers as experiencedby GPs, medical students, and lesbian, gay, and bisexual people in Ireland. It will alsoexplore the training needs of GPs from the perspective of GPs themselves, medicalstudents, and sexual minority patients. The goal of this study is to identify barriers, andsolutions to overcome these barriers by gaining insight into specific training needs, whichcould be used to improve medical education in this area.
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