Room for improvement

Abstract In small studies lesbians report avoiding health care because of difficulty communicating with providers. This study examines lesbians' perceptions of communication with medical and alternative primary care providers using a statewide self-administered survey of members of a lesbian community organization. Univariate and bivariate statistics were used to analyze lesbians' perceptions of communication with their primary care provider about sexual orientation, difficult issues, and health issues important to lesbians. Of 324 respondents, 31% received primary care from alternative providers and 90% are "out" to one or more providers. Respondents who were "out" to their primary care provider were more likely to seek health and preventive care (p ≤ .05), more likely to have ever had a Pap smear (p ≤ .02), and more likely to be comfortable discussing sensitive issues (p ≤ .0001). Respondents rated alternative providers easier to communicate with than M.D.s (4.53 vs. 3.99, p ≤ .001). They reported being more open about sexual orientation (4.58 vs. 4.05, p ≤ .001) and more comfortable discussing difficult issues (4.08 vs. 3.61, p ≤ .001) with alternative providers. Respondents believe alternative providers understand lesbian health needs better than medical doctors (4.21 vs. 3.45, p ≤ .001). Lesbians appear to be motivated to disclose sexual orientation to their primary care providers and disclosure is associated with positive health behaviors. Medical doctors appear to need improvement in their skills in communicating with lesbians so that important medical and psychosocial information can be shared.